Source: Stuff, 16 February 2018
Children who have had scabies are 23 times more likely to
develop rheumatic fever than children who haven't, new
The research, published in the Journal of Paediatrics and
Health on Thursday, found the risk factors for scabies,
rheumatic fever and chronic rheumatic heart disease are "strongly
Joint research from the Auckland Regional Public Health Service,
University of Auckland and AUT highlighted the importance of
treating scabies as a preventative measure, researcher Simon
Scabies is an itchy rash caused by microscopic parasitic
mites that burrow under the skin.
It, like rheumatic fever, is a disease associated with
Dr Simon Thornley said the research highlighted the need to
identify and treat scabies early on - in order to possibly prevent
the development of rheumatic fever or chronic rheumatic heart
disease at a later stage.
High numbers of cases are reported among
young Māori and Pacific Island children - the same
groups most affected by rheumatic fever, public health physician
The study looked at health records of more than 200,000
Auckland children aged three to 12 who attended an oral health
service for the first time between May 2007 and October
Some of these children had previously had scabies, while others
had not. None had previously had rheumatic fever.
Within five years of their scabies diagnosis, 440 were
diagnosed with either rheumatic fever or chronic rheumatic heart
The findings showed children who had scabies were 23 times more
likely to develop rheumatic fever than children who had
Animal studies have shown pigs infected with scabies developed
skin infections Staphylococcus aureus and Streptococcal
The latter is strep throat, a common cause of rheumatic
Most strep throats get better.
However, in a small number of people - mostly children - an
untreated strep throat develops into rheumatic
fever, where their heart, joints, brain and skin become
inflamed and swollen.
The risk of getting rheumatic fever gets higher when
someone has repeated untreated strep throat infections.
While the symptoms of rheumatic fever may disappear on their
own, the inflammation from even one rheumatic fever attack could
develop into rheumatic heart disease, where there is scarring of
the heart valves.
Children in south Auckland were disproportionately affected by
both scabies and rheumatic fever, Thornley said.
Treatment and prevention of rheumatic fever has been targeted at
swabbing and treating the throat as a result, but this research has
"stepped a level back," to find why these infections occur in the
first place, he said.
He said while hospital diagnoses of scabies are rare and tricky
to diagnose, it is easily preventable.
"The fact that it is one of the simplest diseases in medicine to
treat raises the issue: if we did more to treat scabies maybe we
wouldn't see these high numbers of rheumatic fever."
Those diagnosed with scabies also later presented with
cellulitis, dermatitis, impetigo and asthma.
Thornley said he hopes the research will encourage
healthcare providers to not overlook scabies, given
the link between it and rheumatic fever.
Roger Marshall, Paul Jarrett, Gerhard Sundborn, Edwin Reynolds
and Grant Schofield co-authored the paper.