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Sarcoptic Mange

Sarcoptic Mange

The following presentation is an introduction to sarcoptic mange, a common ectoparasite infection found all around the world.

Sarcoptic Mange © 2022 by E. Nomi is licensed under CC BY-NC-SA 4.0

The University of Nomi

February 06, 2024
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  1. Sarcoptic Mange
    Sarcoptic Mange
    March 2022 Photo: petsweekly.com/dogs-101/dogs/dogs-health/parasites-and-mange

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  2. Aetiology
    Sarcoptic mange is caused by the mite Sarcoptes scabiei
    Photo: Niedringhaus et al. 2019, Figure 1

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  3. Aetiology
    Female mite burrows in stratum corneum of epidermis and lays eggs1
    Photo: Sugiura et al. 2018, Figure 2 Photo: Rahdar et al. 2008, Figure 4

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  4. Aetiology
    Photo: © John Bavosi on Getty Images
    Photo: Skin, Illustration by Science Source on Science Photo Library



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  5. Aetiology
    Symptoms1:
    – Intense itching
    – Pimple-like rash
    – Burrows on skin
    – Sores, lesions, scabs
    – Secondary bacterial infection
    Photo: Cixia, 2007, public domain
    Photo: Whybrew, 2017, Figure 1

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  6. Aetiology
    ∙ Spreads via direct contact with infected individual1
    ∙ Rapid infection under crowded conditions1
    ∙ Not influenced by hygiene practices or the availability of water2
    Photo: © Brett Sayles on pexels.com Photo: change.org/p/new-zealand-ban-factory-farming-pigs-in-new-
    zealand-3

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  7. Mammal Hosts
    ∙ Mites have host-specific species variants affecting more than 100
    different mammals3,4,5
    ∙ Mites acquired from other mammals don’t reproduce on humans1
    – Transient symptoms but no persistent infection
    Livestock Wildlife Pets
    Photos: hobbyfarms.com/how-can-i-treat-pig-mites, © Joan Collins from https://www.adirondackexplorer.org/stories/bear-mange, toplapdogs.com/dog-mange/

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  8. Mammal Hosts
    ∙ Common in pigs: 50-95% of herds are infested with S. scabiei mites worldwide6
    ∙ Effect on agriculture and economy2:
    – Lower feed conversion efficiency
    – Reduction in growth and meat/milk production
    Livestock Wildlife Pets
    Photos: hobbyfarms.com/how-can-i-treat-pig-mites, © Joan Collins from https://www.adirondackexplorer.org/stories/bear-mange, toplapdogs.com/dog-mange/

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  9. Mammal Hosts
    Livestock Wildlife Pets
    Photos: hobbyfarms.com/how-can-i-treat-pig-mites, © Joan Collins from https://www.adirondackexplorer.org/stories/bear-mange, toplapdogs.com/dog-mange/
    ∙Millions of wild animals worldwide suffer from sarcoptic mange4
    ∙Effect on ecology7:
    – Infection mortality challenges conservation efforts
    – Transmission between wild and domesticated animals

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  10. Mammal Hosts
    ∙ Common among abused or neglected pets
    Livestock Wildlife Pets
    Photos: hobbyfarms.com/how-can-i-treat-pig-mites, © Joan Collins from https://www.adirondackexplorer.org/stories/bear-mange, toplapdogs.com/dog-mange/

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  11. Camel Hosts
    Sarcoptes scabiei var. cameli
    Photo: "Camel Mange In Tharparkar" by Abdullah Arijo on technologytimes.pk

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  12. Cattle Hosts
    Sarcoptes scabiei var. bovis
    Photo: toxoplasmosiscenter.blogspot.com/2020/04/sarcoptic-mange-in-cattle.html

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  13. Goat Hosts
    Sarcoptes scabiei var. caprae
    Photo: "A goat with sarcoptic mange" by Alan R Walker on southafrica.co.za

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  14. Fox Hosts
    Sarcoptes scabiei var. vulpes
    Photo: “A juvenile fox with mange” by Mary Lee Agnew on wildlifeonline.me.uk
    Photo: © Rob Williams on wildlifeonline.me.uk

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  15. Rabbit Hosts
    Sarcoptes scabiei var. cuniculi
    Photo: Arul Prakash et al. 2016, Figure 6 Photo: Arul Prakash et al. 2016, Figure 5

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  16. Dog Hosts
    Sarcoptes scabiei var. canis8
    – Evidence suggests cross-species mite infection between dogs,
    rabbits and red fox
    Photo: © 2022 Animal Aid Unlimited on animalaidunlimited.org
    Photo: petmd.com

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  17. Pig Hosts
    Sarcoptes scabiei var. suis
    Photo: © The Peninsula Humane Society & SPCA on koit.com/96-5-koit-blog Photo: © Caters News on storytrender.com

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  18. Bear Hosts
    Sarcoptes scabiei (no var. name)9
    Photo: © Joan Collins on adirondackexplorer.org

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  19. Cat Hosts
    Notoedres cati, a look-alike of Sarcoptes scabiei causing mange2
    Photo: allaboutcats.com/mange-in-cats

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  20. Guinea Pig Hosts
    Trixacarus caviae, a look-alike of Sarcoptes scabiei causing
    mange2
    Photo: © EmmasBears on emmasguineapigs.blogspot.com

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  21. Human Hosts
    Sarcoptes scabiei var. Hominis2,10
    – Affects over 200 million people worldwide
    Photo: Rahdar, 2008, Figure 2 Photo: Walton, 2007, Figure 2

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  22. Crusted (Norwegian)
    scabies1,2,4,10
    – Hyperinfestation
    – Thick crusts of epidermis
    contain millions of mites
    and eggs
    – Occurs mainly in the
    immunocompromised
    – Highly contagious,
    spreads on fabrics
    Extreme Symptoms
    Photo: Walton, 2007, Figure 3

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  23. Who Gets Sarcoptic Mange?
    ∙ Found worldwide, affecting people of all socioeconomic levels1,2,11
    ∙ Outbreaks common in institutionalized settings1,2,11
    – Nursing homes, hospitals, jails, childcare facilities
    Photo: Jaimie Ding on oregonlive.com
    Photo: sitedebelezaemoda.com.br/seguro-saude-viagem

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  24. ∙ Females burrow into
    stratum corneum of
    epidermis and feed on
    tissue fluids12,13
    ∙ Deposit 2-4 eggs per
    day5,12
    ∙ Remain there for life
    (1-2 months)5,12
    Life Cycle
    Adapted from Mumcuoglu et al., 2009, Figure 9

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  25. ∙ Eggs hatch in 3-4
    days and larvae
    migrate to skin
    surface5,12
    ∙ Larvae mature into
    nymphs in 3-4 days5
    Life Cycle
    Adapted from Mumcuoglu et al., 2009, Figure 9

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  26. ∙ Nymphs burrow in
    shallow moulting
    pouches and mature
    into adults in 4-6
    days5,12
    Life Cycle
    Adapted from Mumcuoglu et al., 2009, Figure 9

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  27. ∙ Male joins female in
    her moulting pouch to
    mate12
    Life Cycle
    Adapted from Mumcuoglu et al., 2009, Figure 9

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  28. The cycle continues.
    ∙ 10% of eggs develop
    into males12
    ∙ Males rarely seen -
    live in shallow pits
    until they mate12
    ∙Typically up to 15
    mites per host9
    Life Cycle
    Mumcuoglu et al., 2009, Figure 9

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  29. Obligate Parasitism
    ∙ Every life stage of mite requires host
    ∙ Var. hominis and canis mites survive 1-3
    days away from host at room
    temperature1,2
    Figure: Sarcoptes scabiei var. canis in burrow
    Photo: Arlian & Morgan, 2017, Figure 1

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  30. Diagnosis
    ∙ No standardized method or procedure for diagnosis14
    ∙ Usually relies on clinical signs of rash and itching4,15
    Photo: std-gov.org/stds/scabies.htm

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  31. Diagnosis
    Skin Scraping ∙ Direct observation with microscope9
    Pros:
    – Precise, provides clear
    identification
    Cons:
    – Can produce false negatives
    with low mite burden
    Photo: leicesterskinvet.co.uk/diagnostic-and-lab-testing

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  32. Diagnosis
    PCR ∙ Detects mite-specific DNA16
    Pros16:
    – High specificity
    Cons:11,17
    – Low sensitivity with low mite
    burden
    – False positives due to background
    contamination from exogenous
    sources of DNA
    Photo: ipsumdiagnostics.com/homepage/pcr-testing

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  33. Diagnosis
    ELISA
    Photo: enzolifesciences.com
    ∙ Detects antibodies to mite antigens in
    serum8
    Pros5,8,11:
    – Highly specific
    – Supplements PCR results
    Cons5,8,11:
    – Cannot distinguish current from
    past infection status
    – Developed only for animal scabies

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  34. Chemical Treatments
    Photos: drugsdepot.com, thescabiescure.com, ebay.co.uk, drscabies.com/blog/is-sulfur-helpful-in-treating-scabies
    Topical scabicides10:
    – 5% permethrin
    – 0.5% malathion in aqueous base
    – 10–25% benzyl benzoate emulsion
    – 5–10% sulphur ointment

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  35. Ivermectin10:
    – Oral (for humans, safety in
    pregnant women and children
    under 15 kg unknown)
    – Topical Spray
    – Injection
    Chemical Treatments
    Photos: tajgenerics.com/portfolio-item/ivermectin-6mg-dispersible-tablets-taj-pharma, ncvets.co.nz/livestock/sheep/sheep-technician-services, agridirect.ie/product/clik-pouron, walmart.com

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  36. Natural Treatments
    Photo: blog.alikaynaturals.com/tea-tree-oil-benefits
    5% tea tree oil (Melaleuca alternifolia)18,19,20,21:
    – Applied topically once a day or 2-3 times a week for up to 4 weeks

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  37. Natural Treatments
    Photo: realfoodinafastworld.com
    Crude gel of Aloe vera22:
    – Applied topically once a day for 3 consecutive days, repeated
    again 1 week later

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  38. Natural Treatments
    Balsam of Peru (Myroxylon pereirae)23,24:
    – Applied topically over entire body after bathing, once a week for 4
    weeks, with no baths in between
    Photo: indiamart.com

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  39. The Future of Sarcoptic Mange
    ∙ The World Health Organization (WHO) acknowledged sarcoptic mange as
    a neglected tropical disease in 201711
    ∙ Included in WHO roadmap for neglected tropical diseases 2021–2030:
    Photo: WHO, Executive summary. Ending the neglect to attain the Sustainable Development Goals: A road map for neglected tropical diseases 2021–2030

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  40. References
    1. The Centers for Disease Control and Prevention. (2020, September 1). Scabies Frequently Asked Questions (FAQs). Retrieved March 29, 2022 from
    https://www.cdc.gov/parasites/scabies/gen_info/faqs.html.
    2. McCarthy, J. S., Kemp, D. J., Walton, S. F., & Currie, B. J. (2004). Scabies: more than just an irritation. Postgraduate medical journal, 80(945), 382–387.
    https://doi.org/10.1136/pgmj.2003.014563.
    3. Valldeperes, M., Moroni, B., Rossi, L., López-Olvera, J. R., Velarde, R., Molinar Min, A. R., Mentaberre, G., Serrano, E., Angelone, S., Lavín, S., & Granados, J. E. (2021). First report of
    interspecific transmission of sarcoptic mange from Iberian ibex to wild boar. Parasites & vectors, 14(1), 481. https://doi.org/10.1186/s13071-021-04979-w.
    4. Walton, S. F., & Currie, B. J. (2007). Problems in diagnosing scabies, a global disease in human and animal populations. Clinical microbiology reviews, 20(2), 268–279.
    https://doi.org/10.1128/CMR.00042-06.
    5. Niedringhaus, K. D., Brown, J. D., Sweeley, K. M., & Yabsley, M. J. (2019). A review of sarcoptic mange in North American wildlife. International journal for parasitology. Parasites and
    wildlife, 9, 285–297. https://doi.org/10.1016/j.ijppaw.2019.06.003.
    6. Cargill, C. F., Pointon, A. M., Davies, P. R., & Garcia, R. (1997). Using slaughter inspections to evaluate sarcoptic mange infestation of finishing swine. Veterinary Parasitology, 70(1-3),
    191–200. https://doi.org/10.1016/S0304-4017(96)01137-5
    7. Rasero, R., Rossi, L., Soglia, D., Maione, S., Sacchi, P., Rambozzi, L., … Alasaad, S. (2010). Host taxon-derived Sarcoptes mite in European wild animals revealed by microsatellite
    markers. Biological Conservation, 143(5), 1269–1277. https://doi.org/10.1016/j.biocon.2010.03.001
    8. Arlian, L. G., & Morgan, M. S. (2017). A review of Sarcoptes scabiei: past, present and future. Parasites & vectors, 10(1), 297. https://doi.org/10.1186/s13071-017-2234-1.
    9. Van Wick, M., & Hashem, B. (2018). Treatment of Sarcoptic Mange in an American Black Bear (Ursus americanus) with a Single Oral Dose of Fluralaner. Journal of Wildlife Diseases.
    https://doi.org/10.7589/2017-12-310
    10. The World Health Organization. (2020, August 16). Scabies. Retrieved April 18, 2022 from https://www.who.int/news-room/fact-sheets/detail/scabies.
    11. El-Moamly A. A. (2021). Scabies as a part of the World Health Organization roadmap for neglected tropical diseases 2021-2030: what we know and what we need to do for global
    control. Tropical medicine and health, 49(1), 64. https://doi.org/10.1186/s41182-021-00348-6.
    12. The Centers for Disease Control and Prevention. (2020, September 1). Biology. Retrieved April 7, 2022 from https://www.cdc.gov/parasites/scabies/biology.html.

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  41. References
    13. Chouela, E., Abeldaño, A., Pellerano, G., & Hernández, M. I. (2002). Diagnosis and treatment of scabies: a practical guide. American journal of clinical dermatology, 3(1), 9–18.
    https://doi.org/10.2165/00128071-200203010-00002.
    14. Engelman, D., Fuller, L. C., Steer, A. C., & International Alliance for the Control of Scabies Delphi panel (2018). Consensus criteria for the diagnosis of scabies: A Delphi study of
    international experts. PLoS neglected tropical diseases, 12(5), e0006549. https://doi.org/10.1371/journal.pntd.0006549.
    15. Gilson RL, Crane JS. Scabies. [Updated 2021 Aug 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
    https://www.ncbi.nlm.nih.gov/books/NBK544306.
    16. Angelone-Alasaad, S., Molinar Min, A., Pasquetti, M., Alagaili, A. N., D'Amelio, S., Berrilli, F., Obanda, V., Gebely, M. A., Soriguer, R. C., & Rossi, L. (2015). Universal conventional and real-
    time PCR diagnosis tools for Sarcoptes scabiei. Parasites & vectors, 8, 587. https://doi.org/10.1186/s13071-015-1204-8.
    17. Yang, S., & Rothman, R. E. (2004). PCR-based diagnostics for infectious diseases: uses, limitations, and future applications in acute-care settings. The Lancet. Infectious diseases,
    4(6), 337–348. https://doi.org/10.1016/S1473-3099(04)01044-8.
    18. Walton, S. F., McKinnon, M., Pizzutto, S., Dougall, A., Williams, E., & Currie, B. J. (2004). Acaricidal Activity of Melaleuca alternifolia (Tea Tree) Oil. Archives of Dermatology, 140(5).
    https://doi.org/10.1001/archderm.140.5.563.
    19. Shiven, A., Alam, A., & Kapoor, D. N. (2020). Natural and synthetic agents for the treatment of Sarcoptes scabiei: a review. Annals of parasitology, 66(4), 467–480.
    https://doi.org/10.17420/ap6604.287.
    20. Gopinath, H., Aishwarya, M., & Karthikeyan, K. (2018). Tackling scabies: novel agents for a neglected disease. International Journal of Dermatology, 57(11), 1293–1298.
    https://doi.org/10.1111/ijd.13999.
    21. Thomas, J., Carson, C. F., Peterson, G. M., Walton, S. F., Hammer, K. A., Naunton, M., Davey, R. C., Spelman, T., Dettwiller, P., Kyle, G., Cooper, G. M., & Baby, K. E. (2016). Therapeutic
    Potential of Tea Tree Oil for Scabies. The American journal of tropical medicine and hygiene, 94(2), 258–266. https://doi.org/10.4269/ajtmh.14-0515.
    22. Oyelami, O. A., Onayemi, A., Oyedeji, O. A., & Adeyemi, L. A. (2009). Preliminary study of effectiveness of aloe vera in scabies treatment. Phytotherapy research : PTR, 23(10), 1482–
    1484. https://doi.org/10.1002/ptr.2614.
    23. Robinson, S. (1907). Report on the Treatment of Scabies with Balsam of Peru. Journal of the Royal Army Medical Corps, 8(1), 52–54. https://doi.org/10.1136/jramc-08-01-12
    24. Balsam of Peru in the Treatment of Scabies. (1907). The Hospital, 41(1070), 426–427.

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