An employee health nurse complains that she has recently seen five employees with scabies. They have been pulled to various departments. What potential source should the IP investigate?

• A. Other nurses and patients
• B. Environmental surfaces only
• C. Food handling staff
• D. Administrative staff

Answer: (A)

Scabies spreads mainly through close, prolonged skin-to-skin contact between people, and in a hospital setting that often means care providers and patients who interact closely. When five employees across different departments become infected, it points to transmission through people rather than a single environmental cause. The most plausible source to investigate is other nurses and the patients they care for, since they are the ones who have sustained contact that can spread the mites.

Environmental surfaces can harbor mites briefly, but they are less likely to be the primary driver in this scenario, because the transmission pattern aligns with direct contact among staff and patients. Administrative staff and food handling staff have less direct, frequent skin-to-skin exposure to patients, making them a less likely source in this context. Focus the investigation on identifying any undiagnosed cases among staff and patients, and review contacts and shared spaces or equipment that could bridge departments.