Because scabies is easily transmitted during close contact, it is assumed that treating all close contacts of infected persons, even those who are asymptomatic, decreases the spread and recurrence of this disease. Chambliss reviewed the literature to determine whether treatment is required in persons who have had bodily contact with an infected person.
In reviewing articles obtained from a MEDLINE search, the author found that no trials have been specifically performed to evaluate whether treatment of asymptomatic contacts or family members improves outcomes. Studies suggest, however, that scabies is associated with an asymptomatic stage. In one report of scabies transmitted from a patient to nursing staff, symptoms did not develop in the nursing staff until three weeks after exposure. However, patients who have had a previous infection may exhibit symptoms in a matter of days if they are reinfected.
A large body of evidence strongly suggests that close contact, such as sharing the same bed, readily transmits scabies. There is general agreement that the risk of transmission is low if skin-to-skin contact or other close bodily contact, such as hugging or lifting, does not occur or if clothing is not shared.
The author concludes that treatment should be given to all persons with skin-to-skin contact or other close bodily contact with scabies-infected persons. Treatment is not required in casual contacts of adults with scabies. If a child is infected, treatment should be initiated in all family members who have any contact with the child.