In February 2005 we performed an epidemiological study of an outbreak of scabies in a tertiary-care hospital which started from a crusted scabies case. We detected 10 secondary cases, 8 in healthcare workers and 2 in hospitalized patients. The attack rate was 4.1%. In contrast to previously described outbreaks, the crusted scabies case was recognized at admission. The outbreak causes were: lacking adherence to contact precautions, long stay of the primary case in the hospital ward and delay of specific treatment. The main control measures were: alerting the hospital services about the outbreak, performing epidemiologic surveillance, coordinating with the Hospital Direction and the Occupational Health Department, education of healthcare workers in control measures, implementation of isolation measures and treatment of cases and contacts with 5% permethrin topical lotion.

Precautions in attending avian influenza H5N1 inpatientsSeveral agencies have proposed infection control guidelines for management of patients admitted with the diagnosis of avian influenza. These guidelines aim to prevent transmission from the patient to hospital personnel and other inpatients. The guidelines presented here by the Advisory Committee of Nosocomial Infections have been elaborated for the local medical communitty after reviewing currently available recommendations. Key recommendations include admission to an isolation ward, cohorting of confirmed cases, hand hygiene with antiseptic solutions, use of N95 type masks, non-sterile disposable gloves and eye protection equipment during examination or when performing aerosols-generating procedures. Use of patient-exclussive clinical instruments, daily disinfection of the hospital ward, implementation of measures to reduce risk of needle stick injuries and eye splashing, and reinforcement of appropriate sampling and transport of blood and other corporal fluids, are also recommended.