Scabies treatments scarce as Illawarra hospital tackles outbreak (2024)

Scabies, the skin condition affecting a number of Illawarra hospitals, is usually easy to treat with a topical cream bought over-the-counter at pharmacies.

However, this cream Lyclear is currently unavailable in Australia and has been for months, with the disruption understood to lie at the manufacturer's end.

Asim Iqbal from Convenient Chemist Wollongong said Lyclear was out of stock long-term and while some suppliers had said it was due to become available again late this month, these were only indicative dates.

NSW Health's Clinical Excellence Commission advised in June that wholesalers would have limited stock at the end of August.

To mitigate the shortage in the meantime, the Therapeutic Goods Administration has temporarily approved the import and supply of another cream called Encube until the end of October.

But Mr Iqbal said there were also delays in acquiring this and it was considerably more expensive.

Exacerbating the situation is a shortage of the typical second option for treatment, Benzemul.

Mr Iqbal's pharmacy worked with aged care facilities and he said they had turned to the third-line option, Stromectol (ivermectin) but this was a more complex treatment to administer.

How the health district is managing the outbreak

Margot Mains, the chief executive of the Illawarra Shoalhaven Health District (ISLHD), said the service was working hard to control the outbreak of scabies.

As of Tuesday, August 6, 14 patients and 24 staff were confirmed to have the contagious condition, with wards across Wollongong, Shellharbour, Bulli and Coledale hospitals affected.

While scabies usually has no long-term complications, it causes intense itching and sometimes a rash.

Ms Mains said ISLHD took immediate action when a case was confirmed in a Wollongong Hospital patient on July 22.

"This included isolation of the ward and immediate contact tracing of co-located patients and staff who provided direct physical clinical care," Ms Mains said.

But because scabies has an incubation period of six to eight weeks and obvious symptoms don't always appear immediately, other cases went undetected.

"When it was confirmed that cases were not isolated to the initial ward, the district moved to the next level of infection control and management measures, which included the establishment of a specialist outbreak response team," Ms Mains said.

On Sunday, August 4, a decision was made to put in place preventative actions for staff and inpatients at all hospitals across the district.

"Since then, our teams have worked around the clock to coordinate this massive logistical undertaking, which has included the procurement and distribution of sufficient preventative medication stock, the roll-out plan for patient and staff preventative measures, increased cleaning schedules, the establishment of staff clinics and the development of detailed and accurate information for staff, patients and the community," Ms Mains said.

"This was achieved in 48 hours."

ISLHD did not outline how it was treating cases of scabies given the shortage of usual treatments.

Kiama MP Gareth Ward questioned why health officials knew of the outbreak a fortnight before the public alert was issued.

Ms Mains said it was critical that the people directly impacted - in this case, inpatients, staff and discharged patients considered at higher risk - were contacted first.

Stakeholders deemed of highest priority, such as GPs, aged care facilities and NSW Ambulance, were also briefed.

"Once all these stakeholder groups were advised and relevant information was available - the LHD advised the wider community through a media release and website," Ms Mains said.

Health Minister and Keira MP Ryan Park said scabies was common, had no long-term impacts and was easily treatable.

"People don't have to be worried or scared about it, but we are being over cautious, because we're operating in hospital settings," Mr Park said.