What is Scabies?

7 in 10 indigenous children suffer from scabies at least once before their first birthday. If you think its just an itch, think again. Without treatment, scabies can lead to a number of chronic secondary conditions, even premature death.

Scabies, is a highly contagious disease, spreads through direct skin-to-skin contact. When a female scabies mite burrows under the skin and lays eggs, this triggers an immune response to control the mite replication, causing irritation. Scratching the skin leads to development of sores that can lead to bacterial infections

Effects of Scabies

If untreated, scabies can lead to a  number of downstream health problems such as kidney failure and/or rheumatic heart fever. Repeated episodes of rheumatic heart fever increases the likelihood of developing rheumatic heart disease later in life.  

he Northern Territory has the highest documented incidents of rheumatic heart disease in the world. Both of these conditions are significant causes of the premature mortality with our Indigenous Australians living, on average 10-17 years less than non-Indigenous Australians.

Severe Scabies

The severe form of scabies, known as crusted scabies or Norwegian scabies occurs when the immune system is unable to control the scabies mite reproduction. A hyper-infection can then develop with up to millions of mites burrowing under the skin causing disfigurement, and crusting of the skin. Individuals suffer in silence and shame, receiving little ongoing care and become ‘core transmitters’ of scabies in the community.

Source: Short B, Derrick EH. A remarkable case of scabies. Med J Aust 1948;(20):621. © Copyright 1948 The Medical Journal of Australia reproduced with permission.

To find out more about crusted scabies, please watch the video below.  Here, Kenny Wapit Mununggurr explains what it was like living with this disease.




The first in line treatment for simple scabies is a topical cream, which is applied all over the body. Both the person with scabies and any close contact of theirs living in the same household needs to use the cream. There are different lotions and creams that are prescribed depending on the severity of scabies and the age of the individual. To find out more, please refer to ‘CARPA Standard Treatment Manual (2014), 6th Edition’


Diagnosis of crusted scabies can be difficult but a prompt and correct diagnosis is vital. Misdiagnosis can result in unnecessary and expensive treatment and may put the patient’s health at risk. To make a positive diagnosis, One Disease clinical team, along with local clinicians and infectious disease specialists (i) identify/confirm clinical appearance (ii) audit patient clinical files (iii) obtain skin scrapings and (iv) perform contact tracing. Patients who test positive for the above are given ivermectin, an oral medication in combination with topical creams and lotions. For more detailed information, please refer to our ‘Crusted scabies management guide’.


We support household members and explain benefits of using the creams and lotions in reducing skin sores, itching and improved sleep. We involve senior household members who are well respected within the family to help others apply their cream and follow through with treatment.

We also conduct social marketing initiatives to educate and empower communities on diagnosing and treating scabies. Most importantly we work in partnership with our communities and in a culturally respective manner to eliminate this disease.