Scabies is back, with a 750% increase in cases in Italy in three years. Overtourism is among the causes.

It seemed like a forgotten disease , but now it's making a comeback with a vengeance, with cases increasing by up to 750% in some Italian areas. Scabies is a skin infection caused by a small parasite, the mite Sarcoptes scabiei, which is difficult to spot because it's tiny, but capable of burrowing into the skin to lay its eggs. This is what causes the characteristic intense itching, especially at night. It also causes the appearance of small bumps, especially on the hands, feet, and genitals, according to experts from the Italian Society of Dermatology and Sexually Transmitted Diseases ( Sidemast ), who recently shed light on this rapidly growing disease.

Dermatologists point out that in almost all cases, contagion is human-to-human, requiring direct contact between people. Therefore, contagion through pets is a false myth. Traveling with frequent contact with many people, staying in and frequenting crowded places, and situations typical of overtourism can increase the risks. This emergency is undoubtedly due to the fact that scabies is highly contagious. When the parasite lays eggs in the skin, the resulting mites, if not eradicated, quickly colonize other areas of the body and other people. Contrary to what was once believed, scabies is not a disease linked to poor personal hygiene; anyone can be infected. However, for transmission to occur, direct and prolonged contact with an infected person is required, so transmission between intimate partners is easy.

Dermatologists emphasize that mites can live inside mattresses for up to three days, but they require human skin to proliferate. Clothing and underwear are a rare vehicle for contagion. Contagion in swimming pools is equally rare, as humidity prevents mites from emerging from the skin. In Italy, in many regions, "a worrying increase in scabies cases is being recorded," Sidemast points out, "although precise, large-scale data is still lacking, and the phenomenon remains underestimated. Two Italian studies, from the Emilia-Romagna and Lazio regions, are particularly illustrative, providing critical data on the spread of the phenomenon. A recent analysis published in 'Sexually Transmitted Infections' highlights how, between 2020 and 2023, scabies cases increased dramatically in the city of Bologna." Another study, "published in 'Infectious Diseases of Poverty,' documented a post-COVID surge in cases in the Lazio region, calling it an 'emerging public health threat.' The increase was particularly marked in long-term care facilities, with a 750% increase in outbreaks between 2020 and 2023."

The pandemic lockdown contributed to the return of the disease

The pandemic lockdown also paved the way for the resurgence of scabies, when many people spent extended periods of time in crowded, enclosed spaces. In general, therefore, those most vulnerable to infection are certainly children and adolescents between the ages of 5 and 18, partly due to their frequent use of community settings such as schools and gyms. Added to these are the elderly, especially those in residential care homes, and people with social or health vulnerabilities.

Symptoms that should raise suspicion of infection, especially if there has been a case among close contacts, include intense itching, particularly at night—a characteristic sign—and skin papules. In these cases, dermatologists recommend: promptly consulting a doctor or dermatologist; avoiding self-treatment, as an incorrect diagnosis can prolong the infestation and facilitate contagion; if scabies is confirmed, it is important to treat all close contacts, even if asymptomatic; and washing clothing and bed linens at high temperatures.