Volume 25, Number 6—June 2019
Research Letter
Sarcoptic Mange of Fox Origin in Multiple Farm Animals and Scabies in Humans, Switzerland, 2018
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Simone R.R. Pisano, Marie-Pierre Ryser-Degiorgis, Luca Rossi, Andrea Peano, Karin Keckeis, and Petra Roosje
Abstract
Fox-derived Sarcoptes scabiei mites caused an outbreak of mange on a farm in Switzerland in 2018. Pruritic skin lesions suggestive of S. scabiei mite infestation developed in 4 humans who had direct contact with affected farm animals but not foxes. Sarcoptic mange is continuously spreading; such outbreaks affecting humans could start occurring more frequently.
The Sarcoptes scabiei mite is the causative agent of scabies in humans and sarcoptic mange in animals (1). Scabies is considered a neglected reemerging disease of public health concern (2). Sarcoptic mange causes distress in livestock, economic loss in the livestock industry, and disease and death in wildlife (3). The degrees of host specificity and cross-infectivity of S. scabiei mites are still debated (3).
![Thumbnail of Clinical and molecular characterization of an outbreak of fox-derived Sarcoptes scabiei mites in multiple mammal species on a farm in Switzerland, 2018. A) Outbreak timeline displaying animal species (pigs [Sus scrofa domesticus], oxen [Bos taurus], dogs [Canis lupus familiaris], goats [Capra hircus], horses [Equus caballus], and red foxes [Vulpes vulpes]) showing clinical signs compatible with sarcoptic mange and humans with signs of zoonotic scabies in order of appearance. Gray po](https://wwwnc.cdc.gov/eid/images/18-1891-F1-tn.jpg)
Figure. Clinical and molecular characterization of an outbreak of fox-derived Sarcoptes scabiei mites in multiple mammal species on a farm in Switzerland, 2018. A) Outbreak timeline displaying animal species (pigs [Sus scrofa...
In January 2018, sarcoptic mange was suspected on a farm in the Jura Mountains, Switzerland. The outdoor loose housing system of this farm hosting 2 oxen (Bos taurus), 2 horses (Equus caballus), 5 goats (Capra hircus), 4 alpacas (Vicugna pacos), 8 fallow deer (Dama dama), and 15 sheep (Ovis aries) was separated from a stable housing 3 pigs (Sus scrofa domesticus). Six dogs (Canis lupus familiaris) and 17 cats (Felis catus) had access to all stables. Pruritic skin lesions developed in several species 2–3 weeks after repeated episodes of mangy red foxes (Vulpes vulpes) sleeping in the stables and making partial body contact with the livestock (Figure, panels A, B). Pruritic skin lesions also developed in 4 persons who had direct contact with the domestic animals but not the foxes. A fox with mange was found dead nearby and a necropsy was performed. Oxen, dogs, and pigs were treated with avermectins before diagnostic investigations were carried out.
Clinical examination revealed papules, erythema, excoriations, hyperkeratosis, and hypotrichosis with variable severity in 2 pigs, 2 goats, 2 dogs, all horses, and all oxen (Figure, panels C, D). The 3 sheep and 1 cat examined did not have lesions suggestive of mange. Close examination of the fallow deer and alpacas was impracticable. Humans had pruritic erythematous papules and excoriations on their neck, legs, or arms (Figure, panel E). Health authorities temporarily prohibited 1 affected person (a teenager) from attending school because of suspected scabies. Pruritus and skin lesions disappeared in the affected animals and humans within 6 weeks after >2 treatments with avermectins, topical neem oil, or both.
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