Scabies cases surged in 2023

A significant increase in scabies, a skin infection caused by mites, was recorded three years ago, data tabled in parliament by Health Minister Jo Etienne Abela shows.

In 2023, the incidence rate for scabies was 58.57 per 100,000 people, a significant increase when compared to the previous three years.

Abela was replying to a parliamentary question by Nationalist MP Ian Vassallo Hagi, who asked for the incidence rate of scabies between 2020 and 2025.

The data shows that last year the incidence rate stood at 24.02, almost half the peak reached in 2023 but still a 55% increase over the incidence rate recorded five years earlier. The lowest incidence rate for scabies was in 2021, during the COVID-19 pandemic, when 10.77 cases per 100,000 people were recorded.

Tiny mites and intense itching

Scabies is caused by tiny mites that burrow into the skin and lay eggs, causing intense itching and a rash. Left untreated it can lead to skin sores and serious complications like septicaemia (a bloodstream infection), heart disease and kidney problems. Treatment normally consists of creams or oral medications.

According to information sourced from the World Health Organisation (WHO), Scabies is contagious and spreads through close skin contact such as living in the same residence with an infested individual. Given the contagious nature of the disease, whenever a case of scabies is diagnosed, people living with the infected person are normally treated as well even if they do not exhibit symptoms.

WHO estimates that at least 200 million people worldwide suffer from scabies at any one time and an estimated 5%–50% of children in resource-poor areas are affected.

Scabies occurs worldwide but is most common in hot, tropical countries and in areas of high population density.

Symptoms of scabies usually begin between four and six weeks after infestation. Symptoms include: Severe itch, often worse at night; itchy lines and bumps on the fingers, wrists, arms, legs and belt area; enflamed bumps on male genitalia and female breasts; and larger rash in infants and small children, including on the palms, soles of the feet, ankles and scalp.

Most individuals are infected with 10–15 mites.

Additionally, people with suppressed immune systems, including people living with HIV, may develop crusted (Norwegian) scabies. This severe infection can have thousands or millions of mites and causes dry, scaley areas on the skin. It often does not cause itch. Crusted scabies spreads very easily and can cause secondary infections and is life threatening.

The increase in scabies cases in Malta appears to mimic the trend in Europe where a rise in cases has been observed in recent years. The rise in scabies throughout Europe has been attributed to travel and mass migration of people from regions with high scabies prevalence.

However, a recent epidemiological study in the Netherlands found that only eight of 55 scabies cases were contracted abroad or from travellers, suggesting that most transmission occurs through domestic networks. Indeed, the resurgence of scabies in the Netherlands is concentrated predominantly among adolescents and young adults, particularly university students living in communal housing.