Ministry of Health Field Epidemiology Training Program Kingdom of Saudi Arabia Report of an Outbreak of Scabies in Al-Madinah Region,

        Scabies is a skin disease which produce pits under the skin, and it is mainly caused by mite Sarcophagus scabies. The disease spread due to physical contact between two persons. The research considered different areas of Saudi Arabia and how he infection can be spread over the upper layer of human skin. Scabies mites is transmitted by direct skin contact, materials such as clothes, persons body, and towels [1]. The infection can be transferred to others without any discrimination of age, sex, and race. The objective of the research was to confirm the existence of scabies and to determine the possible source of the outbreak. Besides this, the research considered causes of scabies, signs and symptoms, and epidemiology of scabies. Similar to the other diseases, scabies shows signs and symptoms before getting worse. The symptoms and signs of scabies include itching, scratching and rashes. There are different prevention and treatment methods that can be initiated on the symptoms [2]. The right way for the treatment of scabies is by using effective medications like 5 % permeation cream, 10% omicron lotion, and 1 % landline lotion. One of the efficient research methods is descriptive cross-sectional study that is directly based on the collection of data from the public health department, Madinah region, and directorate of health affairs. The data was collected in a specified period of time during April 2018 to end of May 2018. The research confirmed 81 cases during this time period and then number of cases increased in the coming years and statistics confirmed that cases increased up to 152 confirmed cases. The data provided in the research was collected from communicable diseases department in the health affair. Some of the data was collected through HESN program. The environmental investigation considers sources of ventilation, number of cases, and environmental hygiene [1]. The results of the research show that in the previous history, 152 cases of scabies were recorded in which 96 cases were male while 56 cases were female. The majority of cases were children between ages of 1 - 10 years old. Children of 10 years are most affected. The highest rate of the infected cases was recorded as 63 % of males. The issue could increase due to higher physical contact of males during Hajj ceremony of Madinah. The research shows bar graph to describe the relation between levels of distribution of cases according to nationality. The comparison was conducted for different countries including Yemen, Syrian Arab republic, Sudan, Saudi Arabia, Philippines, Nepal, Myanmar, Mauritania, Jordan, Iraq, India, Egypt, Bangladesh, and Afghanistan. The maximum rate of cases was 54.6 % for Saudi Arabia while for India it was 10.5 %. The epidemiological curve demonstrated scabies outbreak in region of Madinah. The distribution of cases was 73, 71, and 8 for Medina, Yanbu, and AlMahd respectively. Madinah is one of the larger population areas [2]. The diagnosis of cases is based on the clinical symptoms and signs. Research shows higher prevalence of skin disease in males. The outbreak of male gender was higher in the winter month. In the research, the genetic investigation was highly important. The variation in the diagnosis changed due to disease. The review of research shows skin infection that is associated with the itching. The disease of scabies causes severe itches and rashes. The limitation of research shows dependence of clinical symptoms and signs without lab confirmation. The research concluded that majority of cases were related to the males. The research suggests that in future research active examination is required to be carried out in different regions of medina. The research shows scabies outbreak can be identified. There are different individual approaches followed by alleviate of scabies. The disease was infested in the crowded areas. In order to control the disease planned diagnosis and monitoring is required to be carried out by the concerned staff. In the further researches, isolation procedures will be carried out for the infestation cases. The management process can be efficient and effective to control the cases. The preventive approach can be used to reduce future outbreak and surveillance system can be used to maintain the strength of surveillance.