There has been a surge in cases of scabies and measles – both highly contagious – as well as rickets and scurvy, conditions we thought had been eradicated. Are public health cuts to blame?

Before Covid-19, Dr Farzana Hussain says, it was rare for her to see a case of scabies at her GP surgery in Newham, east London, but since the pandemic, the number of patients with the parasitic skin infection has increased dramatically.

“By the time a patient comes to me for advice, everyone in the family has it, including all the children,” she says. “The itch is maddening. People demand immediate treatment.”

Transmitted by tiny mites that burrow and lay eggs under the skin, scabies is a disease associated with squalor and overcrowding. Spread by close personal contact, it is so infectious that during the Victorian period, workhouses maintained separate “itch” wards so those infested with the mites could be segregated and treated before being allowed into the workhouse proper.

According to the Royal College of General Practitioners (RCGP), scabies cases are now running at three per 100,000 of the population in England, double the five-year seasonal average. That translates into approximately 2,000 cases of scabies a year. However, in the north, the worst affected region of England, GPs are seeing rates as high as six per 100,000.

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    Before Covid-19, Dr Farzana Hussain says, it was rare for her to see a case of scabies at her GP surgery in Newham, east London, but since the pandemic, the number of patients with the parasitic skin infection has increased dramatically.

    For Marmot, the surge in infectious diseases reflects the cost of living crisis and decade-long cuts to social services and public health, which have left Britain with one of the poorest and most vulnerable populations in Europe.

    But because of cuts to frontline services and a shortage of sexual health counsellors, getting an appointment at a clinic can take weeks, and patients who succeed in getting one can face waits of up to four hours before being seen.

    Helen Bedford, professor of children’s health at University College London, believes the shortfall is one of the factors driving the low uptake of the MMR jab and other vaccines.

    Hussain says another factor is fatigue: “During the pandemic, people took on board the message to get the Covid vaccine, but now don’t feel it’s necessary – or that they have the time – to get the measles jabs for their children.

    Similarly, the incidence of rickets is far below the rate seen in the 1800s, when London was blanketed by smog, blocking UV radiation, and it is estimated that the condition affected 60% of children living in the capital.


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