December 1986, Vol. 25, No.
10
Report
Human Notoedric Scabies From Contact With Cats
Infested With Notoedres cati
AMALENDU CHAKRABARTJ, M . V . S C , PH.D.
From the Department of Veterinary Clinics, Faculty of
Veterinary & Animal Sciences, Bidhan Chandra Krishi
Viswavidyalaya, West Bengal, India
ABSTRACT: Forty-eight human contacts with cats infested
with Notoedres cati were investigated; 30 (62.5%) of the
contacts showed symptoms of notoedric scabies, and N. cati
mites were recovered from 15 (50%) skin specimens. Intense
pruritus without any mite burrows developed within a few
hours of initial contact with the infested cats. People within
the age group of 26-35 years were frequently infested. Hands
and legs were the most common sites of lesions. Prolonged
association with the infested cats was responsible for this
cutaneous disease. The lesions in infested people subsided
when the cats were segregated from huinans.
M ariy species of mites have been reported to be
transmitted from domestic animals to man, but
only Sarcoptes scabiei of canines and their feline acar-
ine counterpart Notoedres cati have been found to be
transmitted frequently to human beings.' Outbreaks
of anirinal or sarcoptic scabies in man are not infre-
quent through contact with domestic or pet animals.^
Cattle, horses, mules, sheep, goats, pigs, dogs, and
cats have all been reported as reservoirs of Sarcoptes
mites for man.^
Notoedres cati infestation (notoedric scabies) is rare
in Britain,"* but in countries like Czechoslovakia and
Japan it is common, and cat or notoedric scabies in
man is seen more frequently than the dog sarcoptic
scabies.^'^ Family or household outbreak of cat scabies
in man also has been reported.''
In India, scabies is prevalent in various domestic and
pet animals, including the cat. Notoedres scabies has
Address correspondence to: Amalendu Chakrabarti, M.V.Sc,
Ph.D., Faculty of Veterinary & Animal Sciences, Bidhan Chandra
Krishi Viswavidyalaya, P.O. 741 252, Nadia, West Bengal, India.
646
been reported in 18.5% of cats in urban and rural areas
of West Bengal,* but there has been no report of trans-
mission of cat scabies in man in Indian literature. This
communication places on record a study of 48 people
who contracted notoedric scabies from N. cat/'-infested
cats. This is the first report of such transmission.
Materials and Methods
Following casual detection of N. cati in a 1-year-old male
cat presented in the clinics of the Faculty of Veterinary and
Animal Sciences, Bidhan Chandra Krishi Viswavidyalaya,
West Bengal, a survey was undertaken in the residential area
of the owner, located in a semiurban area of South Calcutta.
Forty-eight human beings who were in contact with cats (18
men, 30 women) were investigated for the clinical signs of
notoedric scabies and for the presence of mites, if any. Rel-
evant information such as distribution of age, sex, site of
lesions, and occupation were recorded from the subjects.
The skin scrapings were obtained by blunt scalpel or needle.
Collected materials were placed iri 10% KOH solution on
glass slides for examination. Mites were identified based on
micromorphologic characteristics.'
Results
Clinical Profiles
The lesions were characterized by hyperemia and
papulovesicular eruptions without any evidence of
parasitic burrows. Papular lesions were excoriated in
most cases. Eczematous lesions also were observed.
Pruritus developed within a few hours of initial contact
with the infested cats. The distribution differed from
human scabies as the lesions spared the interdigital
webs and the genitalia.
Infestation Rate
Thirty (62.5%) of the 48 contacts showed clinical
manifestation of scabies. Clinical signs appeared in 10
(55.5%) of 18 men and 20 (66.6%) of 30 women.
N. cati mites were recovered in 15 (50%) of 30 skin
scrapings.
No. 10 HUMAN NOTOEDRIC SCABIES Chakrabarti 647

TABLE 1. Age Distribution in 15 Positive Human Cases Who (53.33%) were males and 14 (46.66%) were females;
Developed Notoedric Scabies Lesions
83.33% (25 of 30) ofthe cats were within 6-23 months
Total No. of age group.
N. cati Recovered of People
Age Croup Infested With Occupational Exposure
(Vears) Men Women Notoedric Scabies
All the contacts were engaged in the candlemakirig
6-15 0(0) 1 (11.11) 1 (6.67)
business in the same house where 35 cats were reared.
16-25 1 (16.67) 3 (33.33) 4 (26.67)
25-35 2 (33.32) 3 (33.33) 5 (33.32) Thirty (85.71%) cats were positive for N. cati infesta-
36-45 1 (16.67) 2 (22.23) 3 (20.00) tion. Cats were kept loose and thus had the free access
46-55 1 (16.67) 0(0) 1 (6.67) to all the corners of the house.
56+ T (f6.67) 0(01 r (6.67)

6(100.00) 9(100.00) 15 (100.00) Management

Figures in parentheses indicate percentage. All the infested cats were kept iri confinement in an
isolated room. Cats were treated with 2% lime sulfur.
The lesions of all the humans subsided within 2-3
Age Distribution weeks without any scabietic treatmerit when they were
The age distribution of infested persons is shown in kept away from the exposure to cats.
Table 1.
Most of the infested persons (33.32%) belonged to Discussion
26-35-year-oid age group, followed by 16-25 In the preseht investigation, clinical lesions in the
(26.67%) and 36-45 (20.00%) age groups. human contacts differed from classic scabies lesions.
Lesions were papulovesicular without any parasitic
Distribution of Sites of Lesions mite burrows and located in the odd sites, including
Distribution of the sites of lesions is presented in the face. Pruritus was intense within a few hours of
Table 2. initial contact with infested animals. Mites have been
Hands and legs combined were the most common observed to crawl over the human skin.^° As a corollary
sites of lesions (26.67%), followed by face, hands, and to "dairy mari's itch," "cavajryman's itch,"^ "goater-
legs combined (20.00%). yman's itch,^' and "buffaloman's itch,"^^ the present
symptoms may be described as "cat handler's itch."
Infestation Rate in Cats In some contacts, pruritus was the only cardinal sign
without apparent lesions. This type of clinical condition
Out of 35 cats in the same house, 30 (85.71%) has been referred as "pseudoscabies."^^
showed clinical skin lesions. Mites were recovered Thirty (62.5%) of the 48 human contacts showed
from 100% of the skin scrapings of 30 infested cats. lesions simulating those of scabies, although N. cati
Out of the 30 Notoedres scabies-infested cats, 16 could be recovered from 15 (50%) of 30 skin scrapings.
The magnitude of this finding is a singular observation
as there is no comparable information in the medical
TABLE 2. Distribution of Sites of Lesions in 15 People literature. The contacts were mostly women who were
in Contact With Infested Cats
concerned with looking after the cats. They, more often
Sex Distribution of than the men, would hold the cats or play with them.
Lesions It has been reported that mites spread by direct contact
and human exposure results from intimate contact.^"
Sites of Lesions Men Women Total
A high infestation rate (85.71%) oi Notoedres scabies
Face 0 (0) . 1 (11.11) 1 (6.67) , in caits was observed in the present study. Cats maintain
Fingers 1 (16.66) 1 (11.11) 2 (13.33) large colonies and live loosely. The colony size also
Hands 1 (16.66) 1 (11.11) 2 (13.33) increases very quickly owing to prolific breeding. As
Thighs 1 (16.67) 1 (11.11) 2 (13.33)
Legs 1 (16.67) 0(0) 1 (6.67)
such, once a cat is infested in a particular family, the
Hand and legs 1 (16.67) 3 (33.34) 4 (26.67) disease may spread rapidly, leading to a high infestatiori
Face, hands^ and legs 1 (16.67) 2 (22.22) 3 (20.00) rate.*
Total 6 (100.00) 9(100.00) 15 (100.00)
Mites could be recovered from 50% of the skin
specimens examined. A similar observation has been
Figures in parentheses indicate percentage. reported in cases of buffalo sarcoptic scabies in
648 INTERNATIONAL JOURNAL OF DERMATOLOGY December 1986 Vol. 25

It also has been reported that sarcoptic mites are not
always recovered from human scabies of animal origin
(A. Fain, personal communication). Notoedres mites
were recovered from 100% of the skin specimens of
infected cats. The highest incidence of scabies
(33.32%) occurred in the age group 26-35 years old,
followed by the 16-25-year age group (26.67%). Peo-
ple of this age group were engaged in care and man-
agement of the cats.
Lesions on the hands and legs together were most
common (26.67%). Lesions on the face, hands, and
legs together were next in frequency (20.00%). Lesions
in the finger webs arid genitalia, common in human
scabies, were not observed. Such a pattern of distri-
bution of lesions was observed in a case of human
sarcoptic scabies from water buffalo.'^
The human lesions healed within 2 weeks when pa-
tients were free from exposure to cats. It has been
reported that human skin lesions heal spontaneously
in 7 to 10 days if the human patients are removed far
from the contact with the infested pets.^"*
Comments
The disease described in this report is a self-limiting,
transient infestation characterized by papulovesicular
lesions with intense pruritus. Burrows are absent. Mites
(N. cati) cannot complete their life cycle in aberrent
hosts such as man. The lesions develop because of
hypersensitivity to acarine bite. There is no specific
distribution of lesions. Lesions are abundantly seen in
exposed parts ofthe body. Lesions in human contacts
subside within 2-3 weeks, when the exposure with
the infested cats is prevented.
References
1. Bagnall B, Rook A. Arthropods and the skin. In: Rook A. Recent
Advances iri Dermatology. New York: Churchill-Livingstone,
1977;4:60-90.
2. Beesley WN. Arthropod, oestridial, myiases and acarines. In:
Soulsby EJL. Parasitic Zoonoses. New York: Academic Press,
1974)359-368.
3. Pillsbury DM, Shell WB, Kligman AM. Dermatology. Philadelphia:
WB Saunders, 1963,1055-56.
4. Thornsett LR. Mite infestations of man contracted from dogs
and cats. Br Med ). 1968;3.93-95.
5. Nesvadba J. Notoedric mange as a parasitological, public health
and economic problem. Acta Universatatis Agriculturea Brno,
Facultatis Veterinaria 1967;36:521-526.
6. Ito K, Ho Y, Kondo S, et al. Animal scabies in humahs. Bull
Pharmacological Resch Inst. 1968;77:1-3.
7. Haufe U, Meyer D, Hafe F. Katzen scabies bein Menschen her-
vorgerufen durch eine an Sarcoptesraude and Trichophyte
erkrankte katze. Dermatol Wochenschr. 1966;152:977-978.
8. Chakrabarti A, Chowdhury MN. Survey of the incidence of
mange in domestic animals in West Bengal (India). Indian Vet
MedJ. 1984,8:39-48.
9. Sen SK, Fletcher TB. Veterinary Entomology and Acarology for
India. New Delhi: Indian Council of Agril. Research, 1962;517-
542.
10. Sulzberger HM, Kaminstein S. Dermatology—Diagnosis and
Treatment. Calcutta: Oxford Publishing, 1936, 110-114.
11. Chakrabarti A, Datta AK, Mondal SB, et al. Transmission of sca-
bies from goats to human subjects. Indian J Dermatol. 1980;25:
7-13.
12. Chakrabarti A, Chatterjee A, Chakrabarti K, et al. Human scabies
from contact with water buffaloes infested with Sarcoptes
scabiei var. bubalis. Ann Trop Med Parasitol. 1981,'75:353-
357.
13. Kutzer E, Crunberg W. Zur Fraze der Ubertragung tierischer
Sarcoptesrauden auf den Menschen. Berl Munich tierarztl
Wschr. 1969;82:3n-314.
14. Muller GH, Kirk RW. Small Animal Dermatology. Philadelphia:
WB Saunders, 1976;675-677.

Phytophotodermatitis
Phytophotodermatitis is a characteristic dermatitis induced by exposure to plants containing
light-sensitizing compounds followed by exposure to certain activating wavelengths of ultraviolet
light. One class of phdtotoxic skin sensitizers is the furanocoumarin compounds found in various
plants including celery, parsnips, figs, parsley, and citrus fruits. These compounds are phytoalexins,
chemicals produced by plants as a response to plant disease or injury, and likely contribute to
plant disease resistance.
Human illness from contact with these chemicals has usually been reported in field workers
after contact with celery infected with Sclerotinia sclerotiorum, a common plant fungus. One
outbreak has recently been reported in children cutting and playing with limes at a day camp.
Two previous outbreaks have suggested that this rash also occurs in grocery workers and one
outbreak suggested but did not confirrh that exposure to unpackaged celery might be a risk factor.
.We report an extensive outbreak of phytophotodermatitis that occurred in grocery workers.
This outbreak permitted assessment ofthe role of healthy, uninfected celery in producing disease
as well as the magnitude of the problem in exposed grocery workers.—Berkley SF, Hightower
AW, Beier RC, et al. Dermatitis in grocery workers associated with high natural concentrations of
furanocoumarins in celery. Ann Intern Med / 986; 7 05:35 7-355.