Scabies Cases in Flanders Stabilize After Years of Increase

After more than a decade of continuous increase, the spread of scabies in Flanders is finally stabilizing, according to new research from Belgium’s national health institute Sciensano, the Institute of Tropical Medicine (ITG), and the Flemish Department of Care. The findings, reported by VRT NWS, offer a measure of relief after years of rising infection rates across the region.

Context

Scabies, also known as scabiës or schurft, is a contagious skin condition caused by the scabies mite (Sarcoptes scabiei). The mite burrows into the upper layer of the skin, creating tunnels where it lays eggs, triggering an allergic reaction that causes intense itching—particularly at night. The condition spreads through prolonged skin-to-skin contact or contact with contaminated bedding and clothing, and it is not related to poor hygiene.

Once considered nearly eradicated in Western Europe, scabies has made a significant comeback in recent years. Between 2011 and 2023, Flanders experienced an estimated 15% annual increase in primary care presentations for the condition, with a notable spike occurring in 2020 during the COVID-19 pandemic.

Key Developments

According to the research, the upward trend has been slowing since 2023, and infection rates now appear to be leveling off. The stabilization follows a large-scale prevention campaign launched by the Flemish Department of Care in 2024 under the slogan “Schurft is niet schattig” (“Scabies is not cute”), which aimed to inform the public about symptoms, encourage medical help-seeking, and reduce stigma.

The full research report, titled “Combined perspectives from people affected by scabies and healthcare workers: a mixed-methods study in Flanders, Belgium — PUBLIC REPORT,” was published on Zenodo on March 17, 2026. The mixed-methods study collected data from 83 healthcare providers across 96 medical practices and 115 people affected by scabies via an online survey, supplemented by in-depth qualitative interviews with 11 patients and 33 care providers across five Flemish cities: Antwerp, Bruges, Ghent, Leuven, and Hasselt.

The research revealed that scabies is more commonly diagnosed among young people and young adults aged 15–24, men, and residents of urban areas.

Analysis

The study, conducted by the Institute of Tropical Medicine in collaboration with Sciensano and the Department of Care, highlights that scabies poses a complex healthcare challenge with significant gaps in care delivery. Patients experience not only physical symptoms but also profound psychological and social impacts that extend well beyond clinical cure.

Key findings indicate that people affected by scabies experience acute psychological distress during infection and chronic effects—including hypervigilance, anxiety, and disrupted sleep patterns—that persist after treatment. Social impacts such as isolation and work-related limitations are also common. Healthcare providers reported challenges including difficulties in clinical diagnosis, outdated knowledge on scabies epidemiology, inconsistent treatment guidelines, and unclear environmental decontamination measures.

The research also pointed to disparities in how quickly healthcare providers suspect and refer scabies depending on the patient’s social background.

Study Recommendations

The report made several key recommendations:

• Integrate environmental and psychosocial support into scabies care
• Standardize diagnostic approaches by training general practitioners on dermatoscope use
• Train healthcare providers on updated clinical guidelines and current epidemiology
• Supply healthcare providers with easy-to-read patient information materials

The Department of Care has already taken steps in this direction with its 2024 prevention campaign, which includes posters, informational folders, and online resources with step-by-step treatment plans.

What’s Next

The stabilization of scabies cases represents a positive public health development after more than a decade of increase. The fact that the trend began to slow in 2023—before the major prevention campaign—suggests that multiple factors may be contributing to the turnaround, including increased awareness among healthcare providers and the general public.

However, challenges remain. The study recommends integrated care approaches that address the full scope of patient needs through evidence-based diagnostic, treatment, and environmental management protocols, as well as psychosocial support. Continued monitoring will be needed to confirm whether the stabilization becomes a sustained decline, and the effectiveness of the 2024 prevention campaign will require further evaluation.

As scabies continues to re-emerge across Europe, the Flemish experience offers valuable lessons for other regions facing similar public health challenges. Healthcare systems that can successfully adapt to meet these comprehensive needs will be better positioned to manage not only the current scabies resurgence but also future public health threats requiring similarly integrated responses.