Eurosurveillance - Volume 30, Issue 47, 27 November 2025

Scabies is a skin disease caused by the mite Sarcoptes scabiei, resulting in intense itching and rash, and sometimes secondary infections with complications. Scabies is not typically a notifiable disease, which makes estimating its burden of disease challenging. In recent years, sharp increases have been reported in Europe.

This study characterises scabies epidemiology in Spain from 2011 to 2023.

This retrospective study triangulated data from primary care, hospital admissions, occupational diagnoses and outbreaks. Annual incidence rates (IRs) were calculated to assess temporal evolution, demographics and geographic distribution. Joinpoint regression identified IR changes, and time-series analysis explored seasonality. Occupational and outbreak data analysis identified high-risk activities and settings.

Incidence rates increased across all data sources, with marked acceleration from 2020–21. The greatest rise was seen in primary care (annual percentage change rose from 22.8% (95% CI: 7.2–31.9) in 2011–20 to 65.8% (95% CI: 47.5–96.6) in 2020–23). The IR was highest amongst 15–24-year-olds. Hospitalisations, with highest IR among people > 65 years, peaked each January. Occupational diagnoses were predominantly registered in healthcare settings (82.0%). Islands and northern coastal regions were most affected. Outbreaks were most frequent in households and nursing homes, with largest outbreaks in healthcare settings.

Given the increasing incidence of scabies in Spain, a strong response is needed to improve prevention, diagnosis, and treatment. Improved surveillance and targeted public health initiatives could mitigate further spread, as well as further research to better elucidate the mite-related and epidemiological factors that underline the recent increases across Europe.

HIV screening strategies in alternative settings, such as emergency departments (EDs), aim to increase diagnosis of occult infections and achieve 95–95–95 targets for 2030.

To assess the effectiveness of an opt-in HIV screening strategy in EDs based on six clinical scenarios from a 2020 Spanish consensus document, while examining patient characteristics and linkage to-care.

This descriptive, multicentre, retrospective study analysed epidemiological, clinical, and linkage-to-care data of individuals aged ≥ 18 years newly diagnosed with HIV between July 2021 and March 2024 in 17 EDs covering 73% of the population in Catalonia, Spain.

From 23,105 HIV serologies performed, there were 172 new diagnoses (positivity rate: 0.7%). Of these, 88.4% (152/172) were assigned male at birth, had a median age of 39 years (IQR: 30–50), and 47.9% (81/169) were Spanish. Sexual transmission was reported in 75.6% (130/172) of cases, with 55.5% (81/146) heterosexual. Fiebig stage data, available in 78.5% (135/172) of cases, showed 57.8% (78/135) had acute infection. Advanced HIV was found in 24.2% (30/124). Diagnoses related to the six clinical scenarios accounted for 54.6% (94/172) of cases. For all new diagnoses, 82.0% (137/167) were linked to specialised healthcare and started antiretroviral treatment within 9 days (IQR: 4–17), with no significant differences regarding urban/rural hospital coverage areas.

An opt-in HIV screening strategy in the ED is feasible and effective, especially in detecting highly transmissible patients with acute infection. However, one in five newly diagnosed individuals remained untreated, highlighting the need for improved linkage to care.