The dilemma of whiplash

BACKGROUND: Scabies is not a notifiable disease in most countries. Thus, the reported rates of the disease in large populations are usually inaccurate and based on estimations. Scabies is usually reported only when large outbreaks occur. OBJECTIVE: This article describes the global epidemiology of scabies in the Israel Defense Force. The data used in this study are based on the routine and mandatory reporting of every individual case of scabies to the Army Health Branch Epidemiology Department since 1968. RESULTS: There was a period of 13 years of quiescence from the implementation of reporting in 1968 until 1981. This period was followed by an epidemic of 15 years, peaking in 1985 and 1986, and returning to the baseline rates of the quiescent period by 1996. This prospectively observed pattern of at least 13 years of quiescence followed by a peak of 15 years is consistent with other, mostly retrospective, reports. Although the peak may have been triggered by the "Lebanon" war of 1982, it is noticeable that no peak was observed during the "Yom Kippur" war (1973). CONCLUSIONS: Prospective, mandatory reporting of the kind described here should help to better understand the epidemiology of scabies.