Seasonal variation in scabies

Sir, The article on scabies epidemiology by Mimouni et al.1 is an incomplete account of the literature on the subject. Besides the two studies cited in this article, five other studies have documented an increased incidence in the winter in comparison with the summer.2–6 All these studies covered large sample sizes and collected data over many years. One was even on the same Israeli military population used in this article.3 Our article on the epidemiology of scabies in a U.K. population plotted specific consultation rates between 1967 and 1994.2 A higher incidence for scabies in the winter compared with the summer was seen in the 0–4, 5–15 and 15–44 years age groups, but not in older age groups. Sexually transmitted disease (STD) rates in the U.K. mirrored general practice rates between 1971 and 1983 (time frame of only available STD data). There is little evidence other than coincidence to support the hypothesis that sexual promiscuity has anything to do with scabies transmission.