I don't think you really have anything to worry about here. According to the Centers for Disease Control (CDC), and this is consistent with any other factual websites you can find on Scabies, these mites are "spread by direct, prolonged, skin-to-skin contact with a person who has scabies". The mites simply do not fall off a person and wander around in a room. However.........the CDC goes on to say that it is "possible" for scabies mites to be transferred from an infected person simply with a handshake if that person has the scabies on his hands. Off of the host these mites cannot survive more than a couple of days, so transmission from the general environment would only be possible if you spent time in contact with fabrics or other surfaces that an infected person might have very recently been resting on as well, where the mites may have been dislodged and were still alive when you contacted that surface.
The most contagious form of scabies is called "Crusted" scabies, or Norwegian Scabies, and it refers to a severe condition where the infected person is particularly prone to infection and may have thousands of the mites on him. He develops severe skin reactions to the mites and in turn may be more likely to shed the mites when contacting surfaces or someone else, such as a handshake when the hands are infected in this manner. Thus, it becomes important to know if your exposure was to this form of the problem.
I tend to believe that there are far more diagnoses of "scabies" than there really are scabies infections, as many times people have told me they had scabies and it was diagnosed purely by visual observation of rashes or bumps on the skin. A positive diagnosis requires a skin sample that is then examined under a microscope, as these mites burrow under the top layer of the skin. Too many other causes exist for skin rashes and itchy bumps for a simple quick look to be adequate, given the importance of an accurate diagnosis. It also is a consistent message that insecticides should not be sprayed for scabies mites, as they really do little to control any problem and vacuuming and laundering of fabrics (towels, sheets, blankets, clothing, etc.) that might have mites on them are effective.
The CDC stresses repeatedly that it is only "crusted" scabies that is the real concern with picking up the mites by quick contact with someone or contacting materials in that person's environment, such as their bed or a chair. I would do a little more to find out from this customer what form of the scabies they have. I would avoid challenging the doctor's opinion on whether or not it was diagnosed properly, because this will get you nowhere. As so many health professionals do today it might be appropriate to begin your visit to a bed bug job while wearing disposable gloves. This may make that handshake with the customer more impersonal, but hopefully they will understand. It may be appropriate to have a short interview to ask about such concerns as scabies before you get started, and perhaps ease the tension by relating that you knew another technician who was exposed to this and are just making sure.
But, basic precautions you would take to keep from bringing bed bugs home with you should be adequate for keeping scabies off of you as well. I suppose we have to accept that in these days there are environmental hazards in society, and the seat you choose at the local theater to watch a movie might just have been the seat someone infected with scabies sat in 30 minutes earlier. We can't lock ourselves in padded rooms but we do what is necessary to monitor our health.
Mr. Pest Control
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