Vivalis's health bulletin for October 2026 indicates that scabies has become the most declared pathology in the Brussels Region, surpassing STEC, whose declarations appear to be stabilizing. Shigellosis cases continue to decline, possibly due to the end of the holiday return period. Furthermore, a slight increase in mpox cases is observed. Two invasive meningococcal infections were also declared, highlighting the importance of an up-to-date vaccination status. Invasive Streptococcus pyogenes (iGAS) infections are making their seasonal return with three cases in residential and care facilities (MRS), two of which were in the same establishment, requiring increased attention to hygiene measures.
Scabies, while bothersome, is not serious and is treatable. After a significant rise in Belgium between 2011 and 2023, recent data show stabilization. Transmission occurs through prolonged skin-to-skin contact and can affect anyone. Management recommendations have recently been updated by the WOREL group and are now included in the BAPCOC 2026 guide.
Four treatments are available: permethrin 5%, benzyl benzoate 25%, local ivermectin 1%, and oral ivermectin. Oral ivermectin is often the most realistic solution in collective settings, barring contraindications. Permethrin must remain on the skin for 8 to 12 hours and be repeated on the eighth day. Since June 2025, oral ivermectin has been reimbursed in category b, reducing its cost.
Environmental measures are essential: textiles in contact with the skin in the 3 days preceding treatment must be washed at 60°C or isolated for 72 hours. The household and close contacts should be treated simultaneously with the index case. Scabies is subject to mandatory declaration in case of a cluster within a collective setting, allowing the Vivalis Preventive Medicine Cell to assist with management.
