Zoster transmission is a much more likely culprit in an institution then scabies. Since both, Varicella Zoster and Herpes Zoster are fomites transmissible and therefore can be spread on clothing. I have seen outbreaks in which the subsequent patient developed symptoms as far away as separate buildings on. It s not uncommon in adults to skip units and floors. Who gets it and how it manifests itself depends on prior exposure history and current immune status. If any vesicle formation occurs, you should evaluate for zoster. To complicate matters people with lowered mental status have a tendency to scratch and change the rash pattern due to trauma before initial assessment and diagnosis.
When you think scabies think more of ticks then lice. It is much more common to pick up ticks from outdoors and close intimate (sexual contact) then from casual contact. Since I always have problems with identifying rashes, I use the DERM IS website (http://www.dermis.net/index_e.htm
) to compare rashes when trying to identify them. This website is available in English, German,, French, Spanish and Portuguese. A portion of the DermIS website description for scabies:
"Contagious disorder caused by the mite Sarcoptes scabiei, which attacks infants and children as well as adults. Scabies is transmitted in the course of close physical contact, e.g. during sexual intercourse, as well as in camps and between children under unsanitary living conditions. Transmission by means of underwear or linen is rare
. . ."
Most states have workers compensation web pages and links to the actual regulations. I hope yours does. If you do have trouble finding it out, you are welcome to PM me confidentially your location and I will try some resources I have through my professional memberships.