Three Kindergarten Children Contract Scalp Ringworm From Cat Feces in Sandbox

Three children attending a kindergarten in northern Israel contracted scalp ringworm (tinea capitis) after exposure to cat feces found in the sandbox. The first case involved a six-year-old girl named Noya (a pseudonym), whose mother noticed unusual patches on her scalp about two weeks ago. Initially mistaken for sun fungus, the condition worsened with hair loss, prompting a dermatologist visit where a scalp sample confirmed ringworm infection. Subsequently, two other children from the same kindergarten were also diagnosed with the fungal infection.

The mother suspects the source of infection to be the sandbox, where cats reportedly defecate. According to the kindergarten assistant, cat feces are collected with a plastic bag, but the sand is only replaced during the summer break. Noya has begun medical treatment including antifungal medication and special shampoo, but the infection causes itching, discomfort, and hair loss, affecting her confidence.

Dr. Eran Cohen-Barak, head of pediatric dermatology at Emek Medical Center, explained that scalp ringworm is a fungal infection historically treated with radiation but now effectively managed with oral antifungal drugs over four to eight weeks. He noted that infection can occur through contact with cats or dogs, especially if the animals defecate in sandboxes or come into contact with children’s heads or hands. The disease remains common, with dozens of cases diagnosed weekly.

Dr. Cohen-Barak warned that delayed diagnosis can lead to severe inflammation and permanent scarring of the scalp, potentially causing irreversible hair loss. Laboratory tests can take weeks, during which transmission risk remains. However, once treatment starts, contagion risk drops significantly within days, and children do not need prolonged absence from school. External treatments alone are often insufficient, as the fungus tends to recur without oral medication.

This incident highlights the importance of proper sandbox maintenance and awareness of zoonotic infections in childcare settings to prevent outbreaks of scalp ringworm among young children.