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Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
IMPETIGO 
 
Impetigo is a very common skin infection caused 
by streptococcal or staphylococcal bacteria.  It 
may start at an injured spot on the skin, such as an 
insect bite, cut or burn.  Bacteria can easily be 
spread by the person’s hands to other areas of the 
body.  In children, the face is often involved.  The 
rash appears red, is elevated and may secrete fluid.  
The rash may have a flat honey-colored crust.  The 
area may be itchy.  The staph bacteria can cause 
blisters that break easily and leave raw r ed skin 
exposed.  Impetigo caused by strep bacteria can be 
associated in very rare circumstances with the 
development of a kidney disease.  Impetigo is 
most commonly seen in the warm summer 
months. 
 
Who gets this disease? 
Ordinarily the skin protects the body from 
bacteria.  When the skin is broken (i.e., cut, 
scraped, bitten, scratched), bacteria can get under 
the surface, multiply and cause an infection. 
 
Children – who typically touch everything and 
wash only under duress – are likely to have 
multiple cu ts and scrapes on their bodies at all 
times, which make them more vulnerable to 
impetigo than adults.  Most children have 
impetigo at least a few times during their growing 
up years; adults can get it as well. 
 
How is it spread? 
The bacteria are under, on and in the infected skin, 
and they are shed into the secretions and crusts.  
They can be spread to another person who directly 
touches the infected skin or a surface 
contaminated by the secretions or crusts.  If the 
bacteria then gets under the top protect ive skin 
layer of the second person, they multiply and 
cause infection. 
 
The incubation period for this disease is variable:  
Staph infections 4- 10 days, Strep infections 1- 3 
days. 
 
How is it diagnosed and treated? 
Most of the time, impetigo can be diagnos ed by 
the way it looks.  Bacterial cultures are not usually 
needed.  Strep and staph impetigo may look the 
same, although staph tends to cause blisters more 
often. 
 
How can the spread of this disease be 
prevented? 
1. If children hurt themselves and cause 
breaks in the skin, wash the area 
thoroughly with soap and water and dry 
carefully. 
2. If you think a child may have impetigo: 
a. Wash the rash with soap and water 
and cover it loosely with gauze, a 
bandage, or clothing. 
b. Be sure anyone who touches the 
rash wears dis posable gloves 
carefully. 
c. Dispose of any soiled tissues, 
bandages and gloves carefully.  
Keep any dirty clothing in a plastic 
bag and give to the parent for 
laundering at home. 
3. Ask the parents to have the child seen by 
his/her healthcare provider. Keep 
children’s finger nails short as to prevent 
damage from scratching.  
 
Who should be excluded? 
It is recommended that untreated children and 
staff be excluded from the childcare facility until 
24-hours after they have begun treatment. 
 
Reportable? 
No.  Impetigo is not reportable by New Hampshire 
law to the Division of Public Health Services, 
Bureau of Infectious Disease Control .  However, 
Public Health Professionals are available for 
consultation at (603) 271-4496.