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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. | |