What is Impetigo?

Impetigo is a bacterial skin infection often found on the face, bottom and hands caused by “streptococcus and Staphylococcus aureus AKA: staph” bacteria. It is commonly known as “school sores” because a majority of cases are in school-aged children. However, it can also affect infants, adults and adolescents.

Uncomplicated Impetigo does “not” cause permanent damage to the skin, but is “HIGHLY contagious.

What does it look like?

“Impetigo can easily be misdiagnosed on first glance as Hand Foot & Mouth or even Herpes”.

Impetigo occurs in two forms, blistering and crusted. In Blistering Impetigo the blisters arise on previously normal skin, and “rapidly” grow in size and number. The blisters quickly burst and leave slightly moist or glazed areas with a brown/yellow crust at the edge. The spots expand even after they break open and can be many centimetres wide. They sometimes clear in the centre to produce ring shaped patterns. They are “not” usually painful, but can be itchy.

Impetigo usually appears around the nose, mouth, and other parts of the face. It can also appear on any skin not covered by clothes, such as arms and legs. Impetigo may even appear on the groin or buttocks.

• In severe cases of impetigo there may be swelling of the lymph glands in the face or neck, severe pain, worsening redness, weakness and fever. “Consult your physician immediately”

Crusted Impetigo has a thick soft yellow crust. Beneath this crust is a moist red area. Crusted Impetigo spots grow slowly and are always smaller than the fully developed spots of blistering Impetigo. They are “not” usually painful, but can be itchy.

Impetigo can occur on top of other skin conditions, particularly itchy ones. When the skin is scratched the infection can enter through the broke skin. Some of these conditions are atopic dermatitis “eczema”, scabies, insect bites and head lice.

In cases where a larger area of skin is affected, patience may also have a fever, swollen lymph nodes or feel generally unwell.

How is it diagnosed?

Your doctor may diagnose impetigo based on a visual inspection of the blisters/sores, or by taking a swab to test for bacteria and check which antibiotic to use. The result of the swab takes several days.

How is it treated?

Depending on how bad the infection is, your doctor may recommend the use of an antibiotic ointment or oral antibiotics in severe cases. Antibiotic ointment should be continued until the sores have completely healed. If oral antibiotics are given it is important to finish the whole course of treatment “usually 5 days” and not stop when the impetigo starts to clear. “The blemishes may vanish but the bacteria may remain”.

Sores should be cleaned every 8-12 hours “Soap and Water”, dried thoroughly and covered with a waterproof dressing. Bathing the blisters with salty water will help to dry them out “use saline solution or dissolve about half a teaspoon of salt in a cup of water”.

How is it Spread?

Impetigo is very easy to catch from other people! Impetigo is usually spread through direct contact with other infected people.

The Bacteria primarily enters through damaged skin. People with conditions causing long term damage to their skin, such as eczema or atopic dermatitis, are at greater risk of infection.

How can you avoid spreading the infection?

“While you have the infection”:

• Sores should be kept clean and covered with a waterproof dressing to prevent them being touched or scratched.
• Used dressings should be placed in a sealed bag and put in the garbage bin as soon as they are removed.
• Hands should be washed thoroughly with soap and running water for 10-15 seconds after sores are touched or redressed.

Children with impetigo should be kept home from school or other group settings if their wounds cannot be kept covered until 24 hours after antibiotic treatment has been started, or until the blisters have dried out if antibiotics are not used.

Bedding “Pillow Cases” should be changed and washed each day.

To Prevent Impetigo children should be taught:

• To wash their hands often with soap.
• Not to scratch scabs or pick their nose.
• Not to share their clothes, towels, pillowcases, or toothbrushes
• To have scratches and cuts cleaned and covered

Parents should be careful not to allow items such as clothes, towels, bed sheets, razors or toothbrushes used by the affected person to be used by others. Other grooming items, such as nail scissors or tweezers, should be disinfected / washed thoroughly after each use.

School and Childcare Impetigo Prevention.

In addition to general hygiene measures, specific measures to prevent spread in schools and childcare include”

• Teachers, children and families should understand the importance of hand washing, covering sores and staying home if sick.

Hand washing products “soap dispensers, running water and paper towels” should be available and accessible.

Activities should allow time for hand washing as part of routine practice “before eating and after going to the toilet”

Temporary exclusion from child care or school if their wounds cannot be kept covered until 24 hours after antibiotic treatment as been started, or until the blisters have dried out if antibiotics are not used.

Surfaces such as counters, desks and toys that come in contact with uncovered or poorly covered infections, should be cleaned daily with detergent, and whenever visibly contaminated.

Impetigo “is” dangerous for babies!

It is important for people with Impetigo to keep away from newborns and young babies. Newborn babies are particularly susceptible to impetigo and because their immune systems are not fully developed. This can lead to serious complications, if you suspect your newborn has Impetigo see your physician immediately.

In severe cases of impetigo there may be swelling of the lymph glands in the face or neck, severe pain, worsening redness, weakness and fever. If you or your child has these symptoms, see your physician immediately.

What is the public health response?

Impetigo does “not” need to be reported to Alberta Health Services. Public health units can advise on the control of outbreaks. Schools and Childcare settings must notify parents of students who have potential to contract Impetigo, Parents, Guardians and care givers should be made aware of signs and symptoms and treatment methods that are available to prevent the spread.

Group A streptococcal infection may lead to other rare conditions such as acute post-streptococcal glomerulonephritis 3-6 weeks after the skin infection, which is associated with antibodies produced to fight streptococcal infection. “Consult your physician”

• In communities in “Australia” that have cases of rheumatic heart disease, episodes of acute rheumatic fever are thought to be triggered by impetigo as well as by throat infections with group A Streptococcus. In those communities prompt treatment and control of impetigo is an important part of preventing rheumatic heart disease.

We never know what can happen, its always good to be prepared and have the knowledge we need to help those who need it.

“This material is for information purposes only and is taken from The Canadian Red Cross / Alberta Heart & Stroke Foundation & Alberta Health Services. This information should not be used in place of medical, Technical advice, instructor, and/or treatment. If you have questions, speak to your local Physician or Safety Training Facility.”

Just Remember:

Protect Yourself!!! Call 911!!! Don’t Waste Time!!!

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