7.5.4.1: Impetigo

Impetigo is a common skin infection caused by bacteria. Lesions can be small, red, fluid-filled blisters or red with yellow crusting. When children or staff have lesions that look like impetigo, early care and education programs should:^1–2

• Wash the affected skin areas and cover lesions with a dressing 
• Practice good hand hygiene 
• Clean and sanitize toys, surfaces, or equipment the infected staff or child has touched
• Wash contaminated clothing or sheets
• Tell the family/guardian, and encourage the child or staff to see their health care provider
  

Children or staff with impetigo may stay in the program until the end of the day as long as lesions can be covered. No exclusion is needed if they start medical treatment before they return to the program and lesions are covered while at the program. Children and staff in close contact with an infected person should watch for symptoms of impetigo and be evaluated by a health care provider if they develop symptoms. The local health department should be told if several children develop impetigo.^1–2

RATIONALE

Impetigo is a skin infection caused by bacteria that commonly live on the skin. It is common among young children whose hand hygiene may not be adequate and is caused when the bacteria enter the skin through a sore or opening. The bacteria may spread from contact with another person with impetigo lesions, from sores on one’s own skin on a different part of the body, or from contact with surfaces that have bacteria. Programs should document when children or staff have been infected with impetigo, and parents/guardians of the child should be told to get medical care. When there is an impetigo infection within the program, careful hand hygiene and sanitizing surfaces and objects that have been touched by the infected person are the best ways to prevent spread.¹

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.6.1.1 Inclusion/Exclusion/Dismissal of Ill Children
Appendix A: Signs and Symptoms Chart

REFERENCES

1. American Academy of Pediatrics. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Aronson SS, Shope TR, eds. 5th ed. Itasca, IL: American Academy of Pediatrics; 2020
2. American Academy of Pediatrics. Section 2: Recommendation for care of children in special circumstances; children in group childcare and schools. In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2021 Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics; 2021:128. 

NOTES

Content in the standard was modified on 7/05/2022.