“Super plague every summer”: the infection that spreads among children

Nadav (pseudonym) initially did not attach special importance to the wounds that appeared on his little daughter’s butt. However, within a short time the lesions spread to other areas of the body until a large wound appeared on the nose. After that the family found out that it was impetigo – a very contagious bacterial skin infection that is especially common among children. Dermatologists now warn of an increase in cases towards the summer, and explain how to identify the disease, why it tends to return again and again – and how to prevent re-infection.

“Impetigo is a super plague every summer,” says Dr. Efrat Bar-Ilan, a dermatology specialist and senior general pediatric dermatologist in the Dan district – Petah Tikva. “During this period, children wear short clothes, go to pools, and there is more skin-to-skin contact, which makes it easier to get infected.” The skin may allow bacteria to penetrate and cause infection. “Not a day goes by that I don’t meet a few children with impetigo in the clinic,” she adds, “and we also see cases that get complicated and end up in the hospital.”

“The sores can appear almost anywhere on the body, but they are usually concentrated around the nose, face, or in an area where there was a previous injury, such as a bite or scratch,” explains Dr. Bar-Ilan. “The classic characteristic of impetigo is a honey-colored scab.” According to her, the disease is most often caused by the Staphylococcus aureus bacteria, and a significant proportion of children carry it in their nostrils without developing symptoms. “They are not sick, but they can to infect others – and sometimes also themselves,” she says.

According to her, one of the reasons why the infection tends to return is self-infection, re-infection in kindergarten or school, antibiotic treatment that has not been fully completed or bacteria that have developed resistance to antibiotics. “Parents come to me and say: ‘Save the child, this is the third time he has been infected in the last few months,'” she says. “Sometimes the treatment is not given for the recommended time, and sometimes it is a resistant bacteria that requires the adjustment of another treatment.”

In mild cases, the treatment usually includes a local antibiotic ointment and the use of antiseptic soap, but in more extensive cases, a combination of oral antibiotics is necessary. In more severe cases, when the infection spreads and does not respond to treatment, hospitalization and intravenous antibiotics are also required. “This happens mainly in children who suffer from atopic dermatitis, but not only,” says Dr. Bar-Ilan.

When the disease recurs again and again, Dr. Bar-Ilan recommends performing a swab and culture from the nostrils to check for carriage of the bacteria. “This is a very simple test,” she explains. “If carriage is detected, you can treat the nostrils with an appropriate antibiotic ointment twice a day for 10 to 14 days, thus reducing the risk of the disease recurring.” According to her, in repeated cases it is recommended to consult a dermatologist for clarification and to adjust a more precise treatment.

An increase is also reported in the north of the country. “In the last month we are seeing more cases of the disease, and every day several children arrive with the infection,” explains Dr. Fuad Abu Riya, a specialist in general dermatology in the Haifa and Western Galilee district. According to him, one of the reasons for this is the bathing season. “In the summer, children are more in pools and in shared activities, which increases the risk of infection,” he explains.

Dr. Abu Riya also warns that scratching may worsen the situation and lead to the spread of the infection in the body. “Children scratch the wounds and transfer the bacteria from place to place. That’s why you can see lesions on the face, limbs and different areas of the body.”