Doctors Warn of Summer Surge in Contagious Skin Infection Among Children

Dermatologists across Israel say cases of impetigo are rising with the start of summer and the swimming season. The bacterial skin infection spreads quickly through direct contact, can recur if not treated properly, and is especially common in children. In one example, a family initially dismissed small sores on a young girl’s bottom, but the lesions soon spread and developed into a large wound on her nose before the diagnosis was made.

Dr. Efrat Bar-Ilan, a senior pediatric dermatologist at Clalit in the Dan-Petah Tikva district, said, "Impetigo is a super scourge every summer." She said lighter clothing, pool visits and more skin-to-skin contact make transmission easier. Children with atopic dermatitis are at higher risk, but insect bites, scratches and minor skin injuries can also let the bacteria in. She added that she sees several cases almost every day and that some become severe enough to require hospitalization.

Bar-Ilan said the classic sign is a honey-colored crust, and the sores can appear almost anywhere, often around the nose, on the face or at the site of a prior injury. The infection is usually caused by Staphylococcus aureus, and many children carry it in their nostrils without symptoms, while still being able to infect others or themselves. Repeated infections can stem from self-inoculation, reinfection in kindergarten or school, incomplete antibiotic treatment, or antibiotic resistance. Mild cases are treated with a topical antibiotic ointment and antiseptic soap, more widespread cases may need oral antibiotics, and severe spreading cases may require hospital care and intravenous antibiotics.

For recurring illness, Bar-Ilan recommends a nasal swab and culture to check for bacterial carriage. If carriage is found, doctors can treat the nostrils with an antibiotic ointment twice daily for 10 to 14 days to lower the chance of relapse. In the north, Dr. Fouad Abu Ria of Clalit in the Haifa and Western Galilee district also reported more cases in the past month, saying, "Every day several children come with the infection," and linking the increase to swimming pools and group summer activities. He warned that scratching worsens the infection and can spread it to the face, limbs and other parts of the body.