Europe’s most dangerous pathogens: Climate change increasing risks

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Europe’s most dangerous pathogens: Climate change increasing risks

Date:
August 2, 2017
Source:
University of Liverpool
Summary:
The impact of climate change on the emergence and spread of infectious diseases could be greater than previously thought, according to new research.

The impact of climate change on the emergence and spread of infectious diseases could be greater than previously thought, according to new research by the University of Liverpool.

The study, published in Scientific Reports, is the first large-scale assessment of how climate affects bacterium, viruses or other microorganisms and parasites (pathogens) that can cause disease in humans or animals in Europe.

The results will help policy makers prioritise the surveillance for pathogens that may respond to climate change and, in turn, contribute to strengthening climate change resilience for infectious diseases.

Epidemics

There is growing evidence that climate change is altering the distribution of some diseases, in some cases causing epidemics or making diseases spread within their natural range, for example, Zika virus in South America, or bluetongue and Schmallenberg disease in livestock in Europe.

Dr Marie McIntyre, who led the project at the University’s Institute of Infection and Global Health, explained: “Although there is a well-established link between climate change and infectious disease, we did not previously understand how big the effects will be and which diseases will be most affected.

“Climate sensitivity of pathogens is a key indicator that diseases might respond to climate change, so assessing which pathogens are most climate-sensitive, and their characteristics, is vital information if we are to prepare for the future.”

Largest effects

The researchers carried out a systematic review of published literature on one hundred human and one hundred domestic animal pathogens present in Europe that have the largest impact on health.

Nearly two-thirds of the pathogens examined were found to be sensitive to climate; and two-thirds of these have more than one climate driver, meaning that the impact of climate change upon them will likely be multifaceted and complex.

Diseases spread by insects and ticks (vector-borne diseases) were found to be the most climate sensitive, followed by those transmitted in soil, water and food. The diseases with the largest number of different climate drivers were Vibrio cholerae (cause of cholera), Fasciola hepatica (cause of liver fluke), Bacillus anthracis (cause of anthrax) and Borrelia burgdorferi (cause of tickborne Lyme disease).

Future effects

Dr Marie McIntyre, commented: “Currently, most models examining climate effects only consider a single or at most two climate drivers, so our results suggest that this should change if we really want to understand future impacts of climate change on health.”

Zoonotic pathogens — those that spread from animals to humans — were also found to be more climate sensitive than those that affect only humans or only animals. As 75% of emerging diseases are zoonotic, emerging diseases may be particularly likely to be impacted by climate change.

However, the researchers stress that their response to climate change will also be dependent on the impacts of other drivers, such as changes to travel and trade, land-use, deforestation, new control measures and the development of antimicrobial resistance.

Big Data

The top 100 human and animals list was compiled using the Enhanced Infectious Disease Database (EID2), — a comprehensive and open-access ‘Big Data’ record of over 60 million scientific papers, electronic sources and textbooks associated with infectious diseases that was developed in Liverpool.


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Materials provided by University of LiverpoolNote: Content may be edited for style and length.

New light shed on Lyme disease-causing bacteria

Image result for lyme disease infections 2017Prompt removal of ticks can help prevent transmission of Borrelia mayonii

Date:
august 13, 2017
Source:
Entomological Society of America
Summary:
A new species of bacteria that causes Lyme disease needs the same amount of time for transmission after a tick bite compared to previously implicated bacteria, according to new research. Existing guidelines for frequent tick checks and prompt removal of attached ticks remain the same.

A new species of bacteria that causes Lyme disease needs the same amount of time for transmission after a tick bite compared to previously implicated bacteria, according to new research by the Centers for Disease Control and Prevention (CDC). Existing guidelines for frequent tick checks and prompt removal of attached ticks remain the same.

The duration of attachment of a single nymphal blacklegged tick (Ixodes scapularis) needed for the tick to be likely to transmit the bacterial species Borrelia mayonii, identified in 2016, is 48 hours or more, according to the study. By 72 hours, however, likelihood of transmission has risen significantly. This timeframe aligns with existing research on Borrelia burgdorferi, previously the sole bacteria species known to cause Lyme disease in the United States. The research is published in the Entomological Society of America’s Journal of Medical Entomology.

“Our findings show that recommendations for regular tick checks and prompt tick removal as a way to prevent transmission of Lyme disease spirochetes to humans via the bites of infected ticks applies to the newly recognized B. mayonii as well as B. burgdorferi, for which these recommendations originally were developed,” says Lars Eisen, Ph.D., CDC research entomologist and senior author of the study.

The study authors tested transmission rates of B. mayonii from ticks to mice at four time intervals: 24, 48, and 72 hours after attachment and after the tick’s full feed. Their experiment focused on nymphal-stage ticks (the more common source of pathogen transmission, compared to larval or adult ticks) and exposed the mice to a single infected tick each. They found no evidence of transmission by single nymphs infected with B. mayonii in the first 24 or 48 hours, but 31 percent of mice examined after 72 hours were found to be infected. In mice examined after a tick’s complete feed (4-5 days), the infection rate was 57 percent.

“Our findings underscore the importance of finding and removing ticks as soon as possible after they bite,” says Eisen.

Lyme disease is the most commonly reported vector-borne illness in the United States, with around 300,000 people estimated to be diagnosed each year, mostly in the Northeast and upper Midwest regions. The blacklegged tick is the primary vector of Lyme disease as well as at least a dozen other illnesses.

To reduce the risk of tick bites and tickborne diseases, CDC recommendations include:

  • Avoid wooded and brushy areas with high grass and leaf litter.
  • Use insect repellent when outdoors.
  • Use products that contain permethrin on clothing.
  • Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks.
  • Conduct a full-body tick check after spending time outdoors.
  • Examine gear and pets, as ticks can come into the home on these and later attach to people.

The bacterial species B. mayonii was discovered when six patients exhibiting symptoms of Lyme disease at the Mayo Clinic in Rochester, Minnesota, in 2013 showed unusual blood-test results. The discovery of the new species was confirmed in 2016.

“There is much still to discover about B. mayonii, including to clarify the geographic range of this emerging human pathogen in the U.S., to determine how commonly different life stages of the blacklegged tick are infected with B. mayonii, and to find out whether the same vertebrate animals that serve as natural reservoirs for B. burgdorferi play the same role also for B. mayonii,” says Eisen.


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Typhoid fever

Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in industrialized countries. However, it remains a serious health threat in the developing world, especially for children.

Typhoid fever spreads through contaminated food and water or through close contact with someone who’s infected. Signs and symptoms usually include high fever, headache, abdominal pain, and either constipation or diarrhea.

Most people with typhoid fever feel better within a few days of starting antibiotic treatment, although a small number of them may die of complications. Vaccines against typhoid fever are available, but they’re only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or are traveling to areas where typhoid fever is common.

Symptoms

Signs and symptoms are likely to develop gradually — often appearing one to three weeks after exposure to the disease.

Early illness

Once signs and symptoms do appear, you’re likely to experience:

  • Fever that starts low and increases daily, possibly reaching as high as 104.9 F (40.5 C)
  • Headache
  • Weakness and fatigue
  • Muscle aches
  • Sweating
  • Dry cough
  • Loss of appetite and weight loss
  • Abdominal pain
  • Diarrhea or constipation
  • Rash
  • Extremely swollen abdomen

Later illness

If you don’t receive treatment, you may:

  • Become delirious
  • Lie motionless and exhausted with your eyes half-closed in what’s known as the typhoid state

In addition, life-threatening complications often develop at this time.

In some people, signs and symptoms may return up to two weeks after the fever has subsided.

When to see a doctor

See a doctor immediately if you suspect you have typhoid fever. If you become ill while traveling in a foreign country, call the U.S. Consulate for a list of doctors. Better yet, find out in advance about medical care in the areas you’ll visit, and carry a list of the names, addresses and phone numbers of recommended doctors.

If you develop signs and symptoms after you return home, consider consulting a doctor who focuses on international travel medicine or infectious diseases. A specialist may be able to recognize and treat your illness more quickly than can a doctor who isn’t familiar with these areas.

Causes

Typhoid fever is caused by virulent bacteria called Salmonella typhi (S. typhi). Although they’re related, S. typhi and the bacteria responsible for salmonellosis, another serious intestinal infection, aren’t the same.

Fecal-oral transmission route

The bacteria that cause typhoid fever spread through contaminated food or water and occasionally through direct contact with someone who is infected. In developing nations, where typhoid fever is endemic, most cases result from contaminated drinking water and poor sanitation. The majority of people in industrialized countries pick up typhoid bacteria while traveling and spread it to others through the fecal-oral route.

This means that S. typhi is passed in the feces and sometimes in the urine of infected people. You can contract the infection if you eat food handled by someone with typhoid fever who hasn’t washed carefully after using the toilet. You can also become infected by drinking water contaminated with the bacteria.

Typhoid carriers

Even after treatment with antibiotics, a small number of people who recover from typhoid fever continue to harbor the bacteria in their intestinal tracts or gallbladders, often for years. These people, called chronic carriers, shed the bacteria in their feces and are capable of infecting others, although they no longer have signs or symptoms of the disease themselves.

Risk factors

Typhoid fever remains a serious worldwide threat — especially in the developing world — affecting an estimated 26 million or more people each year. The disease is endemic in India, Southeast Asia, Africa, South America and many other areas.

Worldwide, children are at greatest risk of getting the disease, although they generally have milder symptoms than adults do.

If you live in a country where typhoid fever is rare, you’re at increased risk if you:

  • Work in or travel to areas where typhoid fever is endemic
  • Work as a clinical microbiologist handling Salmonella typhi bacteria
  • Have close contact with someone who is infected or has recently been infected with typhoid fever
  • Drink water contaminated by sewage that contains S.
  • Complications

    Intestinal bleeding or holes

    The most serious complications of typhoid fever — intestinal bleeding or holes (perforations) in the intestine — may develop in the third week of illness. A perforated intestine occurs when your small intestine or large bowel develops a hole, causing intestinal contents to leak into your abdominal cavity and triggering signs and symptoms, such as severe abdominal pain, nausea, vomiting and bloodstream infection (sepsis). This life-threatening complication requires immediate medical care.

    Other, less common complications

    Other possible complications include:

    • Inflammation of the heart muscle (myocarditis)
    • Inflammation of the lining of the heart and valves (endocarditis)
    • Pneumonia
    • Inflammation of the pancreas (pancreatitis)
    • Kidney or bladder infections
    • Infection and inflammation of the membranes and fluid surrounding your brain and spinal cord (meningitis)
    • Psychiatric problems, such as delirium, hallucinations and paranoid psychosis

    With prompt treatment, nearly all people in industrialized nations recover from typhoid fever. Without treatment, some people may not survive complications of the disease.

  • Preparing for your appointment

    Call your doctor if you’ve recently returned from travel abroad and develop mild symptoms similar to those that occur with typhoid fever. If your symptoms are severe, go to an emergency room or call 911 or your local emergency number.

    Here’s some information to help you get ready and know what to expect from your doctor.

    Information to gather in advance

    • Pre-appointment restrictions. At the time you make your appointment, ask if there are restrictions you need to follow in the time leading up to your visit. Your doctor will not be able to confirm typhoid fever without a blood test, and may recommend taking steps to reduce the risk of passing a possible contagious illness to others.
    • Symptom history. Write down any symptoms you’re experiencing and for how long.
    • Recent exposure to possible sources of infection. Be prepared to describe international trips in detail, including the countries you visited and the dates you traveled.
    • Medical history. Make a list of your key medical information, including other conditions for which you’re being treated and any medications, vitamins or supplements you’re taking. Your doctor will also need to know your vaccination history.
    • Questions to ask your doctor. Write down your questions in advance so that you can make the most of your time with your doctor.

    For typhoid fever, possible questions to ask your doctor include:

    • What are the possible causes for my symptoms?
    • What kinds of tests do I need?
    • Are treatments available to help me recover?
    • I have other health problems. How can I best manage these conditions together?
    • How long do you expect a full recovery will take?
    • When can I return to work or school?
    • Am I at risk of any long-term complications from typhoid fever?

    Don’t hesitate to ask any other related questions you have.

    What to expect from your doctor

    Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

    • What are your symptoms and when did they begin?
    • Have your symptoms gotten better or worse?
    • Did your symptoms briefly get better and then come back?
    • Have you recently traveled abroad? Where?
    • Did you update your vaccinations before traveling?
    • Are you being treated for any other medical conditions?
    • Are you currently taking any medications?
    • Tests and diagnosis

      Medical and travel history

      Your doctor is likely to suspect typhoid fever based on your symptoms and your medical and travel history. But the diagnosis is usually confirmed by identifying S. typhi in a culture of your blood or other body fluid or tissue.

      Body fluid or tissue culture

      For the culture, a small sample of your blood, stool, urine or bone marrow is placed on a special medium that encourages the growth of bacteria. The culture is checked under a microscope for the presence of typhoid bacteria. A bone marrow culture often is the most sensitive test for S. typhi.

      Although performing a culture test is the mainstay for diagnosis, in some instances other testing may be used to confirm a suspected typhoid fever infection, such as a test to detect antibodies to typhoid bacteria in your blood or a test that checks for typhoid DNA in your blood.

    • Treatments and drugs

      Antibiotic therapy is the only effective treatment for typhoid fever.

      Commonly prescribed antibiotics

      • Ciprofloxacin (Cipro). In the United States, doctors often prescribe this for nonpregnant adults.
      • Ceftriaxone (Rocephin). This injectable antibiotic is an alternative for people who may not be candidates for ciprofloxacin, such as children.

      These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria.

      Problems with antibiotic resistance

      In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it, however, because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance.

      In fact, the existence of antibiotic-resistant bacteria is a growing problem in the treatment of typhoid fever, especially in the developing world. In recent years, S. typhi also has proved resistant to trimethoprim-sulfamethoxazole and ampicillin.

      Other treatments

      Other treatments include:

      • Drinking fluids. This helps prevent the dehydration that results from a prolonged fever and diarrhea. If you’re severely dehydrated, you may need to receive fluids through a vein (intravenously).
      • Surgery. If your intestines become perforated, you’ll need surgery to repair the hole.
      • Prevention

        In many developing nations, the public health goals that can help prevent and control typhoid fever — safe drinking water, improved sanitation and adequate medical care — may be difficult to achieve. For that reason, some experts believe that vaccinating high-risk populations is the best way to control typhoid fever.

        A vaccine is recommended if you’re traveling to areas where the risk of getting typhoid fever is high.

        Vaccines

        Two vaccines are available.

        • One is injected in a single dose at least one week before travel.
        • One is given orally in four capsules, with one capsule to be taken every other day.

        Neither vaccine is 100 percent effective, and both require repeat immunizations, as vaccine effectiveness diminishes over time.

        Because the vaccine won’t provide complete protection, follow these guidelines when traveling to high-risk areas:

        • Wash your hands. Frequent hand-washing in hot, soapy water is the best way to control infection. Wash before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when water isn’t available.
        • Avoid drinking untreated water. Contaminated drinking water is a particular problem in areas where typhoid fever is endemic. For that reason, drink only bottled water or canned or bottled carbonated beverages, wine and beer. Carbonated bottled water is safer than uncarbonated bottled water is.

          Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.

        • Avoid raw fruits and vegetables. Because raw produce may have been washed in unsafe water, avoid fruits and vegetables that you can’t peel, especially lettuce. To be absolutely safe, you may want to avoid raw foods entirely.
        • Choose hot foods. Avoid food that’s stored or served at room temperature. Steaming hot foods are best. And although there’s no guarantee that meals served at the finest restaurants are safe, it’s best to avoid food from street vendors — it’s more likely to be contaminated.

        Prevent infecting others

        If you’re recovering from typhoid fever, these measures can help keep others safe:

        • Take your antibiotics. Follow your doctor’s instructions for taking your antibiotics, and be sure to finish the entire prescription.
        • Wash your hands often. This is the single most important thing you can do to keep from spreading the infection to others. Use hot, soapy water and scrub thoroughly for at least 30 seconds, especially before eating and after using the toilet.
        • Avoid handling food. Avoid preparing food for others until your doctor says you’re no longer contagious. If you work in the food service industry or a health care facility, you won’t be allowed to return to work until tests show that you’re no longer shedding typhoid bacteria.

Vaccines for adults: Which do you need?

Vaccines offer protection from infectious diseases. Find out how to stay on top of the vaccines recommended for adults.

You’re not a kid anymore, so you don’t have to worry about shots, right? Wrong. Find out how to stay on top of your vaccines.

What vaccines do adults need?

Vaccines for adults are recommended based on your age, prior vaccinations, health, lifestyle, occupation and travel destinations.

The schedule is updated every year, and changes range from the addition of a new vaccine to tweaks of current recommendations. To determine exactly which vaccines you need now and which vaccines are coming up, check the Centers for Disease Control and Prevention’s website.

What factors might affect my vaccine recommendations?

Several factors can affect whether you need certain vaccines. Be sure to tell your doctor if you:

  • Are planning to travel abroad
  • Have had your spleen removed
  • Work in certain occupations where exposures could occur
  • Are or might be pregnant
  • Are breast-feeding
  • Are moderately or severely ill or have a chronic illness
  • Have any severe allergies, including a serious allergic reaction to a previous dose of a vaccine
  • Have had a disorder in which your body’s immune system attacks your nerves, such as Guillain-Barre syndrome
  • Have a weakened immune system or are being treated with an immunosuppressant
  • Have recently had another vaccine
  • Have recently had a transfusion or received other blood products
  • Have a personal or family history of seizures

Your doctor might also recommend certain vaccines based on your sexual activity. Vaccinations can protect you from hepatitis A and hepatitis B, serious liver infections that can spread through sexual contact. The HPV vaccine is recommended for men up to age 21 and women up to age 26.

Why are some vaccines particularly important for adults?

Adults of any age can benefit from vaccines. However, certain diseases, such as the flu, can be particularly serious for older adults or those living with certain chronic illnesses.

How can I keep track of my vaccines?

To gather information about your vaccination status, talk to your parents or other caregivers. Check with your doctor’s office, as well as any previous doctors’ offices, schools and employers. Some states also have registries that include adult immunizations. To check, contact your state health department.

If you can’t find your records, talk to your doctor. He or she might be able to do blood tests to see if you are immune to certain diseases that can be prevented by vaccines. You might need to get some vaccines again.

To stay on top of your vaccines, ask your doctor for an immunization record form. Bring the form with you to all of your doctor visits and ask your provider to sign and date the form for each vaccine you receive.

Lyme Disease Treatment

Lyme disease is an infectious disease caused by the bacteria Borrelia burgdorferi sensu lato. B. burgdorferi is transmitted to humans by a bite from an infected black-legged or deer tick. The tick becomes infected after feeding on infected deer or mice.

A tick has to be present on the skin for 24 to 48 hours to transmit the infection. Most people with Lyme disease have no memory of a tick bite.

Lyme Disease

Lyme disease was first reported in the town of Old Lyme, Connecticut, in 1975. It’s the most common tick-borne illness in Europe and the Pacific Northwest, Northeast, and Upper Midwest regions of the United States. People who live or spend time in wooded areas are more likely to get this illness. People with domesticated animals that are let out in wooded areas also have a higher risk of contracting Lyme disease.

Symptoms of Lyme disease

Lyme disease occurs in three stages: early localized, early disseminated, and late disseminated. The symptoms you experience will depend on which stage the disease is in.

Stage 1: Early localized disease

Symptoms of Lyme disease start one to two weeks after the tick bite. One of the earliest signs is a “bull’s-eye” rash, which is a sign that bacteria are multiplying in the bloodstream. The rash occurs at the site of the tick bite as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isn’t painful and doesn’t itch. This rash will disappear after four weeks.

The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people don’t have this symptom. Some people have a rash that is solid red, while people with dark complexions may have a rash that resembles a bruise.

Stage 2: Early disseminated Lyme disease

Early disseminated Lyme disease occurs several weeks after the tick bite. During this stage bacteria are beginning to spread throughout the body. It’s characterized by flu-like symptoms, such as:

  • chills
  • fever
  • enlarged lymph nodes
  • sore throat
  • vision changes
  • fatigue
  • muscle aches
  • headaches

During early disseminated Lyme disease you’ll have a general feeling of being unwell. A rash may appear in areas other than the tick bite, and neurological signs such as numbness, tingling, and Bell’s palsy can also occur. This stage of Lyme disease can be complicated by meningitis and cardiac conduction disturbances. The symptoms of stages 1 and 2 can overlap.

Stage 3: Late disseminated Lyme disease

Late disseminated Lyme disease occurs when the infection hasn’t been treated in stages 1 and 2. Stage 3 can occur weeks, months, or years after the tick bite. This stage is characterized by:

  • severe headaches
  • arthritis of one or more large joints
  • disturbances in heart rhythm
  • brain disorders (encephalopathy) involving memory, mood, and sleep
  • short-term memory loss
  • difficulty concentrating
  • mental fogginess
  • problems following conversations
  • numbness in the arms, legs, hands, or feet

Contact your doctor immediately if you have any of these symptoms.

How is Lyme disease diagnosed?

The diagnosis of Lyme disease begins with an assessment of your health history and a physical exam. Blood tests are most reliable a few weeks after the initial infection, when antibodies are present. Your doctor may order the following tests:

  • ELISA (enzyme-linked immunosorbent assay) is used to detect antibodies against B. burgdorferi.
  • Western blot can be used to confirm a positive ELISA test. It checks for the presence of antibodies to specific B. burgdorferi proteins.
  • Polymerase chain reaction (PCR) is used to evaluate people with persistent Lyme arthritis or nervous system symptoms. It is performed on joint fluid or spinal fluid.

Treatment

How is Lyme disease treated?

Lyme disease is best treated in the early stages. Early treatment is a simple 14 to 21 day course of oral antibiotics to eliminate all traces of infection. Medications used to treat Lyme disease include:

  • doxycycline for adults and children older than 8 years old
  • cefuroxime and amoxicillin for adults, younger children, and women who are nursing or breastfeeding

Persistent or chronic Lyme disease is treated with intravenous antibiotics for a period of 14 to 21 days. Though this treatment eliminates the infection, your symptoms improve more slowly.

It’s unknown why symptoms, like joint pain, continue after the bacteria have been destroyed. Some doctors believe that persistent symptoms occur in people who are prone to autoimmune disease.

Prevention

How to prevent Lyme disease

Lyme disease prevention mostly involves decreasing your risk of experiencing a tick bite. Take the following steps to prevent tick bites:

  • Wear long pants and long-sleeve shirts when in the outdoors.
  • Make your yard unfriendly to ticks by clearing wooded areas, keeping underbrush to a minimum, and putting woodpiles in areas with lots of sun.
  • Use insect repellent. Insect repellent with 10 percent DEET will protect you for a period of about two hours. Don’t use more DEET than what is required for the time you’ll be outside, and don’t use DEET on the hands of young children or on the faces of children less than 2 months old. Oil of lemon eucalyptus gives the same protection as DEET when used in similar concentrations. It shouldn’t be used on children under the age of 3.
  • Be vigilant. Check your children, pets, and yourself for ticks. Don’t assume you can’t be infected again; people can get Lyme disease more than once.
  • Remove ticks with tweezers. Apply the tweezers near the head or the mouth and pull gently. Check to be certain that all tick parts have been removed. Contact your doctor whenever a tick bites you or your loved ones.

Impetigo – Treatment

What Is Impetigo?

Impetigo is a highly contagious bacterial skin infection. It can appear anywhere on the body but usually attacks exposed areas. Children tend to get it on the face, especially around the nose and mouth, and sometimes on the arms or legs. The infected areas appear in plaques ranging from dime to quarter size, starting as tiny blisters that break and expose moist, red skin. After a few days, the infected area is covered with a grainy, golden crust that gradually spreads at the edges.

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In extreme cases, the infection invades a deeper layer of skin and develops into ecthyma, a deeper form of the disease. Ecthyma forms small, pus-filled bumps with a crust much darker and thicker than that of ordinary impetigo. Ecthyma can be very itchy, and scratching the irritated area spreads the infection quickly. Left untreated, the sores may cause permanent scars and pigment changes.

The gravest potential complication of impetigo is post-streptococcal glomerulonephritis, a severe kidney disease that occurs following a strep infection in less than 1% of cases, mainly in children. The most common cause of impetigo is Staphylococcus aureus. However, another bacteria source is group A streptococcus. These bacteria lurk everywhere. It is easier for a child with an open wound or fresh scratch to contract impetigo. Other skin-related problems, such as eczema, body lice, insect bites, fungal infections, and various other forms of dermatitis can make a person susceptible to impetigo.

Most people get this highly infectious disease through physical contact with someone who has it or from sharing the same clothes, bedding, towels, or other objects. The very nature of childhood, which includes lots of physical contact and large-group activities, makes children the primary victims and carriers of impetigo.

What Are the Signs of Impetigo?

Impetigo starts out as a small cluster of blisters that after a few hours breaks into a red, moist area that oozes or weeps fluid. Impetigo appears mainly on the face but also can develop on exposed areas of the arms and legs.

In a few days, there is the formation of a golden or dark-yellow crust resembling grains of brown sugar. The infection may continue to spread at the edges of the infected area or affect other areas of skin.

Impetigo can be spread by skin-to-skin or infected surface-to-skin (such as towels) contact.

Call Your Doctor About Impetigo if:

  • You have sores or a rash that worsens or becomes more uncomfortable. An impetigo infection needs prompt medical attention.
  • Small, pus-filled sores form, with a dark brown crust. This indicates ecthyma, a deeper form of skin infection that penetrates into the skin. If left untreated, it may cause scarring and permanent changes in skin pigmentation.

NOTE: Sores associated with impetigo may be mistaken for herpes, a viral infection. Impetigo spreads faster and never develops inside the mouth. If in doubt, see a doctor for an accurate diagnosis.

What Are the Treatments for Impetigo?

The key to treating — and preventing — impetigo is to practice good personal hygiene and maintain a clean environment. Once the infection occurs, prompt attention will keep it under control and prevent it from spreading.

Even if only one family member has impetigo, everyone in the household should follow the same sanitary regimen. Wash regularly with soap and water. This should help clear up mild forms of the infection. If this does not help, seek care from your doctor. You may need a prescription medication. Topical mupirocin ointment, available only by prescription, is highly successful in treating mild forms of the infection. Don’t try over-the-counter antibacterial ointments; they are too weak to kill strep and staph infections, and applying the ointment carelessly may actually spread the impetigo. If you have a more severe infection, you may need to take oral antibiotics.

Anyone in a household who develops impetigo should use a clean towel with each washing. Be sure to launder those towels separately. Keep sores covered to prevent spread of the infection to other parts of the body or other people.