Use of Primary Care Data for Detecting Impetigo Trends, United Kingdom, 1995–2010

Laura J. Shallcross

, Irene Petersen, Joe Rosenthal, Anne M. Johnson, Nick Freemantle, and Andrew C. Hayward

Author affiliations: University College London, London, UK

Abstract

Using a primary care database, we identified a major increase in impetigo in the United Kingdom during 1995–2010. Despite a doubled rate of primary care consultations, this increase was not identified by routine surveillance. Primary care databases are a valuable and underused source of surveillance data on infectious diseases.

Impetigo is a common, superficial bacterial infection primarily caused by Staphylococcus aureus. It is the fourth most common dermatologic condition among children seen in general practice; although most infections are mild, outbreaks have a considerable negative effect because infected children may be barred from attending schools and nurseries (1).
In the United Kingdom, hospitalizations for impetigo increased 5-fold from 1989–1990 through 2003–2004; among children, the increase was 12-fold (2). To investigate whether this increase was fueled by increasing rates of infection in the community rather than increased pathogenicity, we used a large and nationally representative primary care database to calculate time trends in incidence of consultation and medications prescribed for impetigo.