While working as a nurse at a residential summer camp, you meet Madison, a 10- year-old. Both her forearms and lower legs have several crusted erythematous superficial lesions with some. Four days ago...

While working as a nurse at a residential summer camp, you meet Madison, a 10- year-old. Both her forearms and lower legs have several crusted erythematous superficial lesions with some. Four days ago was “sleep out” day, so she spent the night in a tent with three friends but didn’t sleep well because “mosquitoes bit me all night.” Madison’s parents return from their vacation, and when they learn of the lesions comment, “Look at her; she’ll probably end up with scars from this.”

1. What do you suspect is the cause of the scattered lesions?

2. Given how impetigo is transmitted to others, what implications does its presence have for infection control practices in the camp setting?

3. What if you learn Madison has never had more immunizations than those she received as an infant because her mother believes the danger of vaccines is higher than contracting “simple childhood infections”? Would immunization have prevented Madison from contracting impetigo? Would you recommend she receive routine immunizations now or, at 10 years of age, is she no longer in much danger from common contagious illnesses?