Tilbury Fox described infectious impetigo in children and newborns in 1864. He drew specific emphasis to the vesicular type, which is currently common in maternity units. Almquist demonstrated in 1891 that the infecting organism was a staphylococcus. Matzenauer established the relationship between pemphigus neonatorum and impetigo contagiosa in 1900 by identifying the activating microorganism. Animal inoculation was often unsuccessful, but in 1911, Landsteiner and his colleagues generated pemphigoid lesions in chimps. With these several discoveries, the understanding of impetigo remained roughly the same until 1917. Surprisingly, throughout the fifty-three years following Fox's discovery, the disease received no special attention in any significant pandemic. However, as a questionnaire confirmed, this hitherto rare and sporadic illness abruptly altered its character and erupted in more or less violent outbreaks in 1917. Few maternity cases were excluded, and several physicians who had never seen impetigo as a nursery concern were overwhelmed by the influx of cases. Nurseries were handled like hospitals for infectious illnesses everywhere, but only to a limited extent. Many were completely closed, and others should have been.
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