Diseases-Staph (MRSA)

On October 17, 2007 in Virginia, all the Bedford County school buildings were shut down in order to scrub and sanitize the buildings.  This action occurred after the death of a high school senior from a drug-resistant strain of staph bacteria, Methicillin-resistant Staphylococcus aureus (MRSA).  The student had participated in athletics in previous years but had not done so this fall; so the source of the infection is not known.

Two days before (Monday), the students launched a protest over unsanitary conditions via text messaging and social networking sites.   On Tuesday, the students took the Schools Superintendent James Blevins on a tour of Staunton River High School to show him the situation in the school and particularly the athletic locker rooms.  The clean up occurred the following day.

On the same Wednesday, school officials at Westin High School, in Connecticut, sent a letter home to parents warning about one confirmed case of MSRA infection and a possible second case. 

Other youth deaths, during the same week, occurred in Salisbury, New Hampshire and Vancleave, Mississippi, and are believed to have been from MSRA infections.  Children or youth have no higher risk for the infection than the general population; however many youth play sports where there is the possibly of cuts and scraped skin, exchanged sweat, and the locker rooms can be high-risk areas if not kept clean.

If staph infection is suspected

Learn to recognize skin infections caused by staph.  These may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. 

If you suspect a staph skin infection, cover the lesion with a clean, dry dressing to contain pus or bacteria, and seek medical attention for evaluation. 

 Pus draining from a lesion is particularly contagious.  An individual with an active lesion should have an adequate, clean, dry dressing in place, that is well-secured and unlikely to be disturbed (e.g. with stretch wrap or ace bandage), or be excluded until the lesion is healed.  To provide a comparison, it is much like poison ivy.

General Advice:

Staph bacteria usually spread from skin to skin contact, usually involving the hands.  Spread can also occur indirectly when environmental surfaces are touched by skin and are not cleaned between users. 

Hand hygiene is the most important prevention measure. Clean their hands regularly.  If there is visible dirt or debris, use soap and water.  Alcohol-based hand sanitizers are also recommended to kill bacteria on hands when there is no visible soil.

Make sure hand-washing facilities are adequate and supplies are available to practice good hygiene.  Liquid soap dispensers are recommended rather than bar soap, which should not be shared. 

Use disposable towels over cloth towels which are typically reused before laundering.

Personal items such as towels, washcloths, clothes and bedding should not be shared.   For gym equipment wipe contact surfaces with the provided wipes.  This is also true for grocery carts.

Cuts and scrapes should be covered with a clean, dry dressing to prevent germs from entering.  The liquid from the wound is the most contagious source.

Environmental cleaning:

Frequent and consistent cleaning of the diapering area is essential.  Diapering surfaces should be cleaned with detergent-based cleaners if visibly soiled, and or Environmental Protection Agency (EPA)-registered disinfectants with each diaper change (see http://epa.gov/oppad001/chemregindex.htm for a list).  Hand hygiene should be performed (as always!) before and after each diaper change.

Regularly clean and disinfect other areas, especially food preparation and eating areas, sleep areas, and toilets

Wash towels and sheets with detergent and water, and dry in a hot dryer. 

Clean and disinfect toys regularly.

More information is available at www.health.state.ga.us/mrsa  and http://www.cdc.gov/Features/MRSAinSchools/