A commentary by Linda Grant, M.D.

Media reports on MRSA or Methicillin Resistant Staphylococcus Aureus have been making headlines in the past few months, capturing school administrators and parent’s attention and elevating concerns… However, schools may be more well-prepared than they realize to address his issue. 

Schools have experience with minimizing risk of illnesses. Universal precautions are the infection control techniques that were recommended following the AIDS outbreak in the 1980s, when the concern was about transmission through bodily fluids. Universal precautions are essentially good hygiene habits, such as hand washing and the use of gloves and other barriers, when dealing with wounds and secretions. Recently, as schools began to prepare for pandemic flu, there was an increased emphasis on hand washing and hygiene as a way to decrease transmission of airborne organisms. In addition, schools often have relationships with local health departments in managing other disease outbreaks such as chicken pox or whooping cough. Thus school systems already have many of the basics for addressing and minimizing the risks of MRSA.

MRSA is a type of common bacterium, staphylococcus aureus or “staph”. Staph is found on the skin and in the nose of 30% of the population, most of whom have no symptoms. When staph infections do occur, most are mild, such as pimples or boils. Some infections can be more severe, such a pneumonia. MRSA behaves like this staph. It can be asymptomatic or cause infections. The factor that distinguishes MRSA from other staph is that MRSA is resistant to some medications. When a skin infection is not improving, a health provider may test for MRSA.

All staph, including MRSA, is spread by direct contact- either skin to skin or contact with items touched by someone with staph. The measures to control its spread are related to decreasing contact.

School –wide measures include:

·       Making hand washing part of the school day. If soap is not available, then using alcohol-based hand sanitizers is an alternative.

·       School cleaning should be routine, particularly areas that are damp and /or exposed to bodily fluids, such as showers, locker rooms and health service offices. School disinfectants should be reviewed for their effectiveness against MRSA

·       The cleaning schedule should include daily cleaning of locker rooms and regular, scheduled cleaning of shared athletic equipment.

·       Health education activities should reinforce these hygienic measures.

Students and staff should:

·       Avoid sharing personal hygiene items.

·       Wash their hands for 15-20 seconds frequently with warm water and soap.

·       Shower after every athletic activity using soap and clean towels

·       Maintain clean, dry bandages on all wounds.

·       Take responsibility for wiping down athletic equipment after personal use.

·       Refrain from contact sports activities if a wound cannot be adequately covered.

These measures should be followed whether there is a known case of MRSA in the school or not. These actions my also help reduce risk for many other communicable diseases.

A student with MRSA can attend school as long as the wound can be covered. Students with MRSA should inform the school nurse and the coaches/physical education teachers. Closing of schools is not an appropriate response to students with MRSA infections.

For more detailed information follow the links below

Resources

•   AAP Statement 
• Centers for Disease Control and Prevention. Community-Associated MRSA Information for the Public
• CDC. Methicillin-Resistant Staphylococcus aureus Infections Among Competitive Sports Participants—Colorado, Indiana, Pennsylvania and Los Angeles County, 2000-2003. MMWR 2003;52:793-795.
• CDC MRSA Educational Materials  
• CDC MRSA Fact sheet (PDF)
• Alex, A. & Letizia, M. Community-Acquired Methicillin-Resistant Staphylococcus aureus: Considerations for School Nurses. The Journal of School Nursing. 2007; 23(4):210-213

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This entry was posted on Wednesday, January 16th, 2008 at 11:08 am and is filed under Health Conditions & Issues, Nursing & Medical Issues, Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.