By John Patrick Gatta
Metro Monthly Staff Writer
With recent infections in Struthers and Niles schools, awareness of Methicillin-Resistant Staphylococcus Aureus – or what’s commonly known as MRSA – has become a high priority for parents. But knowledge of what to look for and how to react when confronted with the MRSA infection can only help allay fears.
As noted in a Clinical Update by National Foundation for Infectious Diseases, Methicillin-Resistant Staphylococcus Aureus was first described in England in 1961. Written in 1998, the update chronicled its growing influence in hospital and nursing home infections over the past two decades. At that time, drug users were estimated to be the primary victims of MRSA.
“I don’t know that there is any scientific evidence showing there has been a spike in MRSA infections in students over the past few weeks,” said Shelly Sikes Diaz, media relations/spokeswoman for the Centers for Disease Control (CDC) in Atlanta during a recent interview. “Rather, this may be an increase in media attention after the recent death of a student, and the recent release of new statistics on MRSA by CDC.” (These statistics were published in “Journal of the American Medical Association.”)
According to recent statistics, the overwhelming majority of MRSA incidents are associated with healthcare. More than 90,000 people developed a serious infection, while nearly 19,000 people died during a hospital stay related to a serious MRSA occurrence. Still, up to 30 percent of Americans may have “colonized” MRSA that will not affect them in any way unless a catalyst has taken place.
“Everyone has many types of bacteria on their skin,” explained Diaz. “If you have MRSA on your skin or in your nose, you are ‘colonized.’ A colonized person may not have any symptoms or infections. An infection may occur when something compromises your immune system, like a cut or abrasion on your skin.”
Symptoms of a staph bacteria, including MRSA, can appear as skin infections that look like a pimple or a boil. They can be red, swollen, painful or have pus or other drainage. In a more serious situation, the infection may cause pneumonia, bloodstream infections or surgical-wound infections. Diaz recommends that individuals consult their physician if they exhibit these symptoms. (A link featuring prevention advice and other informative details may be found online at www.cdc.gov/features/mrsainschools.)
For the affected Niles High School football player, an infected wound on his knee developed into MRSA.
Because the Niles football player’s only possible contact occurred in the school’s locker room, only that area was cleaned rather than the entire building. But in a preventative measure that went beyond guidelines provided by the Ohio Department of Health, the entire Struthers school was disinfected after an incident there.
Diaz from the Centers for Disease Control explained the need for such precautions. “MRSA is mainly spread through skin-to-skin contact. If you had a draining wound, and touched a surface with it, it is conceivable that someone else could touch that surface and become colonized or infected. The person would not need prior colonization to become infected.”
When asked why MRSA has broadened from an individual healthcare problem to one that’s community-associated, Diaz said, “The reasons for the rise of MRSA are complex and not fully understood. Improper use of antibiotics may be one factor.”
“It seems like everything that happens, eventually does get to you as well, every health district,” said Niles Health Department Director Michael Burke.
“We generally check with CDC and follow their guidelines for all these types of issues. Sometimes, we have meningitis scares and we check it out and see what they say we ought to do and follow it pretty much to the letter.”
Despite the influx of new infections in society, there’s no reason to fear contact with the outside world. Simple preventative measures are available such as thoroughly washing your hands with soap or using hand sanitizers when normal washing is unavailable. Still, the CDC is cautioning people to avoid sharing towels or shaving razors at exercise facilities.
But in the case of someone who has been diagnosed with MRSA, individuals should avoid skin-to-skin contact. Individuals who have contracted MRSA should keep clean and dry bandages covering the infection, followed by washing their hands after treatment.
With recent incidents locally and across the U.S., fitness clubs and gyms have taken precautions to minimize health risks.
Mike Shaffer, branch director of Youngstown Central YMCA, pointed out that the facility’s staff has been cleaning equipment and providing hand sanitizers for patrons. Both are methods for dealing with a virus like MRSA as well as communicable diseases such as cold and flu.
“We give them every means to make sure that what they’re using is clean and that they’re keeping their hands clean before and after they use them,” Shaffer said.
Such actions may have kept any MRSA incidents from occurring. “We have gotten some things from the YMCA national encouraging us to do the safe practice things that I described and be on watch in your facilities,” Shaffer said. “Beyond that, we have not heard of any instances of that happening.”
While the focus has been on humans, MRSA infections can also occur in pets or other animals. “My impression is that while the number of staph infections is not on the increase, the percentage of the infections that involve MRSA is increasing,” noted Dr. Jonathan Dyce, associate professor at the Ohio State University College of Veterinary Medicine at Veterinary Clinical Science. Dyce recently treated Jack, a 22-month old Newfoundland that developed an infection in his knee joint that was consistent with MRSA.
The OSU College of Veterinary Medicine treats small and large animals from around the world. “One of the things that we’re moving towards in the hospital here is having an antibiotic oversight committee,” said Dyce. “In other words, whenever you deviate from a select few drugs you have to get permission for another rather heavy-hitting drug to be used.”
Over the past 18 months, the College has set up controls to monitor situations and changing cleaning protocols in the wards where the dogs reside in order to eliminate cross-contamination. “Those sort of things are only as good as the weakest link. You have to educate everybody from the doctors down to the cleaning crew. It’s a very significant issue, and it’s not going to go away.”
Although his experience with MRSA deals with the Animal Kngdom, Dyce’s levelheaded advice encapsulates everyone that may encounter the infection.
“It’s kind of like being an alcoholic. First of all you’ve got to say, ‘My name’s John. I’m an alcoholic.’ So, you’ve got to say, ‘We’re a veterinary teaching hospital and we see MRSA.’ Having admitted that you see it, then what controls do you put in place and how do you trust those cases that come up with it.
“The message is not that this is a death sentence. It’s ‘We’ve got to live with it. We’ve got to deal with it. And we’ve got to do everything we can to control the problem.’ A lot of that is the monitoring and early detection of it,” Dyce said.
