Photo Credit: CDC

SUNDAY October 28, 2007 (Foodconsumer.org) -- The New York city Health Commissioner Thomas Frieden along with Schools Chancellor Joel I Klein and Public Advocate Bets Gotbaum on October 26 issued a statement to urge students, families and educators in the city to wash their hands thoroughly and frequently to prevent the spread of staph infections including infection of Staphylococcus aureus (MRSA).

The statement was issued after a student attending IS 211 in Brook died on October 14 of MRSA.   Earlier health officials had already suspected that the student died of MRSA infection.   In the statement, the health officials once again reassured teachers, students and parents that "there is no indication that any other students are at risk."

"It's a tragedy that one of our students died of this infection," Chancellor Klein said. "It reminds us how important it is to wash our hands with soap and water, keep clean, and visit the doctor if we are at all concerned about our health. We are working with principals, school custodians, and parents to reduce the chances of further infection. I urge everyone to be vigilant and to keep healthy."

MRSA, highly resistant to most of antibiotics, infects about 100,000 people and kills about 20,000 each year, according to the Centers for Disease Control and Prevention, the federal government's disease monitoring agency, which says 25 to 30 percent of the population now carries the staph bacteria.  

"About 85% of all invasive MRSA infections were associated with healthcare, and of those, about two-thirds occurred outside of the hospital, while about one third occurred during hospitalization.   About 14% of all the infections occurred in persons without obvious exposures to healthcare," the CDC states.   People aged 65 or older, blacks and males are most likely to acquire the infection.

Over the last month, cases of MRSA infection have been reported in New York and other states, promoting school administrations to cancel school events and sanitize buildings and facilities. Most infected students recovered, but three have died in New Hampshire, Virginia and Mississippi.

"Staph is both preventable and treatable," Dr. Frieden said. "The best way to avoid infections is to wash hands thoroughly and avoid sharing personal items such as towels and razors. We are working with the school system to distribute informational materials so that everyone is aware of the disease and knows how to prevent it."

In a letter to principal and parent coordinator, the health officials emphasized that staph infections are common skin infections and are treatable, but MRSA is a kind of staph infection that is difficult to treat with certain antibiotics.   The letters says that the best way to prevent infections is to encourage good hand washing, particularly bathrooms and sports equipment should be kept clean and free of staph bacteria.

"It's a fact of life that kids can forget to wash their hands and scrape their knees on the playground," Public Advocate Gotbaum said. "But parents and school officials can be super heroes in the fight against the bug simply by reminding their children to wash their hands and cover cuts. Together, New Yorkers can take the basic steps to protect children and help prevent future tragedies."

The city officials released the following recommendations for minimizing the spread of communicable infections such as MRSA:

Students, educators, and others should wash their hands regularly with soap and water.

Schools must ensure that sufficient soap and paper towels are available in all bathrooms.

Schools should clean “flat surfaces” every day. This includes desktops, cafeteria tables, door knobs, toilet seats, sinks, drinking fountains.

Students should not share towels or other similar personal items during sports or other activities. They should also wipe down shared athletic equipment between users.  

The Centers for Disease Control and Prevention has published an excellent page to explain what MRSA is, how do you get staph infections and how you can prevent staph infection etc.   We cited the common questions and answers for those who are interested in knowing more details.

What is Staphylococcus aureus (staph)?

Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25% to 30% of the population is colonized (when bacteria are present, but not causing an infection) in the nose with staph bacteria. Sometimes, staph can cause an infection. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics (also known as antimicrobials or antibacterials). However, staph bacteria also can cause serious infections (such as surgical wound infections, bloodstream infections, and pneumonia).

What is MRSA (methicillin-resistant Staphylococcus aureus)?

Some staph bacteria are resistant to antibiotics. MRSA is a type of staph that is resistant to antibiotics called beta-lactams. Beta-lactam antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. While 25% to 30% of the population is colonized with staph, approximately 1% is colonized with MRSA.

Who gets staph or MRSA infections?

Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems. These healthcare-associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.

What is community-associated MRSA (CA-MRSA)?

Staph and MRSA can also cause illness in persons outside of hospitals and healthcare facilities. MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are know as CA-MRSA infections. Staph or MRSA infections in the community are usually manifested as skin infections, such as pimples and boils, and occur in otherwise healthy people.

How common are staph and MRSA infections?

Staph bacteria are one of the most common causes of skin infection in the United States and are a common cause of pneumonia, surgical wound infections, and bloodstream infections. The majority of MRSA infections occur among patients in hospitals or other healthcare settings; however, it is becoming more common in the community setting. Data from a prospective study in 2003, suggests that 12% of clinical MRSA infections are community-associated, but this varies by geographic region and population.

What does a staph or MRSA infection look like?

Staph bacteria, including MRSA, can cause skin infections that may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.

Are certain people at increased risk for community-associated staph or MRSA infections?

CDC has investigated clusters of CA-MRSA skin infections among athletes, military recruits, children, Pacific Islanders, Alaskan Natives, Native Americans, men who have sex with men, and prisoners.

Factors that have been associated with the spread of MRSA skin infections include: close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions, and poor hygiene.

How can I prevent staph or MRSA skin infections?

Practice good hygiene:

Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer.

Keep cuts and scrapes clean and covered with a bandage until healed.

Avoid contact with other people’s wounds or bandages.

Avoid sharing personal items such as towels or razors.

Are people who are positive for the human immune deficiency virus (HIV) at increased risk for MRSA? Should they be taking special precautions?

People with weakened immune systems, which include some patients with HIV infection, may be at risk for more severe illness if they get infected with MRSA. People with HIV should follow the same prevention measures as those without HIV to prevent staph infections, including practice good hygiene, cover wounds (e.g., cuts or abrasions) with clean dry bandages, avoid sharing personal items such as towels and razors, and contact their doctor if they think they have an infection.

Can I get a staph or MRSA infection at my health club?

In the outbreaks of MRSA, the environment has not played a significant role in the transmission of MRSA. MRSA is transmitted most frequently by direct skin-to-skin contact. You can protect yourself from infections by practicing good hygiene (e.g., keeping your hands clean by washing with soap and water or using an alcohol-based hand rub and showering after working out); covering any open skin area such as abrasions or cuts with a clean dry bandage; avoiding sharing personal items such as towels or razors; using a barrier (e.g., clothing or a towel) between your skin and shared equipment; and wiping surfaces of equipment before and after use.

What should I do if I think I have a staph or MRSA infection?

See your healthcare provider.

Are staph and MRSA infections treatable?

Yes. Most staph and MRSA infections are treatable with antibiotics. If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless your doctor tells you to stop taking it. Do not share antibiotics with other people or save unfinished antibiotics to use at another time.

However, many staph skin infections may be treated by draining the abscess or boil and may not require antibiotics. Drainage of skin boils or abscesses should only be done by a healthcare provider.

If after visiting your healthcare provider the infection is not getting better after a few days, contact them again. If other people you know or live with get the same infection tell them to go to their healthcare provider.

Is it possible that my staph or MRSA skin infection will come back after it is cured?

Yes. It is possible to have a staph or MRSA skin infection come back (recur) after it is cured. To prevent this from happening, follow your healthcare provider’s directions while you have the infection, and follow the prevention steps after the infection is gone.

If I have a staph, or MRSA skin infection, what can I do to prevent others from getting infected?

You can prevent spreading staph or MRSA skin infections to others by following these steps:

Cover your wound. Keep wounds that are draining or have pus covered with clean, dry bandages. Follow your healthcare provider’s instructions on proper care of the wound. Pus from infected wounds can contain staph and MRSA, so keeping the infection covered will help prevent the spread to others. Bandages or tape can be discarded with the regular trash.

Clean your hands. You, your family, and others in close contact should wash their hands frequently with soap and warm water or use an alcohol-based hand sanitizer, especially after changing the bandage or touching the infected wound.

Do not share personal items. Avoid sharing personal items such as towels, washcloths, razors, clothing, or uniforms that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in clothes.

Talk to your doctor. Tell any healthcare providers who treat you that you have or had a staph or MRSA skin infection.