The Susquehanna Township School District has taken several measures to reduce the likelihood of infection of students or staff with MRSA bacteria and to reduce the chances that anyone infected may spread the bacteria to others.

We have consulted the Pennsylvania Department of Health for information on what preventative measures we can take to protect our students and staff. Information on MRSA can be found on their Website at www.health.state.pa.us.

The Department of Health provides the following information on MRSA:

What is Staphylococcus aureus?

Staphylococcus aureus, often referred to simply as “staph,” is 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) with staph bacteria in the nose or on the skin. Sometimes, staph can cause an infection. Staph is among 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, in some instances staph can cause serious infections (such as surgical wound infections, bloodstream infections, and pneumonic).

What is MRSA (methicillin-resistant Staphylococcus aureus)?

Some staph bacteria are resistant to antibiotics, MRSA is a type of staph that is resistant to the antibiotic methicillin and its close cousins oxacillin, penicillin an amoxicillin. While 25% to 30% of the population is colonized with staph, only about 1% normally carries 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 enters who have weakened immune systems. These healthcare-associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia and are quite different from the MRSA infections that occur in the community setting.

 How is MRSA transmitted in the community?

The main mode of spread of all forms of staph, including MRSA, is by the hands and skin-to-skin contact, crowded conditions, and poor hygiene. The sharing of towels, personal hygiene items like razors, athletic equipment, clothes, nonsterilized tattoo instruments, and illicit drug paraphernalia also promote the spread of S. aureus from one individual to another. Habits like body shaving are also thought to promote MRSA infection.

 Although MRSA has been isolated from environmental surfaces (e.g., floors, work areas, medical equipment) and pets, these are not considered to be the most important sources for spread and there is no need to do environmental sampling in any affected facility. However, it is important to routinely clean shared items like athletic equipment.

 What are the clinical features of CA-MRSA?

CA-MRSA most often presents as skin or soft tissue infection such as boil or abscess. Pimples, rashes, pus-filled boils, especially when warm, painful, red or swollen, can indicate a staph, including MRSA. Patients frequently recall a “spider bite”. Staph infections also can cause more serious infections, such as blood stream infections or pneumonia, leading to symptoms of shortness of breath, fever, and chills.

 How is CA-MRSA treated?

Most MRSA infections are treated by simply administering good wound and skin care: incision and draining of boils by a health care provider, keeping the area clean and dry, washing hands after caring for the area, carefully disposing of any bandages, and allowing the body to heal.

 In some instances, antibiotics are also used to treat MRSA. However, several studies have shown that MRSA skin infections generally heal just as quickly with proper care whether or not antibiotics have been used. If antibiotics are needed, it is important for the patient to use the medication as directed unless the healthcare provider says to stop. If the infection has not improved within a few days after seeing the healthcare provider, the student should contact the provider, the student should contact the provider again.

 The Health Department provides the following recommendations to schools:

• Follow routine procedures for cleaning the school environment. In general, use routine procedures with a freshly prepared solution of commercially available cleaner such as detergent, disinfectant-detergent or chemical germicide, as per the manufacturer’s directions.

• School attendance. Students and staff with a suspected or confirmed MRSA infection can attend school regularly as long as the wound is covered and they are receiving proper treatment. Students and staff do not need to be isolated or sent home in the middle of the day if a suspected staph or MRSA infection is noticed. Wash the area with soap and water and cover it lightly. Those who touch the wound should wash their hands immediately. The student should be encouraged to have the wound looked at by their healthcare provider as soon as possible to confirm a MRSA infection and determine the best course of treatment. The wound should be kept lightly covered until it has dried completely.

 To prevent MRSA infections at the school, consider these guidelines:

• Regular hand washing is the best way to prevent getting and spreading staph/MRSA. Encourage and practice hand hygiene.
• Practice and encourage good skin care. Since staph infections begin when staph enters the body through a break in the skin, keeping skin healthy and intact is an important preventive measure.
• Ensure access to sinks, soap, and clean towels.
• Ensure the availability of alcohol-based hand sanitizers, if soap and water are not accessible.
• Educate school personnel (i.e., coaches, athletic trainers, etc.) about the importance of personal hygiene for students.
• Encourage daily showers with soap and water.
• Discourage sharing of personal items such as towels, razors, and toothbrushes.
• Regularly clean sinks, showers, and toilets by saturating with disinfectant.
• Disinfect athletic equipment between users.
• Launder sheets, towels, sports uniforms, and underclothing with hot water and detergent, and dry on the hottest setting.
• Wear gloves when handling dirty laundry.
• Wear gloves when caring for another person’s wounds, and protect clothing from touching wounds or bandages.
• Encourage those infected to always keep draining lesions covered with dressings.
• Dispose of dressings containing pus and blood carefully.
• Disinfect contaminate portable equipment such as stethoscopes, blood-pressure cuffs, equipment handles, tourniquets, pagers, and cell phones.

 The administration met with the appropriate staff to begin the process of implementing all of the recommendations to minimize the risks to our school population.