Archive: Around Town

On Thursday (October 18th) a story about an 11 year old in Rome, NY who has been fighting a near-death battle with Community-Associated Methicillin Resistant Staphylococcus Aureus (CA-MRSA), NY hit the news. 

	"We do not have any community-aquired cases of MRSA that we know of in Lansing."

On Friday Lansing Middle School nurse Beverly Snow's phone wouldn't stop ringing.  She fielded calls from concerned parents, school colleagues, and health department officials.  The message she had to share was positive: with awareness and caution the chances of catching the potentially deadly infection are slim.  "I'm glad people are aware of it, but we don't want them to panic," she says.  "What I would like to convey to our community is no, we do not have any community-aquired cases of MRSA that we know of in Lansing."


Snow says that the Lansing Schools are taking extra preventative steps, but the best defense is to wash your hands frequently, practice good hygiene, and be sure to cover any wounds or abrasions with a moisture-proof bandage, especially when playing sports or in gym class where equipment is shared.  The schools are also taking pro-active steps like requiring students to take their gym clothes home to be washed while maintenance staff disinfects their lockers and other shared surfaces around the school buildings.  Snow has also met with Athletic Director Ed Redmond, and will meet with coaches, gym teachers, and students to explain the simple steps that will help prevent an outbreak here.

Between 20% and 30% of healthy people have staph bacteria (S. aureus) on their skin or in their noses with no ill effect.  When it causes symptoms it can normally be treated with methicillin, a penicillin-like antibiotic.  But MRSA is resistant to methicillin, and if it is not caught and treated the strain can lead to loss of limbs or even death.  In the past MRSA was only contracted in hospitals, but a new version that can be passed between people in the community began to show up last year.

	Effective Hand Washing Take a paper towel. Turn on the faucet with your hand Wash hands using disinfectant soap Dry hands with towel Use towel to turn off faucet and on door handle when exiting

"We've had staph around for many years," Snow explains.  "It's just recently that we've seen the methicillin-resistant strain in the community.  Almost everybody can take an antibiotic and get better, but in rare cases people do not get better.  The infection ends up in their bloodstream and they can die.  That's the worst that it can be."

But she is clear that there has to be a way for the infection to enter the body such as a cut or abrasion, and that intimate contact such as wrestling could transmit it.  "I'm not talking about kissing and those kind of things," she says.  "You have to have an open cut.  It's not passed on from drinking or something like that.  However it could be transmitted by equipment.  For instance, if you had a shoulder abrasion and you put shoulder pads on that someone else had used."

Snow says that it is not possible to diagnose MRSA without taking a laboratory culture.  But certain symptoms should immediately be brought to the attention of teachers and the school nurses.  "It begins as a skin infection, and that can cause puss and swelling and pain," she says.  "If you see somebody that has a boil or a really nasty looking infection, that could be MRSA and there is only one way to tell -- it needs to be cultured.  A lot of doctors' offices are taking cultures on a regular basis when they see anything that is nasty looking."

There are no known cases of CA-MRSA in Tompkins County, but County Public Health Director Alice Cole notes that because CA-MRSA is not a reportable disease there is no official way to count cases of the infection.  When the story hit the news a week ago, Snow's phone began ringing off the hook.  "I was getting e-mails from the State Health Department," she says.  "Everybody began to panic, thinking 'Oh my God, my child is going to get this.' 

	Have You Washed Your Hands Today? A study last year by the Korea Consumer Protection Board found that your toilet seat is a lot cleaner than many of the items you touch in the course of your day.  Other studies have shown that your computer keyboard, for example, has 400 times the number of germs than your toilet seat.  The Korean study showed these six items as the most infected (measurements are the number of 'Colony Forming Units' per 10 square centimeters): Shopping cart handles - 1100 Internet café computer mouse - 690 Bus hand straps - 380 Public toilet handles and door knobs - 340 Elevator buttons at 130 Train hand straps - 86 The study also showed that only half of the 77% of people who are aware of the importance of hand washing actually do it.

And that's not the case.  I don't think people really need to panic.  The best defense is keeping your hands washed.  And if you are a student athlete and you have a wound of some type, it must be covered with a moisture-proof bandage so organisms can't be transferred from one person to another."

Like all New York school districts, Lansing has a detailed Exposure Control Plan that outlines exactly what to do and who to call if an outbreak occurs, with phone numbers and extensions of specific people to call in Lansing, and the County and State Health Departments.  The plan is a thick three ring binder with contacts on the first page, and procedures outlined in detail.  Snow says that the district is well prepared for this kind of outbreak, and that if a case did occur here the County and State would immediately send response people to help school nurses deal with it.

"I pray to God we don't have an outbreak of MRSA in our community with one of our students, because you don't know which way it's going to go," Snow says.  "Imagine a poor parent losing a child to a staph infection.  Some people carry this resistant strain that can be fatal.  It's very rare, but it can be."

Last year she recalls sending a girl to the hospital with a serious staph infection on her foot.  "She was in trouble, and it could have been a very, very serious thing," Snow says.  "But her parents were on top of it and we were on top of it."

Being on top of the problem, being proactive about hygiene -- personal, school, and at home -- and making parents, school staff, and students aware of what they can do  is key to minimizing the risk of CA-MRSA. 



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