Virginia Department of Health
Guidance on Dealing with "Staph" Infections

(The purpose of this document  is to provide information about MRSA staph infections, which have affected several school divisions in Virginia.  It was provided by the Virginia Department of Health).

MRSA stands for Methicillin-resistant Staphylococcus aureus, a form of staph infection that does not respond to routine treatment with some commonly used antibiotics, although other antibiotics are effective.

While effective treatments are available, the MRSA-related death of a student this week underscores the importance of raising awareness and preventing infection.

I am asking all school divisions to consult with local health departments about steps to control and prevent MRSA, regardless of whether an infection has been reported within a school. Should a MRSA infection be identified in a school setting, division officials should immediately contact local health district directors for further guidance, especially if considering closing schools.

The Virginia Department of Health (VDH) is providing the following information for school personnel and the general public about management and prevention of MRSA.

Methicillin-resistant Staphylococcus aureus Infections: MRSA Facts for Schools:

Staphylococcus aureus ("staph") infections have been around for a long time, causing mild to severe illness. MRSA is a kind of staph infection that may be more difficult to treat but is otherwise the same as a "staph infection." Mild infections 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.

Staph is passed from person to person through direct contact with skin or through contact with contaminated items. The bacteria may live in people's noses and on their skin and most of the time do not cause any problem.  Staph can enter the body through breaks in the skin and sometimes cause infection. The main ways to prevent staph infection are to wash hands and care for wounds properly.

Practical Advice for Teachers:

Observe children for open wounds. If any are draining or contain pus, refer the child to the school nurse.

Encourage hand washing before eating and after toileting.

Coaches should ensure that athletes wash their hands, cover their wounds, and not share personal items and towels.

Practical Advice for Parents:

Clean wounds and cover them with a clean, dry bandage. Wounds that do
not heal properly need medical attention. The only way to determine if an
infection is caused by MRSA is through laboratory testing ordered by a physician or
other health care provider.

Teach children to wash their hands regularly, such as before eating and
after toileting. See:

http://www.vdh.virginia.gov/Epidemiology/Surveillance/Getsmart/documents/germposter.pdf

for a poster on hand washing.

Be sure your family members use antibiotics properly. Take all that are prescribed, even if the symptoms stop before the prescription is used up. Do not share prescriptions.

Children who participate in sporting events should wash their hands after each practice and game. They should not share equipment, uniforms, towels, or other personal items (e.g., razors). Wash uniforms and towels with hot water and detergent after each use.

Disinfection:

In athletics, mats, benches or other shared athletic equipment that might have
skin contact should be disinfected after each game or practice.  Contaminated surfaces may be cleaned using an EPA-registered cleaner or bleach solution (1 part bleach to 9 parts water).

Routine cleaning is all that is recommended. Because the bacteria live on the skin, they may be reintroduced into any environment at any time.  Therefore, hand washing and wound care remain the primary means of preventing staph infections.

Further information about MRSA can be found on the VDH Web site:

http://www.vdh.virginia.gov,

and direct links to information on MRSA are posted on the VDOE home page. If you have questions, or need additional information, please contact Tia Campbell, school health specialist, at 804-786-8671, or Tia.Campbell@doe.virginia.gov.

Handwashing resources:

Here are some general resources for hand hygiene and MRSA prevention:

Posters related to MRSA (including sports-team specific versions) are available
at:

http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_posters.html#Gen

In a similar vein, the CDC has the "Ounce of Prevention" campaign at:

http://www.cdc.gov/ounceofprevention/

Regarding detailed information on hand hygiene, appropriate antimicrobial usage,
etc. the Virginia Get Smart program produced a nice document (see attached).
Although it was produced in 2004 and may be a little out of date (e.g., the contact person, Kate Grant, is no longer here) but the main material may be of use to schools.