MRSA infections remain a back-to-school risk
A private Washington school attended for decades by political luminaries and their children is standing out this month for another reason. St. Alban's is one of the latest schools to to be hit by MRSA infections, which are most commonly thought of as affecting elderly hospital patients.
Two of the high school football team's players have skin infections caused by the superbug known as MRSA, which stands for Methicillin-resistant Staphylococcus aureus, according to a note sent to parents Monday.
The outbreak illustrates just how vulnerable young athletes can be to the superbug, which is both difficult to treat and highly contagious.
MRSA is a bacteria that is resistant to many antibiotics. In the community, most MRSA infections are on the skin, but in hospitals and nursing homes, the bacteria can cause life-threatening bloodstream infections or pneumonia.
Skin infections generally appear as a red, swollen or painful bump, and patients may also have fevers. There’s a higher risk of MRSA skin infections in crowded places or during activities, such as athletics, that involve skin-to-skin contact or shared equipment and supplies.
In its note to parents, St. Albans said the school, lockers, locker rooms and buses were sterilized and disinfected with "industry-standard, hospital-grade cleaning supplies." And it said the school would continue with weekly disinfecting.
It’s not unusual to see outbreaks of skin infections like the one at St. Albans, but public reporting is spotty. In January, some Long Island schools reported cases among sports teams. The Prince William County, Va., public school system, which publicly reports cases on its website, had a confirmed case in January, March and May of this year.
“Unfortunately, it has gotten to the point where it has gotten more and more common,” says Kevin Kavanagh, a physician and superbug expert who runs a Kentucky-based patient advocacy organization called Health Watch USA.
States generally don’t require every individual case of “community-acquired” skin infections to be reported, so statistics can be difficult to come by. And the Centers for Disease Control and Prevention says there are no data showing the total number of people who get MRSA skin infections outside of hospitals.
“We just don’t have good reporting data on this,” Kavanagh says.
The CDC does say two in 100 people carry MRSA, although most of them aren’t infected. Kavanagh says that “colonization rate” can fluctuate up to 6%.
A much higher percentage of Americans — about 30% — carry staph, but not all of that bacteria is resistant to antibiotics. Among staph cultures from outpatient settings, 51% were resistant to Methicillin nationally, and the number was higher — 58% — in the South Atlantic region that includes D.C. It was higher still — 69% — in the East Southern region of the country that includes Kentucky and nearby states.
Kavanagh says he’d like to see more comprehensive, uniform reporting requirements for these infections because greater transparency leads to better tracking of the problem and better prevention. Currently, reporting varies widely by state. “In California, one of the most progressive states, all cases of severe MRSA are reportable,” Kavanagh says, adding that severe cases are those in which an infection in a previously healthy person results in death or admission to a hospital intensive care unit.
In the meantime, he suggests people take steps to protect themselves with simple measures such as frequent hand-washing and keeping surfaces clean. “The most important thing is to have good hygiene,” he says.
Education efforts on the part of schools and their sports teams appear to have made a difference, says Beth Mattey, president of the National Association of School Nurses and a high school nurse in Wilmington, Del. Although the group doesn't track school outbreaks, she says coaches in contact sports such as wrestling now know about the importance of washing mats after every practice and not sharing clothing or equipment without cleaning it first.
"We have a better handle on it," Mattey says of school nurses.
Mattey warns that anyone playing sports or exercising should be sure to clean any mats or equipment as MRSA discharge on a surface or clothing can infect another person. While "skin is a good barrier," people may not realize they have even a small open skin wound that makes them susceptible to infection.
St. Albans also said in its note to parents, obtained by USA TODAY, that the school's medical workers are doing skin checks on all of its upper school football players. All students are being told to cover up any skin lesions and to watch for any abnormalities.
"Because we recognize how serious a MRSA infection can be, we are trying to be as vigilant and transparent as possible, while respecting the privacy of our families, so that we can work with parents as a team to recognize and prevent further infection," the school said in a statement Tuesday night.
St. Albans is a day and boarding school for boys in grades 4-12 that costs more than $40,000 a year for tuition. Famous alumni include former vice president Al Gore and Secretary of State John Kerry.