Education, Hygiene Key to Stopping Staph 'Superbug'

By MICHAEL WALSH, Capital News Service

WASHINGTON - Health officials are targeting sports teams in an effort to stop recent outbreaks of a "superbug," a drug-resistant strain of staph infection, in Maryland and Virginia.

The death of a 17-year-old male Virginia student Monday has focused recent attention on getting control of the microbe's spread, but the bug is not uncommon. There are nearly 19,000 deaths from MRSA, methicillin-resistant Staphylococcus aureus, per year and 94,360 cases of the infection nationwide, according to the Journal of the American Medical Association.

MRSA has typically been associated with athletes, specifically football players, because of the infection's ability to be transmitted through open wounds or through sharing equipment and supplies, including weight-training apparatus, razors or towels.

"It's transmitted by either indirect or direct contact," said John Jernigan, MRSA expert at the Centers for Disease Control and Prevention. "It's potentially easy to transmit in that way, however it's also pretty easy to interrupt transmission."

Disruption of the "superbug" in sports teams is crucial, according to reports.

Seven football players at Sherwood High School in Montgomery County were diagnosed with skin infections in June. Three of the first four cases reported in Anne Arundel County were athletes, said Bob Mosier, spokesman for Anne Arundel County schools.

Anne Arundel has had 57 reports of skin infections so far this year, Mossier said. There have been 32 reports of MRSA infections in the Washington area, according to reports, including a case at the University of Maryland-College Park.

The cause of the recent spread is unclear, but studies have shown higher rates of MRSA in athletes, particularly football players.

"Staph infections in football players - including infections with MRSA - have been well described and appear to be relatively common," said David Blythe, Maryland state epidemiologist.

How likely football players are to contract MRSA can depend on what position they play, according to a study of 100 Connecticut college football players released in 2004 by the Infectious Diseases Society of America.

Cornerbacks and wide receivers were the most likely to contract MRSA, according to the study, which found 10 MRSA cases in 100 players. Four of the eight cornerbacks studied tested positive for MRSA, as well as four of 12 wide receivers.

The study concluded that frequent contact between cornerbacks and receivers in practice resulted in higher rates of MRSA. Players who experienced turf burns or engaged in cosmetic shaving (i.e. chest, arms or legs) were at a higher risk.

Now, Mossier and other school officials in Maryland are trying to educate coaches and players about the dangers of MRSA with help from the state health department.

Beginning this winter, the health department has agreed to give presentations to coaches about skin infections as part of the basic information before their seasons start.

"Usually we have people come in and give presentations on rules and regulations," Mosier said. "Now the health department will give a presentation."

Anne Arundel has also started cleaning the school with a higher grade of hospital cleaner, including all locker rooms and weight equipment and will install soap dispensers in their showers.

When asked how the infections could be stopped, Jernigan said simply: "Avoid touching wounds, avoid sharing items."

Despite the increased media attention to skin infections in schools this year, Mosier said that he and the health department believe that there has not been an exceptionally high number of staph infection cases this year to date.

"Skin infections are not legally reportable conditions," Mosier said. "So we asked the health department, 'Do you think we have more cases or more reports?' and they said, 'We think you have more reports because of the raised level of awareness,' and that's a good thing, you want that awareness."

Maryland reported two cases of MRSA in schools in 2006 and including the two reported to date this year, six in school settings since 2000.

But more parents are coming forward with skin infection reports this year, Mosier said, sometimes reporting infections that are months old.

"What we're getting now are parents saying, 'Hey, Jimmy had this in July,'" Mosier said.

When the outbreak first occurred, their child had more than likely been on a sports team, but Mosier said that isn't the case now.

"Three of the first four were athletes," Mosier said. "But it's not all athletes, it's not all dance students, it's not all chess club."

Jernigan agreed.

"(MRSA can occur in) any setting where there are very close confines particularly where that is combined with lapses in hygiene and cuts and scrapes," he said.

As far as the health department and Mossier are concerned, the school and sports schedules will continue, uninterrupted.

"We've asked [the health department], 'Do you think we should close schools and cancel sporting events?'" Mossier said. "And each time we've been told 'no.'"

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