Worried about MRSA?
Thursday, November 15, 2007
If you haven’t heard of MRSA yet you probably will. MRSA, pronounced Mersuh, stands for Methcillin Resistant Staph Aureus. It gets its name because it is a Staph germ that developed resistance to the antibiotic Methcillin in the 1960s. Until recently MRSA was found almost exclusively in hospitals, where it has been a well-known cause of infections in very sick patients for more than 40 years.
In the last few years MRSA has been found in patients who had not been in the hospital. This strain of MRSA has been named "community acquired" (CA-MRSA) to describe its origin. The MRSA found in hospitals is considered a "super bug" because it can survive exposure to all but a few antibiotics. CA-MRSA is a different strain and can often be treated with several common medications.
In October, CA-MRSA caused at least two deaths: a 17-year-old high school senior in Virginia and a 12-year-old student in Brooklyn. Both were previously healthy. This led to so much alarm and confusion that some parents pulled their children out of the schools and demanded the buildings be "disinfected" before their return.
As a parent, it is scary to think that a locker room germ could cause a child’s death. Any parent would be concerned, worried and ready to take action. But in spite of recent publicity, deaths from CA-MRSA are very rare and the action we should all take is as simple as washing our hands.
Staph, including CA-MRSA, is a common germ that lives harmlessly in the noses of 20-30 percent of the population without ever causing a problem. It is considered part of normal skin bacteria. When Staph does cause an infection, it is usually an infection of the skin consisting of a red, tender pimple that may be mistaken for a spider bite. In most instances the body’s immune system takes care of these without treatment. Sometimes the pimple will form a soft, tender area filled with pus called a boil or an abscess. These infections can be painful and bothersome, but are generally treated with warm compresses, simple drainage and/or antibiotics.
Rarely, CA-MRSA can cause an infection that spreads through the blood stream causing pneumonia and severe illness. In those cases hospitalization for intravenous antibiotics is necessary. A doctor should be called immediately for a rapidly progressing area of redness, warmth or drainage accompanied by a fever.
CA-MRSA and all Staph infections are spread by several known factors. Most common is by direct skin-to-skin contact or by contact with shared items or surfaces that have come into contact with someone else’s infection (e.g., towels, used bandages). One recent medical article cautioned about "The 5 Cs": Crowding, frequent skin-to-skin Contact, Compromised skin (i.e. cuts or abrasions), Contaminated items and surfaces and lack of Cleanliness. The 5 Cs are most common in schools, especially locker rooms, dormitories, health clubs, daycare centers and some homes.
It is tempting to think that we should simply decontaminate those areas, but remember, 20 to 30 percent of the population carries the germ everywhere they go. Since these silent carriers don’t know they harbor the germ, a decontaminated space will quickly become re-contaminated when people return to it.
Fortunately, there are simple and effective ways to defend your child and yourself against CA-MRSA.
First and foremost: wash your hands. Teach your children to lather up before every meal and discourage them from frequently touching their faces. Carry an alcohol-based hand sanitizer with you for snack times when water isn’t available. Keep cuts covered with a bandage until healed. Routinely wash surfaces and floors and never share personal items such as towels, toothbrushes or tubes of antibacterial ointment.
If your child does get infected with CA-MRSA, it is not necessary to keep him or her out of school unless directed by your doctor. Instead, keep the infected area covered with a clean bandage until it is healed and continue to encourage frequent hand washing to avoid spreading the infection to others.
As the first super bug to make its way into the community, it is likely CA-MRSA will continue to grab headlines. But with good hygiene and increased awareness children can stay safe, healthy and infection-free.
Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago. E-mail her at drlisa