November 7, 2007

Dear Parents:

As the Medical Director of the Central Michigan District Health Department, I am writing to provide you information on Methicillin Resistant Staphylococcus Aureus (MRSA). MRSA has been the subject of concern, not just recently, but for many years.

Staphylococcus infections are very common. MRSA is a subclass of staphylococcus infections. The unique feature of MRSA is that it resistant to common antibiotics. However, MRSA is not necessarily life threatening and many infections will respond to incision and drainage of the infected tissue.

Staphylococcus bacteria are just about everywhere. Staphylococcus, including MRSA, is found on your skin, on counter tops, door handles, and even in people’s nasal passages. The best we can do about staphylococcus is learn to live with it. That is, we have to accept the fact that staphylococcus is all around us but it need not harm us. If people take a few simple measures then the risk of a serious staphylococcus (and MRSA) infection can be reduced.

The number of people that carry staphylococcus bacteria in their nasal passages is about 35 percent. The number of people that carry MRSA is estimated to range from 0.5 percent to 2.2 percent. These figures are important because it gives us an idea of the scope of the presence of staphylococcus in people.

In reality, everyone at some time or another during their lifetime has had a staphylococcus and/or MRSA infection. Our immune system is wonderfully adept at keeping bacteria and other germs under control. Occasionally, our immune system is stressed out or weakened and an opportunistic germ, such as staphylococcus, is able to start an infection. Nearly every time an infection starts our immune system will rally and throw off the offending agent. It is a truly rare instance when a simple staphylococcus infection turns into a deadly situation in an otherwise healthy person.

In the overall spectrum of diseases, staphylococcus infections and MRSA infections are minor players. Far more people will be hospitalized due to influenza and more people will die from influenza than from staphylococcus and MRSA infections. This doesn’t mean however that society should ignore staphylococcus and MRSA. Indeed, the things that we do that help to prevent the spread of influenza can help stop the spread a whole list of infections such staphylococcus, influenza, and norovirus.

It is the health department’s opinion that personal preventative measures would be more effective and give less of a false sense of security than large scale cleaning of buildings and other public venues. Because of the widespread presence of staphylococcus bacteria, the second that someone touches a recently cleaned object such as a doorknob, the chances are staphylococcus will be reintroduced onto the surface.

The CMDHD recommends that everyone including schools, health care settings, and other agencies that host groups of people follow some basic guidelines to reduce the risk of the spread of germs that can be spread from person to person such as staphylococcus, influenza and norovirus.

Recommendations:

Hand washing with soap and water for a minimum of 15 seconds. At a minimum people should wash their hands before eating, before preparing food, and after going to the bathroom. In addition to these opportunities, CMDHD recommends that school children wash their hands when coming to school and after recess.

In the event that, for whatever reason, soap and water are not available then a waterless hand cleaner can be used to wash one’s hands.

Also at school students should not share athletic equipment such as shoulder pads.

Common use equipment such as weight lifting equipment should be sanitized with a bactericidal wash after each use.

People should not share personal hygiene utensils such as toothbrushes and razors.

People should not share towels. In public settings people should use hot air blow dryers or individual disposable paper towels to dry their hands.

People should keep open sores, cuts or scratches covered.

Minor cuts, scratches, and abrasions should be washed with soap and water. Deeper cuts and wounds should be evaluated and treated by your family doctor.

Knowing the signs and symptoms of a staphylococcus infection is important. It is recommended that people be evaluated by their family doctor at the first sign of a possible staphylococcus infection. Symptoms of a possible staphylococcus infection include; a honey colored discharge from a cut or a scrape; a red, swollen, painful, pimple or bump on the skin; a red streak that leads away from a cut, scrape; or a yellowish thick discharge of pus from a deep cut or incision.

We hope that the information provided in this message answers your questions. If you have any further questions please contact us.

Robert Graham, DO, MPH, FAAFP

Medical Director