New, invasive staph strain a growing school threat

Students, athletes urged to change habits to avoid infections

08:45 PM CDT on Friday, October 5, 2007
By LAURIE FOX / The Dallas Morning News
lfox@dallasnews.com

Texas schools this fall have tackled what's becoming an increasingly familiar foe.

Outbreaks of contagious skin infections from Staphylococcus aureus have cropped up in Southlake and Flower Mound this school year.

Officials in Southlake's Carroll ISD reported a handful of cases of staph infections at Carroll High School. Lewisville ISD officials confirmed that Flower Mound High School also had an outbreak, although the number of cases was not available.

"The schools are seeing these outbreaks every year for the last three years," said Dr. R. Doug Hardy, an infectious-disease expert at UT Southwestern Medical Center. "We need to get this issue into people's thinking because it's here to stay."

Officials with local health departments say they ask schools to report such outbreaks to them. They also keep track of the issue anecdotally.

Dallas County health department officials said there haven't been any reported staph infection cases in schools so far this year. A half-dozen Dallas County schools reported cases last year.

Last fall, six cases of staph infections were also reported at a Frisco middle school.

Doctors said what's made the issue important to schools is that the new strains of staph have moved from hospitals into the community. And some are more resistant to antibiotic treatment.

Locker rooms are a notorious breeding ground. Staph bacteria can cause infections through open wounds or other breaks in the skin. The easiest way to transmit it is through skin-to-skin contact or by sharing items that come into close contact with skin, such as towels, bar soap and sports equipment.

Sports such as football, lacrosse and wrestling often involve players who have cuts or abrasions. A locker room culture of sharing soap or towels, or in some cases, not showering at all, can spread the infection.

A new, more invasive strain of staph is called methicillin resistant Staphylococcus aureus, or MRSA. The medical community refers to this strain as "community-acquired" because it's being contracted outside hospitals.

MRSA is a staph bacterium resistant to many common antibiotics that can cause several ailments. Most common is a contagious skin infection that causes pimples and boils.

Staph infections begin abruptly. Symptoms may include a large area of redness on the skin, swelling and pain, followed by sores. If left untreated, staph infections can infect blood and bones, causing severe illness that requires hospitalization.

"If one young person gets this infection, unfortunately, so do many others," said Dr. Richard Wenzel, president of the International Society for Infectious Disease, who has studied staph infections. "But this is not your father's staph. It has a couple of extra genes that make it antibiotic-resistant and toxins that destroy tissue."

More serious and much less common infections include pneumonia caused by MRSA. Patients with the disease get very sick, with symptoms that can include high fever, dropping blood pressure and shortness of breath. It eats holes through lungs, releases toxins through the body and can cause kidney failure. It can kill within days and must be treated with specific antibiotics.

Those in the medical and athletics community have been warning schools about staph infections.

The Centers for Disease Control and Prevention has worked with several sports organizations, including the NFL and NCAA, to educate athletes on hygiene and preventive measures.

The University Interscholastic League and the Texas Department of State Health Services have information for parents, athletics trainers and coaches including fliers, fact sheets and posters.

Some school districts are taking steps to curb the issue and educate their communities about staph infections.

Last year in Plano, officials sprayed artificial turf on three indoor practice fields with a coating to kill algae, fungi and bacteria, including staph.

Carroll ISD officials posted information on the district Web site about staph infection at the high school and tips for stopping its spread.

Doctors said athletes and those who supervise them must develop new sets of behaviors.

Using liquid soap, cleaning shared athletics equipment, covering wounds and washing a favorite practice T-shirt after each use could go a long way toward stemming staph infections, doctors said.

"A single case in a football player is considered an outbreak because one gets it and the entire line gets it," said Dr. John Carlo, medical director for the Dallas County Health Department. "There's an old system in the way things are done in some locker rooms. This is a new threat that requires a new way of thinking."

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