Microsoft word - mrsa recommendations parents.doc

State of Wisconsin 608-266-1251
Department of Health and Family Services Bureau of Communicable Diseases and Preparedness
Recommendations for Controlling the Spread of Community Associated Methicillin Resistant
Staphylococcus aureus (CA MRSA) Among Students and Athletes
October, 2007
CA MRSA is a bacterium normally carried in the nose or on the skin of about 1% of the population. It usually causes mild skin infections such as abscesses or boils but occasionally may cause more serious skin and soft tissue infections. Cases of invasive disease such as blood stream infections and pneumonia have occurred but are rare in healthy individuals. MRSA is resistant to some antibiotics such as amoxicillin, but can still be treated with several other commonly used antibiotics, and many infections can be treated successfully without antibiotics. MRSA is spread by direct person to person contact or contact with contaminated surfaces, equipment, or items such as used towels, razors, and bandages. The following recommendations will help reduce transmission of CA MRSA among students and athletes in the school setting. Keep skin clean 1. Hand washing facilities, soap, and alcohol hand sanitizers should be readily available to all staff and students to encourage good hand hygiene. Alcohol hand sanitizers should be provided in situations where sinks, soap, and water are not available. 2. Sports team members should be expected to shower after team practices and sports events. 3. Persons doing wound care or examining skin lesions should wear disposable gloves when in contact with infected areas, and should wash hands immediately after discarding gloves. 4. Students should not share personal items such as towels, razors, soap bars, water bottles, used 1. Ensure that all sports team members wear suitable, good-fitting protective gear during all sports 2. If cuts or breaks in the skin do occur, clean the area with soap and water and cover with a Early detection of skin infections Students and athletes should be instructed to report open wounds to a designated person such as the school nurse or athletic coach. Routine active screening of students for signs and symptoms of skin infection may not be necessary unless an outbreak (three or more cases among close contacts) is suspected (see management of outbreaks below). Signs and symptoms of skin infections include lesions that may appear as pustules or boils which are often red, swollen, painful, or have pus or other drainage. Lesions may be misdiagnosed as “spider bites.” Exclusion of persons with skin infections If infected areas can be covered and wound drainage is contained with bandages or clean, dry dressings, infected persons may be allowed to remain in school and should be instructed to practice good hand and personal hygiene. Infected persons should be excluded from athletic activities if wound coverings are not likely to be maintained during those activities. Maintaining a clean environment 1. Showers, locker rooms, weight rooms, mats, benches, sports equipment and other commonly used items and areas should be routinely cleaned and disinfected with EPA registered disinfectants or diluted bleach solution. Follow all directions on product label and allow disinfectants to remain on items for the amount of time recommended by the manufacturer. A list of appropriate disinfectants is located on the EPA website at Selection of disinfectant for use on sports equipment that could potentially be damaged by some disinfectants should be based on equipment manufacturer recommendations. 2. Whirlpools should be drained and disinfected routinely, paying special attention to cleaning of 3. Whirlpools should not be used by persons with open wounds or active skin infections. 4. Used bandages and dressings that are heavily soiled or saturated with blood or wound drainage should be sealed in a plastic bag before discarding into regular trash containers. 5. Uniforms, used towels, and other laundry should be washed routinely in hot water and detergent or warm water and bleach and dried in a hot dryer. 6. Liquid soap dispensers are recommended in place of soap bars for use in common areas such as rest rooms and locker rooms. Soap dispensers should contain bottles or bags that are replaced when empty to avoid addition of soap to used containers. Management of outbreaks An outbreak is defined as three or more cases of skin infections among close contacts (e.g. students from the same classroom or athletes on the same sports team) in which CA MRSA has been isolated from a culture of the infected area. 1. Students and staff, especially close contacts of cases, should be screened for signs and symptoms of skin infections, referred for medical treatment, and evaluated for the need to be excluded from school or sports activities. 2. Contact the local health department for technical assistance on management of the outbreak. 3. School administrators should be prepared to distribute informational material to students, staff, and parents regarding strategies to control transmission of CA MRSA.


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Original Paper Accepted: September 11, 2006 Published online: November 27, 2006 Use of Sedation for Routine Diagnostic Upper Gastrointestinal Endoscopy: A European Society of Gastrointestinal Endoscopy Survey of National Endoscopy Society Members S.D. Ladas L. Aabakken J.-F. Rey A. Nowak S. Zakaria K. Adamonis N. Amrani J.J.G.H.M. Bergman J. Boix Valverde S. Boyacioglu I. Cremer

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