Superbugs: How to Protect Your Family

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If you’re like most parents, recent news reports about temporary school closings, and even deaths, from so-called “superbugs” have probably left you feeling a bit unnerved — and concerned about how to keep your child safe, whether at day care, school or the football locker room. Here’s the info you need to protect your family.

What are these “superbugs”?
Several decades ago, a new strain of staph bacteria showed up in hospitals. It was resistant to the broad-spectrum antibiotics commonly used to zap it, according to the Mayo Clinic. Named methicillin-resistant Staphylococcus aureus (MRSA), it was one of the first germs to defeat all but the most powerful drugs.

About 30 percent of the population carries regular staph bacteria on their skin or in their nose, according to Gregory Moran, M.D., a professor of medicine at UCLA School of Medicine in Los Angeles and a physician with the emergency-medicine and the infectious-diseases departments at Olive View-UCLA Medical Center. About 1 percent of the population carries the MRSA bacteria, he says.

Staph bacteria generally don’t cause a problem unless they enter the body through a cut or other wound, and even then they often cause only minor skin problems in healthy people. In young children, older adults and people who are ill or have weakened immune systems, ordinary staph infections can sometimes lead to MRSA infection.

“Staph infections, and even MRSA infections, are actually quite common,” says Moran. “But the vast majority resolve and don’t turn into a life-threatening situation. We see these infections every day in ERs across the U.S.,” he adds. “They are mild, self-limiting skin infections. We drain the abscess and they virtually always get better.”

Life-threatening MRSA infections are rare, says Moran, noting that most occur in elderly patients who are hospitalized with other serious medical problems. But, as we’ve seen in recent news reports, sometimes these infections can be deadly in children and teens, too. It’s just important to keep these news reports in perspective, he notes.

Diagnosis and Treatment
MRSA infection can appear as pustules or boils that often are red, swollen, painful or have pus or other drainage, according to the CDC. These infections commonly occur at sites of skin trauma, such as cuts and abrasions, and areas of the body covered by hair (back of the neck, groin, buttock, armpit, beard area of men).

Doctors can take a tissue sample or a sample of a patient’s nasal secretions to check for MRSA bacteria. The sample is sent to a lab where the bacteria can grow and be tested. It takes about 48 hours for the bacteria to grow with this type of test. But, according to the Mayo Clinic, newer tests, which can detect staph DNA in just hours, are becoming more widely available.
Mayo Clinic experts recommend keeping an eye on minor skin problems such as pimples and insect bites in addition to cuts and scrapes, especially in children. If wounds become infected, see your doctor.

Almost all MRSA skin infections can be treated by drainage of pus — with or without an antibiotic — the CDC notes. More serious infections, such as pneumonia, bloodstream infections or bone infections, are very rare in healthy people who get MRSA skin infections.

Request that your doctor have any skin infection tested for MRSA before starting antibiotic therapy, advises the Mayo Clinic. Drugs that treat ordinary staph bacteria aren’t effective against MRSA — and using them when not necessary can lead to more-resistant bacteria.

How Is MRSA Transmitted?
According to the CDC, MRSA is usually transmitted by direct skin-to-skin contact or contact with shared items or surfaces that have come into contact with someone else’s infection (towels, used bandages, etc.). MRSA infections can occur anywhere, but some settings have factors that make transmission easier, says the CDC. These factors are referred to as the 5 C’s:
1. Crowding
2. Frequent skin-to-skin contact
3. Compromised skin (i.e., cuts or abrasions)
4. Contaminated items and surfaces
5. Lack of cleanliness

Locations where the 5 C’s are common include schools, dormitories, military barracks, households, correctional facilities and day-care centers.

Protecting Your Family
Careful hand washing remains your family’s best defense, says the Mayo Clinic. Scrub hands briskly for at least 15 seconds, then dry them with a disposable towel and use another towel to turn off the faucet. It’s helpful to carry a small bottle of hand sanitizer for times when you don’t have access to soap and water.

The CDC also suggests that teachers enforce hand hygiene with soap and water or alcohol-based hand sanitizers (if available) before students eat and after they use the restroom.

Wash all abrasions and cuts with soap and water and cover them until healed, Moran suggests. Avoid sharing personal items that come into contact with bare skin, the CDC advises. Use a barrier (clothing, a towel, etc.) between your skin and shared equipment such as weight-training benches. Establish cleaning procedures for frequently touched surfaces and surfaces that come into direct contact with people’s skin.

If you or a family member has a cut or sore, wash towels and bed linens in hot water with bleach and dry them in a hot dryer, the CDC suggests. Wash gym and athletic clothes after each wearing.

How Should Schools Handle MRSA Infections?
The decision to close a school for any communicable disease should be made by school officials in consultation with local and/or state public-health officials. However, in most cases, it’s not necessary to close schools because of an MRSA infection in a student, says the CDC. MRSA transmission can be prevented by simple measures such as hand hygiene and covering infections.
“I’ve got two young kids, and I wouldn’t freak out about this,” says Moran. “I wouldn’t pull my kids out of school (if a student at the school was diagnosed with an MRSA infection).”

In general it is not necessary to close schools to “disinfect” them when MRSA infections occur, the CDC says. MRSA skin infections are transmitted primarily by skin-to-skin contact and contact with surfaces that have come into contact with someone else’s infection. Covering infections will greatly reduce the risks of surfaces becoming contaminated with MRSA.

Cleaning and disinfection should be performed on surfaces that are likely to come in contact with uncovered or poorly covered infections, the CDC advises. Cleaning surfaces with detergent-based cleaners or Environmental Protection Agency-registered disinfectants is effective at removing MRSA from the environment. Environmental cleaners and disinfectants should not be used to treat infections.

If your child has an MRSA infection, talk with your school about its policy for notification of skin infections, the CDC advises. Unless directed by a physician, students with MRSA infections should not be excluded from attending school. Exclusion from school and sports activities should be reserved for those with wound drainage (“pus”) that cannot be covered and contained with a clean, dry bandage and for those who cannot maintain good personal hygiene, according to the CDC.

For more information on MRSA infection, visit the CDC’s Web site at www.cdc.gov.

Kathy Sena is a freelance journalist and mother of a 12-year-old son.