Schools respond to MRSA outbreak

Once limited to hospitals and nursing homes, infections of methicillin-resistant Staphylococcus aureus (MRSA) have become increasingly common in the general population in recent years.

But many school boards took note of this growing health issue after the death of a 17-year-old Virginia high school student in October, about the same time as a report published in the Journal of the American Medical Association revealed that MRSA infections are far more prevalent and deadly than initially believed.

Yet public health officials suggest school boards and administrators keep the risks of MRSA in perspective. Encouraging good hygiene among students can limit the spread of the infection, which is resistant to penicillin and other “beta-lactam” antibiotics but can be successfully treated with other drugs.

“This is a very serious concern,” says Amy Garcia, executive director of the National Association of School Nurses. “But there are other infections that are also easily spread in the school setting, so schools should have policies and procedures in place for dealing with MRSA but also tuberculosis, influenza, and other serious illnesses.”

According to the Centers for Disease Control and Prevention (CDC), more than 90,000 Americans are infected each year by MRSA -- and nearly 19,000 die. That’s more than the number of AIDS-related deaths each year, but less than the 36,000 killed annually by the flu.

The medical community has been following the spread of MRSA for years, but for most school officials -- as well as students and parents -- this drug-resistant bacteria has appeared almost out of nowhere. And, in many communities, news of a student infection has sparked anxiety, alarm, and even some school closings.

In Bedford County, Va., where Staunton River High School student Ashton Bonds died of MRSA after being hospitalized for more than a week, officials closed down schools so district custodians and a commercial cleaning firm could wipe down gyms, locker rooms, door handles, counters, computer keyboards, desks, and other surfaces with disinfectant.

That decision followed a prayer vigil organized by students that turned into a spontaneous protest over the cleanliness of Staunton High. Superintendent James Blevins later toured the school with students to examine locker rooms and other areas of concern.

“Students saw one of their classmates die, and that put the fear in them,” says district spokesperson Ryan Edwards. “It absolutely scared them to death. It was an infection they knew nothing about, and they were afraid to go into the school.” So when the superintendent saw how emotional the community was, he made the decision to close the schools and “spend the day educating the public and easing their fears.”

Closing the schools gave officials an opportunity to work with the media to get information out to the community about the actual health risks and procedures that parents and schools could take to reduce future infections. The system also sent home letters to parents and used its automated telephone dialing system to call parents with a reassuring message.

That kind of all-out public awareness effort should serve as a crucial lesson for other school systems that find themselves confronting a similar outbreak, Edwards says. “When it comes to a situation like MRSA, which has created an outstanding amount of paranoia and fear in our community, getting word to the public as quickly as we could was in our best interest.”

Mark Thomas, communications officer for the Birdville (Texas) Independent School District, where 10 students have been infected, agrees that constant communications with the community can limit any overreaction to news of an outbreak.

So far, he says, “I’d be surprised if we’ve had more than a dozen calls with people really expressing a concern. We’ve been really proactive.”

Most infected students can return to school once they’ve begun treatment, the CDC states. Only those with a wound that cannot be contained by a bandage -- or those who cannot maintain good personal need to stay home.

From a medical perspective, the CDC says it is not necessary to inform the entire school community about a single MRSA infection, although the school nurse and appropriate public health authorities “should determine, based on their medical judgment,” whether notification of some or all students, parents, and staff is necessary.