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Indiana State Department of Health

Epidemiology Resource Center Home > Surveillance and Investigation > Diseases and Conditions Resource Page > Methicillin-resistant Staphylococcus aureus (MRSA) in Schools Methicillin-resistant Staphylococcus aureus (MRSA) in Schools

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About... Methicillin-resistant Staphylococcus aureus (MRSA) in Schools

What is Staphylococcus aureus?

MRSA is a type of Staphylococcus aureus (staph) bacterium that is resistant to antibiotics such as methicillin, penicillin, and others.   MRSA infections in students or school staff members can cause a great deal of anxiety for parents and others in the community.  Schools may provide favorable conditions for transmission, but with proper preventative procedures, the spread of MRSA (and other staph infections) can be controlled.

How is MRSA spread in schools?

MRSA is spread normally through direct skin-to-skin contact.  MRSA and other staph infections can also be spread through contact with items that have been touched by a person with MRSA, such as towels, shared athletic equipment, and locker room benches. Some settings, such as schools, make it easier for infection to spread due to factors such as crowding, frequent skin-to-skin contact, compromised skin (e.g. cuts or abrasions caused during sporting events or gym classes), contaminated items, and lack of cleanliness.

Should schools be closed when MRSA infections occur?

Schools SHOULD NOT be closed due to MRSA infections in students or staff.  MRSA transmission can be prevented by simple measures such as hand hygiene, covering wounds appropriately, and others as noted below.  Consult local and state public health officials if school closure is being considered.

Should schools be completely disinfected when a MRSA infection occurs?

Generally, it is NOT NECESSARY to “disinfect” schools when MRSA infections occur.   Surfaces which are likely to have had contact with uncovered or poorly covered, draining wounds should be cleaned and disinfected.   Covering infections with clean, dry bandages reduces the risk of surfaces becoming contaminated with MRSA.  When cleaning and disinfection is warranted on surfaces suspected of being contaminated, Environmental Protection Agency (EPA) registered disinfectants should be used exactly as indicated on the label of the product. A fresh (prepared daily) 1:100 dilution of sodium hypochlorite (bleach) is an effective alternative disinfectant.

How can MRSA transmission be prevented in schools?

  • Schools should consider these general guidelines for the prevention of MRSA:
    • Provide anyone identified with MRSA with general information about the disease, such as the ISDH Quick Fact Sheet on MRSA at http://www.in.gov/isdh/22122.htm or the CDC Web site information listed at the end of this document.
    • Encourage proper, frequent hand washing.
    • Ensure access to sinks, soaps, and disposable towels.
    • Have alcohol-based sanitizers available when and where appropriate if soap and water are not available.
    • Discourage sharing of personal items such as towels, razors, toothbrushes, etc.
    • Regularly clean sinks, showers, toilets, shared athletic equipment, and common surfaces, such as locker room benches.
    • Encourage daily showers and bathing with soap and water.
    • Launder towels, sheets, sports uniforms, and underclothing with water and laundry detergent and dry completely on the hottest recommended setting.

Should the entire school community and staff be notified of every MRSA infection?

Normally it is not necessary to inform the entire school community, including parents, about each case of MRSA.   When a MRSA infection occurs in a student or staff member, the school nurse, administrators and school physician should determine whether all or some students and/or staff should be notified.   MRSA and other staph infections have been common causes of skin infections for many years.  If a notification letter is sent home, the local public health department should be informed prior to the letter being sent.

Should students or staff with MRSA (or skin infections) be excluded from school?

There are no specific exclusion provisions in Indiana communicable disease laws or rules for MRSA.  Students or staff should not be excluded from attending school unless directed by a health care provider, if wound drainage cannot be covered and contained with a dry bandage, or if good personal hygiene cannot be demonstrated. Students and staff do not need to be isolated or sent home in the middle of the school day if a suspected skin infection with staph or MRSA is noticed.  Make sure the area is washed with soap and water and covered. 

What additional advice is there for school health staff?

School health personnel should notify parents and guardians if a child has a possible skin infection, and if necessary, the student should be referred to a licensed health care provider for diagnosis and treatment.  School nurses and others should use standard precautions (e.g., hand hygiene before and after contact, wearing gloves) when caring for potential infections.  The ISDH has a Care of Your Skin poster which can be downloaded (http://www.in.gov/isdh/files/MRSA_SkinInfectionPoster.pdf) and strategically placed in the school. 

How can teachers help?

Teachers who observe children with open draining wounds or infections should refer the child to the school nurse.  Teachers should encourage and enforce hand hygiene with soap and water or the use of alcohol-based hand sanitizers before eating, after using the restroom, and other appropriate times.

All information presented is intended for public use. For more information on MRSA, please refer to the Centers for Disease Control and Prevention Web site:

http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html
http://www.cdc.gov/mrsa/


This page was last reviewed August 31, 2009.


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