MRSA concerns

MRSA around the facility and locker room

Gil Fried, Professor, University of New Haven
Special Consultant, Widerman Insurance

It is all over the media. Schools, hospitals, government agencies, and other entities are now scrambling to deal with an issue that for years was a concern, but was on the back burners. Staph infections have been around for years and were looked at primarily as a concern around hospitals. A specific type of Staph infection has generated significant media coverage and it is called methicillin-resistant Staphylococcus aureus, or MRSA. MRSA infections are usually manifested as skin infections, such as pimples and/or boils, and can occur in otherwise health individuals.

A government report last month found that more than 94,000 Americans get potentially deadly Staph infections each year. Of these victims, nearly 19,000 died as MRSA is resistant to many antibiotics. It should be noted that 85% of these cases are connected to health care related facilities. The virus is so dangerous because it can live on all types of environments from towels to lockers and everything in between.

Having an MRSA outbreak does not mean you have a poor facility. Over the past ten years there have been outbreaks in elementary school gyms to NFL locker rooms. In 2003 a Lycoming College football player died from a bloodstream infection linked to MRSA bacteria. In 2004 newspapers reported that some members of the Denver Broncos came down with the virus and future hall-of-fame player Junior Seau allegedly caught it while playing for the Miami Dolphins.

In 2007, a former college football player sued Iona College over an antibiotic-resistant staph infection that nearly cost him his leg. The player, Nick Zaffarese, accused team trainers of initially brushing off his burgeoning MRSA, infection in September 2005. He claims that the team's locker room was an unsanitary environment in which players shared towels and equipment. While the College disputes the allegations, it recently disinfected a weight room and went over hygiene advice after 10 members of an athletic team (including a coach) were diagnosed with MRSA in September. The lawsuit seeks more than $250,000 in damages.

Other cases have sprung up around the country including:
Three students in Detroit were diagnosed with MRSA,
School officials disinfected a locker room in Indiana after a student was diagnosed,
At least six football players at a North Carolina high school were diagnosed and the school sanitized the locker room and equipment,
Five fencers at a club in Denver were infected,
Two football players diagnosed with the disease at a college in Los Angeles,
Two wrestlers at a high school in Indiana came down with MRSA, and
Numerous outbreaks all across the country affecting from 1-40 students have been reported.

MRSA is not something that can be caught only from close physical contact. In fact, three of the biggest concerns have involved minimal human-to-human contact. Shaving is one of the big concerns. Many swimmers and cyclists shave their bodies and each time someone shaves they are creating micro-abrasions that can quickly become infected. Body shaving according to one study increases the chance of MRSA infection by 43%. A similar concern exists with body piercing. With the growth of body piercing, more and more athletes have open wounds that can easily become infected. Lastly, surfaces from diving boards to fake grass (whether on a playing field or on walking areas) can help spread the disease. One study highlighted that those who suffered from turf burns from products such as AstroTurf are seven times more likely to catch the disease. In early 2006, GeneralSports Venue (GSV), the exclusive U.S. licensee of the AstroTurf brand, offered TurfAide™ from SportCoatings (a state-of-the-art antimicrobial protection), as an optional component for AstroTurf fields. As of October 2007, it became standard on all new AstroTurf systems.
How can you minimize the chance of having MRSA spread or develop in your facility? The answers are common sense cleanliness, but it should be pointed out that viruses live on all surfaces and we are exposed to them on a regular basis.

Potential solutions for combating MRSA include:
Rubberized flooring that is specifically treated to deal with infectious diseases,
Sanitizing/disinfecting surfaces on a regular basis to kill various viruses from MRSA to Hepatitis strains,
Encouraging facility users to wash their hands frequently with soap or hand sanitizers,
Use air blowers rather than paper towels for drying hands,
Discourage facility users from sharing personal items such as shavers, soap, combs, clippers, etc…, and
Thoroughly wash towels at a hot enough temperature (over 160 degrees) to make sure they are clean.

Another major solution is properly training the staff. If staff members understand why they are cleaning surfaces, they might be more inclined to give their best effort. In 2005 staff members at the Dollan Aqua Centre (Scotland) were faced with a crisis. Traces of MRSA were found on a cafeteria table, a toilet handle, and a female locker after a secret investigation by a Sunday newspaper. Unacceptable high risk levels of MRSA are deemed to be anything above 0.5 colonies per square centimeter - the amount found in the female locker at the Dollan was 2.2. Management’s challenge was to get the staff to make sure strict cleaning procedures were adhered to on a regular basis.