MRSA (Methicillin resistant Staphylococcus aureus)
The Contra Costa County Public Health Department has received several calls of concern from the community about the possible presence of staph infection, and methicillin resistant Staphylococcus aureus (MRSA) within the school communities and other public settings. Staphylococcus aureus, or staph, is a common germ that many people carry in their nasal passages, under fingernails or on their skin without ill effects. MRSA is a type of staph bacteria that has developed antibiotic resistance (certain antibiotics are unable to kill the bacteria). Since staph is spread primarily by direct (skin-to-skin) human contact or with direct contact to wound drainage of someone who is carrying or infected with the bacteria, anyone with a break in his or her skin is at risk. MRSA may also occur less frequently through indirect contact with contaminated surfaces or items. MRSA is not spread through the air.
MRSA Fact Sheet
What is Staphylococcus aureus?
It is a common type of bacteria. Most refer to these bacteria as "staph" (pronounced staff). It is normal to find different types of Staph bacteria on the skin and in the nose. It is also found in our lungs and intestines.
What is MRSA?
MRSA is a type of bacteria Staphylococcus aureus. MRSA is resistant to some antibiotics.
What are the symptoms of an infection with MRSA?
The symptoms of infection depend on the part of the body infected. Skin infections may result in redness, warmth, swelling, painful lesions (sores), boils and blisters. Persons may have the bacteria in their lungs so they would have symptoms of a respiratory illness: fever, cough, shortness of breath, fatigue. Infections can also occur in surgical wounds, burns, catheter sites, and in the blood. Sometimes persons may be a carrier of MRSA. This means it is living in their body without causing them to be sick.
How does a person get MRSA?
Skin infections often begin where there is an opening or break in the skin such as a cut or insect bite.
How is MRSA spread?
These bacteria are spread through direct contact with the hands of a health care worker or persons who are infected or are carriers of the organism. Bacteria can rub off the skin during close contact.
How do I know if I have MRSA?
MRSA infections can be diagnosed when a health care provider obtains a sample of mucus or pus from the site of infection and submits it to the laboratory. This test sample is called a culture. If the lab finds MRSA in the test sample, the test is positive, this means that you have MRSA in or on your body.
If you or any family members have symptoms as described above, you are encouraged to contact your family doctor. Treatment is not required if you do not have symptoms.
Students and their family members should take the following precautions to help prevent skin infections:
- Encourage careful hand washing - the single most effective way to control spread of MRSA.
- Encourage frequent hand washing with soap and warm water.
- Encourage students to keep their fingernails clean and clipped short.
- Avoid contact with other people’s wounds or anything contaminated by a wound.
- Avoid sharing personal items such as razors, body jewelry, towels, deodorant, or soap that directly touch the body.
- Clean and disinfect objects (such as gym and sports equipment) before use.
- Wash dirty clothes, linens, and towels with hot water and laundry detergent. Using a hot dryer, rather than air-drying, also helps kill bacteria.
- Encourage students who participate in contact sports to shower immediately after each practice, game, or match.
- Keep open or draining sores and lesions clean and covered. Anyone assisting with wound care should wear gloves and wash their hands with soap and water after dressing changes.
Is it safe to have contact with persons who are infected with MRSA or those who may be "carriers"?
If basic hygiene precautions are followed, MRSA carriers are not a hazard to others including their family and friends.
MRSA and Schools
Should schools close because of an MRSA infection?
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 is not necessary to close schools because of an MRSA infection in a student. It is important to note that MRSA transmission can be prevented by simple measures such as hand hygiene and covering infections.
Should the school be closed to be cleaned or disinfected when an MRSA infection occurs?
- Covering infections will greatly reduce the risks of surfaces becoming contaminated with MRSA. In general it is not necessary to close schools to "disinfect" them when MRSA infections occur. 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.
- When MRSA skin infections occur, cleaning and disinfection should be performed on surfaces that are likely to contact uncovered or poorly covered infections.
- Cleaning surfaces with detergent-based cleaners or Environmental Protection Agency (EPA)-registered disinfectants is effective at removing MRSA from the environment.
- It is important to read the instruction labels on all cleaners to make sure they are used safely and appropriately.
- Environmental cleaners and disinfectants should not be used to treat infections.
- The EPA provides a list of EPA-registered products effective against MRSA
Should the entire school community be notified of every MRSA infection?
- Usually, it should not be necessary to inform the entire school community about a single MRSA infection. When an MRSA infection occurs within the school population, the school nurse and school physician should determine, based on their medical judgment, whether some or all students, parents and staff should be notified. Consultation with the local public health authorities should be used to guide this decision.
- Remember that staphylococcus (staph) bacteria, including MRSA, have been and remain a common cause of skin infections.
Should the school be notified that my child has an MRSA infection?
- Consult with your school about its policy for notification of skin infections.
Should students with MRSA skin infections be excluded from attending school?
- Unless directed by a physician, students with MRSA infections should not be excluded from attending school.
- Exclusion from school 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.
- Students with active infections should be excluded from activities where skin-to-skin contact is likely to occur (e.g., sports) until their infections are healed.
Practical Advice for Teachers
- If you observe children with open draining wounds or infections, refer the child to the school nurse.
- Enforce hand hygiene with soap and water or alcohol-based hand sanitizers (if available) before eating and after using the bathroom.
Advice for School Health Personnel
- Students with skin infections may need to be referred to a licensed health care provider for diagnosis and treatment. School health personnel should notify parents/guardians when possible skin infections are detected.
- Use standard precautions (e.g., hand hygiene before and after contact, wearing gloves) when caring for nonintact skin or potential infections.
- Use barriers such as gowns, masks and eye protection if splashing of body fluids is anticipated.
MRSA in Healthcare Settings
- Overview of MRSA in Healthcare Settings
- Fact Sheet for Healthcare Personnel
- MRSA Prevention Healthcare Guideline
- Hand Hygiene Healthcare Guideline
MRSA in the Community
- Overview of MRSA in the Community
- Information for the Public
- Information for Healthcare Providers
- Clinical Management Strategies
- Educational Materials (Posters and Information Sheet)
- Questions and Answers about MRSA for School Health Professionals*, Commonwealth of Massachusetts Department of Public Health
- MRSA Toolkit for Middle & High Schools*, Tacoma-Pierce County Health Department
- MRSA Facts for Schools* Connecticut Department of Public Health
- Guidelines for Reducing the Spread of Staph/CAMRSA in Non-Healthcare Settings, v2* Los Angeles County Department of Public Health
- Strategies for Clinical Management of MRSA in the Community: Summary of an Experts' Meeting