Methicillin-resistant Staphylococcus aureus Infections (MRSA): 

Staphylococcus aureus (“staph”) infections have been around for a long time, causing mild to severe illness.  MRSA is a kind of staph infection that may be more difficult to treat but is otherwise the same as a “staph infection”.  Mild infections may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage.  More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.

Staph is passed from person to person through direct contact with skin or through contact with contaminated items.  The bacteria may live in people’s noses and on their skin and most of the time, do not cause any problem.  Staph can enter the body through breaks in the skin and sometimes cause infection. The main ways to prevent staph infection are to wash hands and care for wounds properly.

Practical Advice for Teachers

• Observe children for open wounds.  If any are draining or contain pus, refer the child to the school nurse.
• Encourage hand washing before eating and after toileting.
• Coaches should ensure that athletes wash their hands, cover their wounds, and not share personal items and towels. 

Practical Advice for Parents

• Clean wounds and cover them with a clean, dry bandage. Wounds that do not heal properly need medical attention. The only way to determine if an infection is caused by MRSA is through laboratory testing ordered by a physician or other health care provider.
• Teach children to wash their hands regularly, such as before eating and after toileting.   For additional information go to Stopping the Spread of Germs at Home, Work, & School. 
• Be sure your family members use antibiotics properly. Take all that are prescribed, even if the symptoms stop before the prescription is used up. Do not share prescriptions.
• Children who participate in sporting events should wash their hands after each practice and game. They should not share equipment, uniforms, towels, or other personal items (e.g., razors). Wash uniforms and towels with hot water and detergent after each use. 

 School/Nurse Responsibility

• Make referral to licensed health care provider. Skin infections may need to be incised and drained and/or antibiotic treatment based on a wound culture and sensitivity.
• Ensure contact precautions when doing wound care. Ensure standard precautions if the potential for splashing exists.

Control of Spread

• Students or staff members, who are colonized or infected with MRSA, do not need to be routinely excluded from the classroom.
• Exclusion from school should be reserved for those with wound drainage that cannot be covered and contained with a clean, dry dressing taped on all 4 sides.
• Typically, it is not necessary to inform the entire school community about a MRSA infection. When MRSA occurs within the school population, the school nurse and school physician should determine, based on their medical judgment, whether some or all parents and staff should be notified.
• Students with weakened immune systems may be at risk for more severe illness if they get infected with MRSA. These students should follow the same prevention measures as all others to prevent staph infections.
• Athletes with active skin and soft tissue infections should not participate in wrestling until wounds are completely healed. Consider using this rule for all contact sports.
• Individuals with open wounds should keep them covered with clean, dry bandages that are taped on all four sides.
• Gloves should be worn if you expect to have contact with non-intact skin or mucous membranes. Hands should be washed immediately after removing gloves.
• Good personal hygiene and hand washing with soap and water for at least 20 seconds should be encouraged.
• If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol concentration.
• Potentially contaminated surfaces should be cleaned with an EPA-registered disinfectant labeled effective against MRSA and manufacturers directions should be followed. Household bleach diluted 1:100 (new solution every day) may be used.
• Clean and disinfect health room cots regularly (at least daily), and use pillow protectors.
• If soiled linens and clothing are washed on school premises, wash with laundry detergent in hot water (minimum 160°F), add one cup of bleach if water is not 160°F and dry in a hot dryer.  

Further information about MRSA can be found at:

• General Information about MRSA in the Community  (CDC)
• Questions and Answers about MRSA for School Health Professionals.

The Tacoma-Pierce County Health Department in Washington State has developed a MRSA Toolkit for Schools that may be helpful in responding to questions about MRSA and schools.

This toolkit has been designed to help prevent and stop or reduce the spread of MRSA skin infections in middle and high schools. It contains educational materials targeted to the school health team, athletic directors/coaches, custodians, athletes/students and parents.

Information about environmental cleaning & disinfecting for MRSA is available at the CDC website. The Environmental Protection Agency (EPA) provides a list of EPA registered products effective against MRSA.

If you have additional questions about MRSA, please contact your physician, your local health department, or the Connecticut State Department of Public Health (860-509-7994).