New strains of MRSA, a drug-resistant bacteria, are emerging nationwide. Though cases once were confined to hospitals, they are showing up in schools, prisons and athletic facilities.
New strains of drug-resistant MRSA bacteria are showing up in communities, causing hundreds of thousands of infections a year that go unreported and untracked by public health agencies, according to a USA TODAY examination of federal data, reports and academic studies.
Once confined to hospitals and other health care settings, MRSA cases now crop up just about anywhere that people are in close contact, particularly in environments where hygiene might be less than ideal. Infections from the bacteria are reported regularly in schools, athletic facilities, prisons -- even NFL locker rooms.
Formally known as methicillin-resistant Staphylococcus aureus, MRSA typically causes skin infections, from small pimples to painful boils, that usually can be treated effectively by doctors. In some cases, the infections advance, destroying tissue and causing large abscesses that can require hospitalization. And when staph enters the bloodstream or attacks the lungs as bacterial pneumonia, it becomes especially dangerous — often fatal. Federal data suggest that nearly 23,000 people die each year with MRSA infections.
Though cases usually are isolated, the infections can spread in places where people are in close contact. Here are some settings where MRSA infections often emerge. (For a more in-depth report, visit usatoday.com):
Sports facilities: Teammates share towels and equipment, have skin-on-skin contact and incur turf-burns on the field, making locker rooms and other sports environments ripe for MRSA.
•Cases: Since the early 2000s, the Centers for Disease Control and Prevention has documented MRSA cases in many sports settings — among college football players in Pennsylvania, high school wrestlers in Indiana, fencers in Colorado. Five NFL players on the Rams were infected in 2003, and an NFL physicians survey said the league had 33 infections from 2006-2008. In a high-profile NFL case this year, three Tampa Bay Buccaneers got MRSA infections.
IN-DEPTH REPORT: MRSA spreading into communities
•Causes: Athletes often have open skin – scrapes, nicks, etc. – and routinely have physical contact with other athletes and shared equipment. In 2007, three Brooklyn high school football players got infections after training camp; the CDC identified shared towels as a possible cause. In a case where fencers contracted MRSA, sensor wires worn under their suits were seen as a potential source.
•Lessons: The CDC urges MRSA education for coaches and players about hygiene and laundry practices. Routine cleaning and disinfection is recommended for locker rooms, weight rooms and other training areas.
Prisons: Jails and prisons are a common setting for community-acquired MRSA outbreaks because the living conditions are tight and hygiene often is poor.
•Cases: The first documented prison outbreak was at Central Mississippi Correctional Facility in 2000, hitting 59 of 3,000 inmates. Since then, MRSA has caused outbreaks in Texas, Georgia and Los Angeles County. From 1996-2002, nearly 11,000 Texas prisoners had MRSA infections, and three died, according to the CDC. A Los Angeles County outbreak in 2002 hit 928 inmates.
•Causes: The CDC says infections spread more rapidly when inmates shared belongings or "[lanced] their own boils or other inmates' boils." In December 2000, the CDC and Mississippi Department of Health recommended hygiene education for inmates, antibacterial soap and the development of a "MRSA skin infection surveillance system," along with improving laundering methods.
Schools: Though no major MRSA outbreaks have been reported in schools, they frequently report individual cases among students or faculty.
•Cases: This year, two Michigan districts closed schools briefly for disinfection after MRSA struck several students and teachers. Most cases involve minor skin infections that can be cleared up with antibiotics. But two students have died this year from MRSA, one in Nashville, another in Redding, Calif.
•Causes: MRSA can find its way into open sores and cuts. Poor hygiene can contribute if students don't wash hands regularly. In some schools, locker rooms have been implicated because they weren't cleaned frequently or thoroughly enough with proper disinfectants.
•Lessons: Schools increasingly use hospital-grade disinfectant and focus cleaning on high-touch areas, such as doorknobs and counters. Parents and teachers are advised to cover cuts and make sure good hygiene, especially hand washing, is built into students' routines.