Six States Report MRSA Infections, At Least Three Youths Have Died

October 18, 2007

School districts in at least six states have reported students infected with Methicillin-resistant Staphylococcus aureus. Three youths have died as a result of the infections.

Ashton Bonds, 17, of Bedford, Va., died Monday as a result of the infection. Boscawen Elementary preschooler Catherine Bentley of Salisbury, N.H., and Shae Kiernan, 11, of Vancleave, Miss. both succumbed to the infection last week.

School officials at one North Carolina high school said Thursday at least six football players are infected with MRSA (MUR'-suh). And in West Virginia, at least seven students at three different schools have been diagnosed with it. Two teens in Connecticut have also have the infection.

School officials in upstate New York, Connecticut and New Hampshire have sent letters home to parents informing them of recent cases. Meanwhile cases have prompted schools in Indiana, Virginia and West Virginia to sanitize facilities, particularly locker rooms and gyms where the germs are most easily spread.

The concern is because MRSA doesn't respond to penicillin and other antibiotics. It can be spread by skin-to-skin contact or by sharing an item used by an infected person, particularly one with a cut or abrasion. A number of the cases have involved student athletes.

The Centers for Disease Control and Prevention reported this week that MRSA infections are a major public health problem and more widespread than previously thought. A government study out this week said more than 90,000 Americans could get the "superbug" each year.

This was underscored in a stunning report by CDC researchers published in the Journal of the American Medical Association that says MRSA infections ultimately could kill more people annually than AIDS. The report says the deadly strain killed nearly 19,000 Americans in 2005 and suggests such infections may be twice as common as previously thought, according to its lead author, Dr. R. Monina Klevens.

In recent years, so-called superbug staph infections have been spreading through schools, hospitals, prisons and athletic facilities, CDC officials said.

The bacteria often is carried on the skin and in the noses of healthy people and can be spread by skin-to-skin contact or sharing an item used by an infected person, particularly one with an open wound.

"Essentially, what has happened here is that MRSA was, at one time, pretty much confined to patients in hospitals, and these were patients that were seriously ill," said Dr. Pascal James Imperato, the former commissioner of public health for New York City. "Now we know, there’s also a community-acquired strain of MRSA. That doesn’t mean that it hasn’t always existed. It’s just that now, we have become knowledgeable about it."

The MRSA strain is believed to have evolved through several biological mechanisms, including the overuse of antibiotics, said Imperato, chairman of the Department of Preventive Medicine and community health director of the Master of Public Health program at SUNY Downstate Medical Center.

All 21 school buildings in Bedford County, Va., were being scrubbed and sanitized Wednesday following the death of Bonds.

The schools, all in Bedford County, Va., were closed after students there launched a protest over unsanitary conditions Monday, using text messages and social networking sites.

The students took Bedford County Schools Superintendent James Blevins on a tour Tuesday of Staunton River High School to show him how unclean it was, in particular the

Michael J. Martin, superintendent of schools for SAU 46, which includes Boscawen Elementary, told the Union Leader that once they were advised of Bentley’s illness, the district worked closely with the state department of health to make sure students were not at risk.

"Initially they said there was no reason to be concerned. Then we heard about the report of the death in Virginia, so we contacted the department of health again. They reassured us there was no change," Martin said.

Kiernan, 11, was buried on Monday. The funeral took place in Kiernan’s hometown of Vancleave, a small community in Jackson County, Miss.

In the majority of cases, children are at no higher risk for the infection than the general population, Imperato said. But the bacteria do thrive in locker rooms and gymnasiums, he said.

"This scenario sets up the perfect scenario for the organism to invade the skin," he said. "In this setting, you have sweat and good exposure to skin. With youths who play football or lacrosse, the skin might also be cut or scraped, making the skin more vulnerable."

The best method of prevention is staying clean. Frequent hand-washing is a good way to prevent the spread of MRSA. And youths, as well as adults, who participate in sports or any type of physical fitness program should shower immediately after.

"Good old-fashioned cleanliness serves as the best barrier to these organisms," he said. "Just washing with ordinary soap and water is enough to remove any of the organisms that may have colonized in the skin."

About one-quarter of invasive cases of staff infection involve patients in hospitals and more than half are related to the health care industry, occurring in people who recently had surgery or were on kidney dialysis, according to the CDC study.

Officials still do not know how the infections were spread that killed the three youths. Ashton Bonds played football at one time, which would have required him to use the school’s locker room and athletic facilities, but school officials said he was not playing this year.

The Associated Press contributed to this story