Attention rose to a fever pitch last fall about the dangers of potentially life-threatening infections from a drug-resistant bacteria known as Staphylococcus aureus, or staph, with widespread media reports of cases spread through athletic programs and in locker rooms.
Experts caution that while staph infections can be controlled through simple steps, those measures require constant vigilance and wide-ranging educational efforts among the user population.
The simplest defense against such infections includes following your mother’s advice: Wash your hands and body.
“Very simply put, common-sense cleaning, disinfecting and hand hygiene save people’s lives,” says Nancy Bock of the Soap and Detergent Association, a manufacturers’ trade group.
”Even if a contaminated surface is touched, the germ involved can be removed through simple hand-washing,” says Rachel Gorwitz, a medical epidemiologist with the Centers for Disease Control and Prevention.
And people with cuts or other infections should also take careful precautions, she says.
“Covering infections will greatly reduce the risk of surfaces becoming contaminated with staph, including methicillin-resistant Staphylococcus aureus (MRSA),” Gorwitz says.
One nonprofit organization, NSF International, which creates standards and certifies food, water and consumer products, has launched an educational effort for children, the Scrub Club, featuring a Web site with “soaper-heroes” to teach hand-washing.
The site includes interactive games, music, downloadable activities and educational materials for teachers and parents.
“By teaching children the importance of proper hand-washing with the help of the Scrub Club, we can make a difference in preventing the spread of MRSA and other serious infections,” says company Vice President William Fisher.
Lindsey Lesher, who coordinates MRSA surveillance for the state of Minnesota, says the state health agency has developed educational materials for the general public, schools, athletes and coaches. “The important message is that MRSA is preventable through basic measures such as covering wounds and washing hands,” she says.
In addition to encouraging the use of basic soap and water, several companies are marketing their sanitizing and cleaning products as effective against the spread of staph. One such firm, Boca Raton, Fla.-based SafeHands Inc., states its alcohol-free, instant hand-sanitizer can succeed where alcohol-based products fail.
“Alcohol kills germs by stripping away the skin’s natural oils,” says CEO Jay Reubens, calling SafeHands “more persistent” in killing germs than alcohol, in addition to being nontoxic and nonflammable.
The company has received a great deal of interest from school officials, and also offers a school poster program promoting hand-sanitizing.
In Union County, Ky., the school system has students apply another company’s hand-sanitizing product, Protec-4, when getting on the bus every morning, according to Massachusetts-based marketing firm Triple-S. Teachers also have bottles of the sanitizer in the classroom. The alcohol-free antibacterial lotion is manufactured by Las Vegas-based Skinvisible Inc., and marketed by Triple-S, a janitorial and sanitary supply firm.
“Support and maintenance staffs also have Protec-4 available for their use,” said Triple-S board director Ken Crutcher.
If you have an outbreak in your facility, it’s not necessary to “disinfect” the entire institution, says Minnesota’s MRSA expert Lesher.
“Cleaning and disinfecting should [be] performed on surfaces that are likely to contact uncovered or poorly covered infections,” she says.
Her agency recommends routine cleaning with detergent-based products or those registered with the U.S. Environmental Protection Agency. (A list is available at http://epa.gov/oppad001/chemregindex.htm.)
“It is important to follow the manufacturer’s instructions on the product label,” Lesher said.
Lesher says that in locker rooms, dirty towels should be hung up, not left lying around, and liquid soap should be made available to users, Lesher says.
Joan Warfield Bluzicki, spokeswoman for MARCOR Remediation Inc., a national environmental contractor, says employees of recreation facilities should be educated about infection control, and users should be educated about good hygiene.
“Custodial staff should be trained and diligent in proper cleaning/disinfection of athletic mats/equipment, and there should be training and procedures for proper handling of blood and other potentially infectious materials,” she says.
Several companies offer disinfectants for use in a variety of facilities. One, PURE Bioscience, states its disinfectants, marketed under several private-label brands, eliminated staph infections entirely in the Tulsa County, Okla., jail since it was introduced in August 2006. Sheriff Stanley Glanz says the nontoxic product is helpful because it does not require rinsing or the use of protective gear such as gloves or masks. His jail uses it in cells, bathrooms and booking areas.
Another technique that can be used is atmospheric fogging, says Priscilla Wolfe, spokeswoman for DTR Corporation, which markets a cleaning product called EasyDECON. She says it has been used by professional football teams in locker rooms, in nursing homes and in the hospitality industry.
“The best strategy for control of staph transmission is proper, frequent and thorough disinfection,” Wolfe says, arguing that traditional surface-disinfection leaves many areas untouched. A typical treatment of atmospheric fogging can cost anywhere from 15 to 35 cents per square foot, she says.
There are also other options available, including professional cleanup and remediation. MARCOR’s Warfield Bluzicki says, with the high rate of turnover in the custodial employment industry, cleanup after an outbreak may best be handled by professional firms. Such companies will use specialized equipment that improves the disinfecting and cleaning process, and the employees will be trained in proper techniques and wear personal protective equipment. She says cleanup costs include many variables, including location, facility size and amount of equipment involved.
And what about covering all the unanticipated costs–not just the basic cleanup expenses, but the overall costs of convincing users that your facility or operation is safe again?
Insurance companies in some areas are now offering “contagion risk” policies to help.
Richmond, Va.,-based Markel Corporation recently expanded its contagion-risk coverage to include public
The coverage can be used to offset losses, including lost revenue, decontamination and disinfection and public relations expenses.
Part of the difficulty with contagion risk is the psychological risk associated with a closure,” says Barrett Hubbard, VicePresident of Markel Re.
“It is unlike a fire or other physical loss–customers … want to feel absolutely certain it is safe to return to the premises. That usually involves specialized cleaning methods, testing and clear communications.”
There also have been concerns expressed about the possibility of staph infections from artificial turf on indoor and outdoor sports fields and complexes.
A Connecticut study in 2004 reported on an outbreak of MRSA involving a college football team, which likely spread through skin breaks during practice. The study, published in the journal Clinical Infectious Disease, recommended that athletic trainers take a close look at prevention of turf burns, as well as educate players about the risks of cosmetic body shaving.
One of the nation’s largest producers of artificial turf–AstroTurf–has offered an anti-microbial product integrated into the turf since 2006. The parent company, GeneralSports Venue, says its TurfAide product can protect against “a wide variety of mold, fungi and bacteria,” including MRSA.
The TurfAide treatment is invisible and odorless, won’t wash off, and doesn’t change the performance or appearance of the turf, the company states.
“With infections such as staph and MRSA on the rise in the sports community, we are committed to providing the best defense available,” says Michael Dennis, chairman of GeneralSports Venue.
Dan Shortridge is a freelance writer and editor from Delaware. He worked for five years as an outdoor skills instructor and director at a Boy Scout summer camp in Maryland.
For More Information On Staph
The Scrub Club: www.scrubclub.org
Protec-4: www.skinvisible.com or www.triple-s.com
MARCOR Remediation Inc.: www.marcor.com
Markel Corporation: www.outbreakinsurance.com, www.markelcorp.com
Centers for Disease Control and Prevention: www.cdc.gov
Staph Q & A
What is staph?
Staphylococcus aureus is a bacteria usually found on the skin or in the nose. An antibiotic-resistant type of staph, methicillin-resistant staphylococcus aureus, or MRSA, was once generally found in health-care settings but has recently emerged in the broader community.
How is MRSA spread?
It is generally spread through skin-to-skin contact or by contact with shared items, such as towels, athletic equipment surfaces, etc., that have touched an infected area. The U.S. Centers for Disease Control and Prevention states athletes may be more susceptible to MRSA because of repeated skin-to-skin contact during sports and because of the increased likelihood of cuts and abrasions on the skin.
What does an infection look like?
Most are minor skin infections, appearing as red, swollen, painful or pus-filled sores or boils. They most often occur at breaks in the skin or areas of the body covered by hair.
Which athletes are most at risk?
Infections including MRSA have been found in contact sports, including wrestling, football and rugby. However, the CDC cautions that even in sports with little physical contact, staph and other infections can easily spread in locker room environments.
Source: U.S. Centers for Disease Control & Prevention (www.cdc.gov)