LANDSTUHL, Germany — Every year, a particular infectious disease or “bug” comes along that grabs the public’s attention and becomes a household word.
In recent years, West Nile Virus and the Ebola virus entered the popular culture lexicon. Last year, bird flu became a hot topic, but methicillin-resistant Staphylococcus aureus — better known as MRSA (pronounced “mer-sa”) — currently reigns as the disease du jour.
In October, a student at Vogelweh Elementary School in Kaiserslautern was infected with MRSA, treated at Landstuhl Regional Medical Center and released with a clean bill of health. The student returned to school, but officials did not immediately notify other parents of the occurrence, drawing some ire.
Earlier the same month in the United States, a seventh-grade student in Brooklyn and a high school senior in Virginia died from MRSA. The ensuing buzz had dozens of U.S. schools temporarily closing for deep cleanings.
MRSA is a staph infection that is resistant to certain antibiotics and normally appears in the community as a skin infection. Because of its resistance, MRSA has been called a “superbug.”
Doctors at Landstuhl maintain that referring to MRSA as a “superbug” is an exaggeration and that closing schools for deep cleanings in an effort to prevent MRSA infections is of little value.
“It’s not a superbug,” said Air Force Col. (Dr.) Steven Princiotta, Landstuhl’s deputy commander for clinical services. “Community-acquired MRSA has been sort of an emerging problem for actually several years now. It’s really most commonly a mild, outpatient problem most often seen in the pediatric clinic. Really, it’s more of a nuisance diagnosis than anything in most cases.”
Princiotta noted that MRSA is not a highly infectious microbe nor is it reportable, which means the hospital does not have to notify public health officials when a case occurs.
But what about letting parents know when a student at their children’s school contracts MRSA?
It should not be necessary to inform the entire school community about a single MRSA infection, according to the CDC Web site.
In a letter to parents and staff dated Nov. 5, Diana Ohman, DODDS-Europe director, addressed the MRSA incident at Vogelweh. “We are concerned about individual cases but we don’t want to unduly alarm parents when one person has been identified in a school unless there is potential that the class or school has been exposed to the infection,” according to the letter.
“When MRSA occurs within the school population, the principal and school nurse will consult with local military health authorities and determine appropriate notification and communication.”
On its Web site, the Centers for Disease Control said, in most cases, it is not necessary to close schools because of a 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,” according to the CDC web site.
Closing schools for top to bottom cleanings when a student gets a MRSA infection is an overreaction, said Army Capt. George Kallstrom, chief of the infectious disease lab at Landstuhl.
“That happens a lot, especially when you get into infectious diseases,” Kallstrom said. “When the anthrax scares happened, I can remember that post office building in D.C., they did some nasty decontamination on that thing just because they got one spore out. Was that really a threat — that one spore? No. It’s very common because the public gets alarmed.”
While MRSA is resistant to some antibiotics, it can be treated with many others, Kallstrom said.
“When people start using the word ‘superbug’ I think it kind of gives the impression that there’s no treatment or there’s only one treatment,” he said.
MRSA developed its resistance through the over-prescription of penicillin-like antibiotics, and that puts selective pressure on the bacteria where they are more likely to acquire resistance mechanisms, Kallstrom said.
In the community, most MRSA infections are skin infections that may appear as pustules or boils, which often are red, swollen, painful, or have pus or other drainage, according to the CDC web site.
Washing your hands, covering wounds with Band-Aids or clothing and maintaining a clean environment are steps that can be taken to prevent MRSA infections, Landstuhl doctors said.
