Run Away! It’s MRSA!

Raise your hands. How many of you know what MRSA is? OK. How many of you worried about it last year? Now how many of you worry about it currently? I bet more of you raised your hands for ‘currently’ Our national media went on­ a MRSA ‘full freakout’ this Fall. Their coverage was quite sensational – you came away with the idea that your kids were going to go to school and die from a raging untreatable skin infection. Sporting events were canceled at the first hint of a student with a skin infection. Entire school districts were disinfected because a single case was identified. In one case a school district spent a quarter of a million dollars cleaning all it’s buildings, school buses, locker rooms, and more. Yet once news broke that they did this, experts made clear that this would not reduce the chance of other students contracting it. It was quite the hysteria for a few weeks.

So exactly what is MRSA?


MRSA is a resistant variation of the common bacterium Staphylococcus aureus. It has evolved an ability to survive treatment with beta-lactam antibiotics, including penicillin, methicillin, and cephalosporins.[2] MRSA is especially troublesome in hospital-associated (nosocomial) infections. In hospitals, patients with open wounds, invasive devices, and weakened immune systems are at greater risk for infection than the general public.

The media much prefers to use the term ‘superbug‘ because it sometimes does not respond to normal antibiotic treatment and ‘superbug’ sounds so much more ‘scary’.

So how does MRSA impact youth soccer and youth sports in general? MRSA is becoming more common among student athletes.

The Journal of the American Medical Association also published a study this week that found that about 95,000 Americans had MRSA infections in 2005, which killed 18,650 people. Most of those cases were in hospitals, where MRSA has long been a problem. The bacterium is becoming more common in other settings, including schools, where it can infect students. Doctors call this kind of MRSA “community-acquired,” meaning that it comes from the community and not from a hospital setting. Athletes are at especially at risk because they often have close physical contact with one another.

So why the media circus and overreaction by school districts? A student in Virginia, died in October due to an MRSA infection, followed by another a week later in New York. It’s tragic anytime someone dies, especially a child. But this, combined with the release of a CDC report on MRSA, led many media outlets to completely freak out. Why? Because the CDC report estimated that MRSA was infecting 94,360 people, resulting in 18,650 deaths in 2005. 18,650 deaths! Our children are in serious danger! That’s huge. That’s more people than AIDS killed in a year! What most in the media failed to note, however, was that the vast majority of MRSA deaths happen in hospitals among already sick patients who contract an MRSA infection, are already weakened, and treatment doesn’t work.

Once the media circus broke out, in part due to the CDC report, Dr. Julie Gerberding, head of the CDC went before members of Congress to bring things back into perspective:

“This isn’t something just floating around in the air,” Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention, told members of Congress on Wednesday.

It takes close contact – things like sharing towels and razors, or rolling on the wrestling mat or football field with open scrapes, or not bandaging cuts – to become infected with the staph germ called MRSA outside of a hospital, she said. But MRSA is preventable largely by common-sense hygiene, Gerberding stressed.

“Soap and water is the cheapest intervention we have, and it’s one of the most effective,” she told a hearing of the House Committee on Oversight and Government Reform.

But the CDC’s report coincided with the death of a 17-year-old Virginia high school student, prompting a spate of reports of MRSA infections in schools. That prompted lawmakers to pepper Gerberding with questions Wednesday:

  • Should schools close for cleaning if a student gets MRSA? That’s not medically necessary, Gerberding said. Bleach and a list of other germicides can be used in routine cleaning of areas and equipment where bacteria cluster.

There’s no need to go in and disinfect a whole school because that isn’t how this organism is transmitted,” she said.

  • How worried should parents be? Some 200 children a year will get serious MRSA, and the vast majority will be treated successfully, Gerberding said. Community-spread MRSA is still easily treated by many other routine antibiotics. So wash and bandage cuts, and seek prompt medical care if they show signs of infection.

Most outbreaks of community-spread MRSA occur not in schools but in prisons, where inmates share toiletries and lack or don’t use soap.

Emphaiss mine. Clearly the media freakout was unwarranted. While it helps to raise awareness of MRSA, when the best defense is common hygiene (washing hands, etc), you know spending a quarter of a million dollars to sanitize a school is a bit over the top.

The reason I’m writing about this is that I’ve had parents asking me about it as well, in large part due to the media coverage. What is the soccer league going to do? How can this be prevented? Our response will clearly be a common sense approach. Soccer is a contact sport. Kids get cuts and there is plenty of skin to skin contact (“Hey ref! He’s pushing my kid!” :) ). Kids should wash their hands often and coaches should be on the lookout for players who have skin lesions. Mom’s Team put together an excellent and well balanced article about MRSA that tried to stress that parents need not panic, but coaches and parents should take some common sense precautions. They also linked to a set of recommendations from the National Athletic Trainers Association for reducing the chance of spreading infectious diseases. Helen Gilson also has an excellent MRSA article online.

One specific area of concern is we have soccer teams that bring towels in dedicated iced down coolers for kids to cool down with during matches in hot weather. There’s no question the weather is getting hotter. When you have 20+ days where the temperatures are above 90 degrees in August, you’re going to have kids that need help staying cool. They get subbed out, grab a cold wet towel, put it on their neck, forehead, etc. and then put it back in the cooler. They are shared. Bacteria can survive freezing temperatures. So it presents a problem. Why?

Because I’m a heck of a lot more concerned about an athlete suffering from heat stroke than I am about them possibly contracting a skin disease from their teammate. Our soccer players are exposed to high temperatures during competitive play on numerous occasions during the year. It’s simply not feasible to cancel competitions when the temperatures go above 95 degrees. We bring canopies to every match where the temps are expected to be above 70 (or it’s raining), but having the towels helped a lot in addition to having plenty of cold liquids. The risk of an MRSA outbreak is very small as the CDC study found the incidence of invasive MRSA in children aged 5-17 was 1.4 per 100,000. The vast majority of MRSA infections are treated successfully, but as the October news shows, not always. So what to do?

Clearly the easiest preventative measure for MRSA is to prohibit the use of cooling towels. Even if they aren’t shared, they’re dipped in a cooler of ice cold water between uses which could spread bacteria. I tried to find scientific data on the ability of MRSA to survive freezing temperatures, but was unable to. But their usefulness in keeping players cool is clear. Using disposable paper towels would generate a ton of trash, and they don’t hold water was well. Perhaps a more sensible approach is to educate coaches and parents that any child with open cuts, sores, or lesions should NOT use the cooling towels, or should have one they keep separate from the rest. We already ensure the towels get cleaned and bleached between uses. My guess is we’ll continue to use the cooling towels for our competitive players, but also work to educate our parents and coaches on how to minimize the chances of an infection. We may investigate getting additional towels so players have 2-3 each and once they use one, they put it in a bag for later cleaning. Thus the towels in the cooler are always clean and sanitized. But that’ll be expensive.

So there you have it. MRSA is something to be concerned with, but clearly not to the level the media would have had you believe in October. While the common preventative measures are common sense, their absolute implementation could expose players to additional, though unrelated, risks.

Does your league have a MRSA policy? Have they published information about MRSA or changed how they do things?

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  1. MRSA LIVES ON SURFACES 10-14 DAYS. A PERSON INFECTED IN THE NOSE SNEEZES THE BACTERIA, IT LANDS SOMEWHERE, IT IS TOUCHED BY SOMEONE WITHIN 14 DAYS, WHO TOUCHES THEIR NOSE AND BECOMES INFECTED………..

    IT’S NOT JUST SORES, PIMPLES ON YOUR ATHLETES……..

  2. MRSA can survive on surfaces for months (See http://ibe.sagepub.com/cgi/content/refs/15/1/85), though it dies off fairly quickly in the first 10 days. But surface to patient transmission is one of the less common methods of infection. See http://www.nfid.org/publications/id_archive/staph.html

    The main reservoir of MRSA in hospitals is patients colonized or infected with MRSA. Although colonized patients have no signs or symptoms of infection, they can still serve as a source from which transmission may occur. Colonized personnel and contaminated environmental surfaces can also serve as reservoirs, but are not as important as affected patients. Presumably, MRSA reservoirs in LTCFs are similar to those in hospitals.

    MRSA is most frequently transmitted from 1 patient to another via personnel who have not washed their hands between patients. Healthcare personnel who have persistent nasal colonization can transmit the organism to patients, especially if they develop a concomitant viral upper respiratory infection or MRSA sinusitis. Personnel with dermatitis colonized or infected with MRSA have also been responsible for outbreaks of MRSA infection. Transmission via contaminated articles or environmental surfaces may occur but this is a less important source. Airborne transmission is uncommon but may be a problem in special units housing patients with burn injuries or extensive dermatitis.

  3. MRSA is a very serious threat to anyone, especially those who partake in sporting activities, where some sharing of equipment is a normal event.

    While MRSA was once, more or less, confined to hospital settings, Community Acquired MRSA is on the increase and the strains of CAMRSA are getting more resistant.

    A recent report from the Castro district in San Francisco, claimed that one in every 365 people were now carrying a new strain of MRSA, called MRSA USA300.

    Straphylococci.

    The genus Staphylococcus are pathogenic bacterium found in humans and other mammals. Traditionally they were divided into two sub-groups based on the coagulase reaction. Staphylcocci are generally found inhabiting the skin and mucous membranes of mammals and birds. Some members of this genus can be found as human commensals and these are generally believed to have the greatest pathogenic potential in opportunistic infections of humans.

    Staphylococcus aureus.

    This bacterial strain is a major cause of nosocomial (hospital-acquired) and community-acquired infections. Since its discovery as an opportunistic pathogen, Staphylococcus aureus continues to be a major cause of mortality and is responsible for a wide variety of infections, including; boils, furuncles, styes, impetigo and other superficial skin infections in humans. Staph.aureus is also known to cause more serious infections, particularly in the chronically ill or immunocompromised. These include pneumonia, deep abscesses, osteomyelitis, endocarditis, phlebitis, mastitis and meningitis. The ability to cause invasive disease is associated with persistance in the nasal cavity of a host and is commonly recognised as ‘colonization’.

    Staphylococcus aureus USA300. USA300, is a methicillin resistant strain of Staphylococcus aureus – MRSA. It has been implicated in epidemiologically unassociated outbreaks of skin and soft tissue infections among healthy individuals in at least 24 U.S. states, Canada and Europe. USA300 is also noted for its strong association with unusually invasive pathogenic diseases, which include; severe septicemia, necrotizing pneumonia and necrotizing fasciitis.

    Necrotizing Fasciitis.

    This disease is one of the quickest-spreading infections known to man, as it spreads easily and rapidly across the fascial plane within the subcutaneous tissue. For this reason, it is popularly called the “flesh-eating bug,” and although once quite rare, but now on the increase, it became well-known to the general public in the 1990’s. Even with todays modern medicines, the prognosis can be bleak, with a mortality rate of approximately 25-35% with severe disfigurement common in survivors.

    PVL – Panton Valentine Leukocidin

    It has been found that MRSA strains can also contain genes that encode the panton valentine leukocidin toxin (PVL). The PVL toxin has been shown to be responsible for many of the severe clinical symptoms of infection with MRSA, such as furunculosis, severe necrotizing pneumonia, and necrotic lesions of the skin and soft tissues.

    Never underestimate this pathogen, it already kills more people each year than AIDS. How can we overcome the possibility of infections? By taking preventative measures and using an antimicrobial solution to treat scratches, scrapes and wounds.

    We have been successfully treating mild to very serious MRSA and VRSA infections with this solution for over two years. Antibiotics have had their day. Most are no longer effective against some of these MDR (Multi-Drug-Resistant) strains.

    Prevention is always better than cure but how many people actually practise preventative measures? That number will soon grow as the spread of this strain develops, because there are no second chances with USA300. The only way to treat this strain is to surgically remove the infected skin or organ. That is, unless you prevent it from entering the body in the first instance.

  4. Michael,

    Thanks for the in depth MRSA information. It might be worth noting you represent (or at least link to) a company (MRSA Medical) looking to profit from fighting MRSA through the sales of a colloidal silver solution for full disclosure. I think it’s also worth noting that there are some concerns about the toxicity of colloidal silver. Finally, I’m curious if the FDA has reversed it’s final ruling that colloidal silver is not recognized as ‘safe and effective’.

    The FDA has issued a Final Rule declaring that all over- the-counter (OTC) drug products containing colloidal silver or silver salts are not recognized as safe and effective and are misbranded.

    Colloidal silver is a suspension of silver particles in a colloidal (gelatinous) base. In recent years, colloidal silver preparations of unknown formulation have been appearing in stores. These products are labeled to treat adults and children for diseases including HIV, AIDS, cancer, tuberculosis, malaria, lupus, syphilis, scarlet fever, shingles, herpes, pneumonia, typhoid, tetanus and many others.

    According to the Final Rule, a colloidal silver product for any drug use will first have to be approved by FDA under the new drug application procedures. The Final rule classifies colloidal silver products as misbranded because adequate directions cannot be written so that the general public can use these drugs safely for their intended purposes. They are also misbranded when their labeling falsely suggests that there is substantial scientific evidence to establish that the drugs are safe and effective for their intended uses.

    The indiscriminate use of colloidal silver solutions has resulted in cases of argyria, a permanent blue-gray discoloration of the skin and deep tissues.

    Colloidal silver ingredients and silver salts include silver proteins, mild silver protein, strong silver protein, silver chloride, and silver iodide. The dosage form of these colloidal silver products is usually oral, but product labeling also contains directions for topical and, occasionally, intravenous use.

    In reaching its decision, FDA considered all of the information described in the proposed rule (October 15, 1996) and submitted by the public in response to that proposal, the Final Rule becomes effective on September 16, 1999, 30 days after publication.

  5. Thank you for the above comments. Actually, the solution we use is classified as a ‘Silver-Sol’ which is a brand new technology. It is made by completely different methods to a normal colloidal silver. Our product is also patented, whereas colloidal silvers are not patentable, as they all produce the same results.

    In essence, the solution we use has four methods of eradicating bacterium, whereas a normal colloidal silver has only one.

    It has also been tested in 154 actual cases of Malaria in Ghana, where full recovery was established within 5 days and the Ghanian Government has officially listed it as an alternative to antibiotics. There were no failures and this is fully documented.

    We also have a full list of independent test results conducted by leading research establishments that specialize in the particular pathogen that we were testing against. A full list can be found here: http://www.mrsamedical.com/newsilversolutioninfo.htm

    You will also observe that full and comprehenisve safety studies were carried out, again by independent research laboratories and recommended dosages of the product are well within the EPA guidlines for safety of silver.

    Because of the way in which the product works, Argyria is not a problem. This is because there is little or no residue left behind after the eradication process. The supercharged silver nano-paticles do not die off after killing a pathogenic bacteria, they remain active until after being passed through the body. This normally occurs within 48 hours.

    In practise, we have treated hundreds of cases of MRSA since early 2007 and to date have had no failures and no-one has turned blue either. In fact, we have treated people with open wound infections where antibiotics have failed them. The choice of the patient is then to try something different or have the limb amputated.

    In a recent case, we cured a gentlemans VRSA condition within 25 days, after intravaenously administered Vancomyacin for 30 days duration failed to eradicate the infection. His Medicade bill was in excess of $46,000 and all it did was to escalate the condition from MRSA to VRSA. He had suffered this condition for over three years.

    We work with medical departments of both the US Military and FDA. While FDA approval might seem a sensible thing to achieve, in the cold light of day, FDA approval means removal of the product to a ‘Doctors Only Prescription’ and with current medical practise being what it is, there would be nothing to stop the influential ‘Big Pharma’ companies from burying our product in favor of their antibiotics.

    If everyone were turning blue from colloidal silver products, then why do we only see one person, who made and drank his own colloidal silver in quantities that were excessive and in terms of parts per million, exceeded all boundaries and guidlines? I think therein lies the answer – there aren’t any others.

    Unlike any other company out there, we have striven to prove that our product works and we have evaluation at the highest level. The tests are all independent and mostly from the same resources as the FDA use for testing. They are therefore undeniable. Death is a far more permanent condition than turning blue, if it ever did occur, which it will not.

    Doctors are now being told not to prescribe antibiotics for infections because they cause resistance factors. Unfortunately, they have nothing else to offer. Over 100,000 people died in the US last year from mis-prescribed, mis-diagnosed and blatant abuse of antibiotics.

    To say that MRSA medical profits from MRSA is unjust, unfounded and untrue. The site was founded to help people who suffer from MRSA infections. The solution is sold at the cheapest price allowed and all the International calls, consultations and e-mails are done at my own expense. If a few bucks a month is profiteering, then what have you got to say about Pharmaceutical companies who make trillions of dollars a year from antibiotics? … That don’t work very well these days … But they’ll always prescibe you another!