MRSA Guidance Document (10/23/2007)
New Jersey Department of Health and Senior Services

What is MRSA?

MRSA stands for methicillin-resistant Staphylococcus aureus which is a type of “Staph” bacteria. Staph bacteria are one of the most frequent causes of skin infections in the U.S. Most of the time these skin infections are minor, but Staph can also cause serious infections.

Can MRSA be treated?

Yes, MRSA can be treated. It is resistant to certain types of antibiotics which makes it more difficult to treat. But there are other antibiotics that are still able to kill the MRSA bacteria. Treatment may also include draining the boil/abscess by a healthcare provider.

If an antibiotic is prescribed, it is critical to TAKE ALL THE ANTIBIOTICS, even if the infection is getting better. Don’t share antibiotics with other people or save unfinished antibiotics for use at another time.

Is MRSA new?

MRSA bacteria are not new, but infections caused by MRSA are increasing among certain groups of people such as hospital patients, prisoners, nursing home residents, children attending day care, athletes, military recruits and people with weak immune systems. These are groups of people that either live in close contact with each other, people who have direct skin contact with each other or share equipment or personal items.

How is MRSA spread?

Staph bacteria, including MRSA, are almost always spread by direct physical contact. Staph bacteria are not spread through the air. The bacteria can also spread when people come into contact with objects that have been contaminated with the bacteria. These objects include towels, clothing, bedding, gym or sports equipment, soiled bandages, bars of soap, contaminated surfaces, etc.

Are there any cases of MRSA in NJ now?

Since single cases of MRSA are not reportable in New Jersey, we do not have statistics on the exact number of MRSA cases in New Jersey. However, we do know there are cases occurring throughout New Jersey, just like there are cases occurring throughout the rest of the country. Approximately 30% of the general population is colonized with S. aureus and about 1% is colonized with MRSA, which means the “Staph” bacteria can live in their nose or on their skin without causing an infection. As such, we expect to see a certain number of MRSA cases in NJ, just like the rest of the country and throughout the world.

Are MRSA infections reported to health authorities?

Doctors, schools, correctional facilities and other entities are required by New Jersey Administrative Code to report suspected outbreaks of any disease, including MRSA, to the local health department within their jurisdiction. An outbreak is defined as two or more laboratory-confirmed cases diagnosed in the same time period and same location. In addition, Governor Corzine signed a bill this year requiring hospitals to report cases of MRSA to the state health department. We are hoping to have statistics on these healthcare-related infections in the next few years.

FOR SCHOOLS

Is MRSA reportable?

Single cases of MRSA are not reportable; however, if there is a cluster (2 or more non-household cases) of MRSA infections within a school, the local health department should be contacted so they can determine if an outbreak might be occurring.

Should infected students/employees be excluded from school?

School should not be closed and classes should not be canceled. People who are infected are permitted to attend school/work as long as they are compliant with infection control measures. Skin infections should be kept clean and bandaged. Students who participate in contact sports may be excluded from participating if they cannot keep their wound properly bandaged. If there are multiple confirmed cases of MRSA infections among members of a particular sport, and the sport team shares common equipment, that sports team may be closed down temporarily. These recommendations should be made in consultation with the local health department.

Should we notify parents if a student has a MRSA infection?

NJDHSS does not recommend parent notification for isolated cases. However, if a particular school chooses to notify parents, please do so in coordination with your local health department. The local health department will review any letters for technical accuracy and can assist with phone inquiries from concerned parents.

What can schools do to prevent MRSA infections?

  • Provide students/parents with information about MRSA and preventive behavior.
  • Encourage frequent hand washing by students and employees.
  • Encourage proper personal hygiene among students and employees such as showering after sports activities, wearing clean clothing, etc.
  • Discourage the sharing of personal items such as clothing, towels, bar soap, sports equipment, etc.
  • Ensure proper environmental cleaning with EPA approved disinfectants.
  • Encourage staff and students to keep any wounds bandaged and to consult with their healthcare provider for evaluation of any suspicious skin lesions.

Should any special soap be used for hand washing?

Any kind of soap is fine for hand washing. It does not have to be antibacterial. Frequent hand washing is very important and the act of washing is more important than the type of soap.

Should special laundry detergent be used?

There is no need for special laundry detergent. Washing clothing in hot water with regular laundry detergent and drying in a hot air drier will kill the bacteria.

Should special disinfectants be used?

There is no need for special disinfectants. Use an EPA-approved product and follow use instructions carefully. A list of EPA-approved disinfectants can be found on the NJDHSS Web site at http://www.epa.gov/oppad001/list_h_mrsa_vre.pdf.

Where can we get more information?

The NJDHSS website has resources for schools and athletic settings. Please visit http://nj.gov/health/cd/mrsa/index.shtml or the Centers of Disease Control and Prevention (CDC) at http://www.cdc.gov/ncidod/dhgp/ar_mrsa.html.

Does the NJDHSS have any educational materials?

The NJDHSS has a brochure entitled “MRSA: Preventing Skin Infections in School and Athletic Settings.” It is available for download and printing from the NJDHSS Web site (listed above). A limited quantity of the brochure is available here.