WASHINGTON – There have been no new drug-resistant staph infection cases reported in Maryland since an initial outbreak last month, however MRSA has established itself in the community, experts told lawmakers Wednesday.
Experts told the House Committee on Oversight and Government Reform that MRSA, methicillin-resistant staphylococcus aureus, is not confined to the hospitals where it traditionally cropped up or even to the locker rooms where it proliferated.
“The epicenter is no longer at the hospital,” said Robert Daum, a pediatrics professor at the University of Chicago. “The problem has now shifted to the community.”
Daum went as far as to label the recent MRSA outbreaks an “epidemic.”
Committee Chairman Henry Waxman, D-Calif., reiterated parents’ fears that the stubborn pathogen has spread beyond hospitals.
“Now we are learning that drug-resistant staph infections can be contracted at schools and other places where people congregate,” Waxman said. “This has alarmed parents across the nation.”
Anne Arundel County reported seven cases of MRSA and Montgomery County reported 32. One student in Virginia died during the same outbreak. Maryland’s health department does not require MRSA cases to be reported so an overall total is unavailable.
Anne Arundel schools are arming against another outbreak by stepping up their cleaning practices and informing students and parents.
“We’ve been working with the health department nearly every day,” said Bob Mossier, spokesman for Anne Arundel County Public Schools. “We’ve switched to a second hospital-grade cleaner that we’re using in locker rooms. . . . It will be part of our standard cleaning procedure from here on out. The cleaner is specifically aimed at MRSA.”
The Anne Arundel school system sent home a pair of letters and developed a section on its Web site where students and parents can get information about staph infections and tips on prevention both at school and home.
Soap dispensers will be installed in all locker rooms and showers and the Maryland health department will meet with coaches at the beginning of each athletic season, Mossier said.
“We’ve tried to be as open as possible and as proactive as possible,” he said.
All seven of the MRSA-infected students in Anne Arundel County are back in classes, Mossier said.
“(The students) have been treated and have been back for several weeks,” Mossier said.
Montgomery County has 21 “recovered” cases, said spokeswoman Kate Harrison.
“We still have 11 active cases,” she said. “But they’re undergoing treatment and doing well.”
Julie Gerberding, director of the Centers for Disease Control and Prevention, tried to allay fears that schools were waiting for another outbreak to happen.
“We want to assure parents that schools are taking steps to protect (students),” she said. “But steps also need to be taken in the home.”
Gerberding pointed out that closing a school for disinfection was not necessary, because that “isn’t how this organism is transmitted,” adding that most community outbreaks of MRSA begin in prisons, not in schools.
Concerns have been spreading among parents and lawmakers after an October report from the Journal of the American Medical Association said that 18,000 people died from invasive MRSA in 2005.
Gerberding told representatives the study painted an excessively alarming picture of community-based staph.
“It’s a little bit of apples and oranges,” Gerberding said. “They took MRSA from the community plus the MRSA from hospitals. . . But it is a high number.”
According to the study, only 15 percent of the 18,000 deaths were from community-based staph.
Community-based staph has a different “fingerprint” than hospital staph that allows CDC to track it, Gerberding said.
A common misconception is that the community-based MRSA is the result of the hospital strain moving into the community.
The two strains are “distant cousins,” with the community-based strain rising on its own, Daum said in his testimony.
When it does appear in schools, the lack of school nurses to properly diagnose and treat potential MRSA cases helps the disease gain a foothold, Gerberding said.
“Our schools simply don’t have access to the health care professionals they need,” she said, noting that one-third of schools don’t have a full-time nurse.
Committee members questioned Gerberding on the development of a vaccine for MRSA, but she said the prospects were less than promising.
“Our vaccine story with staph is not robust,” she said. “There are prototypes underway, but they aren’t getting a boost and not getting the attention they need.
“I don’t think we’re going to eliminate staph aureus as a human pathogen, but I do think we can have an impact.”
Even without a vaccine, the disease can be easily avoided by using soap and water and not sharing personal items.
“Some (staph) may be adapted to hospitals, some may be adapted to the community,” Gerberding said. “But all are preventable.”
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