Many reports are coming out of the new strand of staph making its way into the firehouse. We as firefighters must be on our toes to the threat . What precautions are in place? How is it caught?
What are the symptoms?

At Dickson County, We have each duty shift clean and disinfect the common areas, bedrooms, and equiptment used on the shift. Every one has thier own laundry they are responsible for. Staph is caught thru cuts, sores,laundry,towels and infected equiptment and people. Some symptoms include red bumps that looks like a spider bite,fever,fatigue,flu like symptoms, and tightness in chest. all or none of these symptoms can be present on an infected person. these symptoms came from the mayoclinic.com. Has anyone on had any cases in thier counties?

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My guess is this new strain is MRSA, it's a methicilian resistant staph aureous (hope I spelled all of that right... lol). I actually saw on the news that it shut down a couple of schools in the Detroit area, but apparently it was unwarranted. MRSA is highly contagious, but mainly only if you are elderly, very ill or otherwise health compromised. With this strain, our biggest worry is being a carrier from one call to another within a couple of hours.
I was exposed to this with HepC, and HIV all in the same patient and since we were back in the station right after that call, we were able to clean. We didn't know what he had at the time, but thanks to being able to see the green crap that came out of his lungs, we knew that a good de-con would be in order.

To avoid it, just keep things clean. Wash your hands and equipment if you are treating very ill or elderly patients, if you respond into a hospital or critical care facility. De-con as often as you find necessary (the equipment) and be sure to have a healthy supply of hand sanitizer to use immediately after calls. I have been known to rub that on my face... just in case.
I would be curious as to what the numbers are on this staph infecton that is going around. I keep getting the warnings all over the place, but so far have not seen a single case. Has anybody else? Of course I am not saying dont take all of the precautions, we should be doing that with or without the threats, but just curious...
I honestly don't think this is going to be a real issue for firefighters. It's more an issue where hand washing may not be at it's best, such as schools, or as mentioned where there are seriously ill or elderly. As long as we keep up our decon methods we should be fine. I know we have had direct contact, my hands (although gloved) were in a man's mouth who had pretty much everything. I wiped my face with the back of my glove, small particles can always enter the eyes, mouth or nose and I was not infected.

Keep up cleaning and decon methods as well as wearing full protection when deemed necessary (masks and eye protection on top of the regular gloves) and there really shouldn't be any issues.
It's ironic, but what is the first thing big companies cut back on when they are looking at tightening the budget?
Janitorial services, that's what. It goes from cleaning every day to every other day to one a week.
Crap is piling up in the corners, the restrooms looks like cattle was let in and you get the feeling when you walk into a restroom that the creeping crud is JUMPING on you.
I had a staph infection many years ago(it's on my blog) that damned near killed me.
They are nothing to mess with, they are serious and necessary precautions need to be taken. Our school district just had a confirmed MERSA staph.
Art
You have janitorial services???? We do the cleaning ourselves in the stations. Every morning, 9am, everything is cleaned, swept, mopped and tidied. We have to stay on top of it, but there are some chairs I don't sit in and I don't use the gym at my current station. Shoes on the feet in the shower and I still wipe the seat before I sit on it... lol... of course, I am a germaphobe, so I do that everywhere but at home! lol

I have heard of staph infections at gyms from the dirty mats, etc. Ick... MRSA is definitely making it's way into schools, so it's a good idea to remind the kids to keep themselves safe and wash hands often!
Brian, here is an article in a local publication about the MRSA staph going around. It's causing a lot of problems in our area. The Ten Steps for Students at the bottom of this article could be adapted for any public area. Wendy

MRSA Info Should be Forthcoming, Not Withheld
Why Didn't Superintendent Bartling Alert Parents of MRSA Cases Here?
By: Donna Capurso
Schools nationwide are reporting outbreaks of Staphylococcus aureus skin infections. Some of them are MRSA infections, which has caused a number of deaths. MRSA is an acronym for methicillin-resistant Staphylococcus aureas.
Per http://www.MayoClinic.com, staph infections emerged in hospitals decades ago, which was resistant to the broad-spectrum antibiotics commonly used to treat it. Dubbed methicillin-resistant Staphylococcus aureus (MRSA, pronounced MERSA), it was one of the first germs to outwit all but the most powerful drugs.
MRSA infection can be fatal. This point was illustrated by the death of a previously healthy 17-year-old high school football player in Bedford, Va. the middle of last month and the death of a 12-year-old Brooklyn student on Oct.14.
Despite the death of a student in a Jackson County school in southern Mississippi where the school disinfected the bathrooms and locker rooms, the school district refused to close the school for a complete disinfectant treatment, stating that their cleaning methods were sufficient. Another student died from MRSA in Gulfport, Miss. the second week of October. Another good source for MRSA information is http://www.CDC.gov
Staph bacteria are normally found on the skin or in the nose of about one-third of the population. If you have staph on your skin or in your nose but are not sick, you are said to be "colonized" but not infected with MRSA. Healthy people can be colonized with MRSA and have no ill effects, however, they can pass the germ to others.
Staph bacteria are generally harmless unless they enter the body through a cut or other wound, and even then they often cause only minor skin problems in healthy people. But in older adults and people who are ill or have weakened immune systems, ordinary staph infections can cause serious illness called methicillin-resistant Staphylococcus aureus or MRSA.
In the 1990's, a type of MRSA began showing up not just in hospitals or health facilities, but in the wider community. Today, that form of staph, known as community-associated MRSA or CA-MRSA, is responsible for many serious skin and soft tissue infections and for a serious form of pneumonia.
Vancomycin is one of the few antibiotics still effective against hospital strains of MRSA infection, although the drug is no longer effective in every case. Several drugs continue to work against CA-MRSA, but CA-MRSA is a rapidly evolving bacterium, and it may be a matter of time before it, too, becomes resistant to most antibiotics.
Staph infections, including MRSA, generally start as small red bumps that resemble pimples, boils or spider bites. These can quickly turn into deep, painful abscesses that require surgical draining. Sometimes the bacteria remain confined to the skin, but they can also burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.
With infections on the rise locally of MRSA in Coeur d'Alene and Post Falls schools, why didn't Superintendent Bartling alert the parents and community of the MRSA cases originating in the Boundary County Middle School and Bonners Ferry High School when these cases of MRSA broke out recently?
Why weren't we all made aware of the fact that the end of August a staff person had contracted MRSA? Now there are a number of our children infected, which could possibly have been prevented with the dissemination of information by our school district to parents and our kids on this staph "superbug" and how infection can be prevented and treated.
According to Dr. Raymond B. Otero, PhD and
Hey There, because of what is going on in my area, I did a little more digging...this is what the Journal of the Amercan Medical Association has to say about MRSA...
Found this today - Journal of American Medical Association (JAMA) W

MRSA Infections
Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacterium. Staph bacteria, like other kinds of bacteria, frequently live on the skin and in the nose without causing health problems. Staph becomes a problem when it is a source of infection. These bacteria can be spread from one person to another through casual contact or through contaminated objects. Infections with MRSA are more difficult to treat than ordinary Staph infections because these strains of bacteria are resistant to many types of antibiotics—the medicines used to treat bacterial infections. Infections can occur in wounds, burns, and other sites where tubes have been inserted into the body. In 2005, there were an estimated 94 360 cases of MRSA infections in the United States.
MRSA that is acquired in a hospital is called hospital-associated methicillin-resistant Staphylococcus aureus (HA-MRSA). MRSA infections are now becoming more common in healthy, nonhospitalized persons. These infections can occur among young people who have cuts or wounds and who have close contact with one another, such as members of sports teams. This type of MRSA is called community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). The October 17, 2007, issue of JAMA includes an article that documents the increasing incidence and burden of invasive MRSA infections.
CAUSES OF MRSA INFECTIONS



Leading causes of antibiotic resistance include
Unnecessary antibiotic use—for decades, antibiotics have been prescribed for colds, flu, and other viral infections that do not require or respond to antibiotics.
Antibiotics in food—antibiotics are routinely given to cattle, pigs, and chickens.
Bacterial mutation—bacteria that survive treatment with one antibiotic may develop resistance to the effects of that drug and similar medicines.

RISK FACTORS



Risk factors for hospital-acquired MRSA include
A current or recent hospitalization
Residing in a long-term care facility
Invasive procedures
Recent or long-term antibiotic use
Risk factors for community-acquired MRSA include
Young age—incomplete development of immune system
Participation in contact sports
Sharing towels or athletic equipment
Having a weakened immune system, such as persons with HIV/AIDS
Living in crowded or unsanitary conditions such as prisons

TREATMENT AND PREVENTION



Both hospital- and community-associated MRSA still respond to certain medications. Doctors often rely on vancomycin (an antibiotic) to treat resistant Staph infections, but vancomycin-resistant MRSA can also occur. Current research is directed toward improvements in surveillance, surgical treatments, and development of new antibiotics. To protect yourself, family members, and friends from hospital-acquired MRSA infections:
Ask hospital staff to wash their hands before touching you.
Wash your own hands frequently.
Make sure that intravenous tubes and catheters are inserted and removed under sterile conditions.
Follow the hospital's isolation procedures for gowns, gloves, and masks as indicated by signs.

FOR MORE INFORMATION


Centers for Disease Control and Prevention
http://www.cdc.gov/ncidod/diseases/submenus/sub_mrsa.htm
American Academy of Family Physicians
http://www.aafp.org
Alliance for the Prudent Use of Antibiotics
http://www.apua.org

INFORM YOURSELF



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: Centers for Disease Control and Prevention, American Academy of Family Physicians, Alliance for the Prudent Use of Antibiotics
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: INFECTIOUS DISEASES
John L. Zeller, MD, PhD, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2007;298:1826.
RELATED ARTICLES


This Week in JAMA
JAMA. 2007;298(15):1733.
FULL TEXT
Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States
R. Monina Klevens, Melissa A. Morrison, Joelle Nadle, Susan Petit, Ken Gershman, Susan Ray, Lee H. Harrison, Ruth Lynfield, Ghinwa Dumyati, John M. Townes, Allen S. Craig, Elizabeth R. Zell, Gregory E. Fosheim, Linda K. McDougal, Roberta B. Carey, Scott K. Fridkin, and for the Active Bacterial Core surveillance (ABCs) MRSA Investigators
JAMA. 2007;298(15):1763-1771.
ABSTRACT | FULL TEXT

This Week in JAMA
JAMA. 2007;298:1733.
Invasive MRSA Infections in the United States



Using data from an active population-based surveillance system, Klevens and colleagues (SEE ARTICLE) assessed the incidence and distribution of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in 9 US communities, classified the infections as either health care associated or community associated and estimated the burden of invasive MRSA infections in the United States in 2005. They found a standardized incidence rate of 31.8 per 100 000 persons and estimate that 94 360 infections occurred in 2005, of which 18 650 were potentially fatal. Most infections were health care associated, but 58% occurred outside of the hospital, caused by strains commonly attributed to both community and health care sources. In an editorial, Bancroft (SEE ARTICLE) discusses the increasing problem of infections caused by antimicrobial-resistant organisms and the need for more effective prevention strategies.
Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States
R. Monina Klevens, DDS, MPH; Melissa A. Morrison, MPH; Joelle Nadle, MPH; Susan Petit, MPH; Ken Gershman, MD, MPH; Susan Ray, MD; Lee H. Harrison, MD; Ruth Lynfield, MD; Ghinwa Dumyati, MD; John M. Townes, MD; Allen S. Craig, MD; Elizabeth R. Zell, MSTAT; Gregory E. Fosheim, MPH; Linda K. McDougal, MS; Roberta B. Carey, PhD; Scott K. Fridkin, MD; for the Active Bacterial Core surveillance (ABCs) MRSA Investigators
JAMA. 2007;298:1763-1771.
Context As the epidemiology of infections with methicillin-resistant Staphylococcus aureus (MRSA) changes, accurate information on the scope and magnitude of MRSA infections in the US population is needed.
Objectives To describe the incidence and distribution of invasive MRSA disease in 9 US communities and to estimate the burden of invasive MRSA infections in the United States in 2005.
Design and Setting Active, population-based surveillance for invasive MRSA in 9 sites participating in the Active Bacterial Core surveillance (ABCs)/Emerging Infections Program Network from July 2004 through December 2005. Reports of MRSA were investigated and classified as either health care–associated (either hospital-onset or community-onset) or community-associated (patients without established health care risk factors for MRSA).
Main Outcome Measures Incidence rates and estimated number of invasive MRSA infections and in-hospital deaths among patients with MRSA in the United States in 2005; interval estimates of incidence excluding 1 site that appeared to be an outlier with the highest incidence; molecular characterization of infecting strains.
Results There were 8987 observed cases of invasive MRSA reported during the surveillance period. Most MRSA infections were health care–associated: 5250 (58.4%) were community-onset infections, 2389 (26.6%) were hospital-onset infections; 1234 (13.7%) were community-associated infections, and 114 (1.3%) could not be classified. In 2005, the standardized incidence rate of invasive MRSA was 31.8 per 100 000 (interval estimate, 24.4-35.2). Incidence rates were highest among persons 65 years and older (127.7 per 100 000; interval estimate, 92.6-156.9), blacks (66.5 per 100 000; interval estimate, 43.5-63.1), and males (37.5 per 100 000; interval estimate, 26.8-39.5). There were 1598 in-hospital deaths among patients with MRSA infection during the surveillance period. In 2005, the standardized mortality rate was 6.3 per 100 000 (interval estimate, 3.3-7.5). Molecular testing identified strains historically associated with community-associated disease outbreaks recovered from cultures in both hospital-onset and community-onset health care–associated infections in all surveillance areas.
Conclusions Invasive MRSA infection affects certain populations disproportionately. It is a major public health problem primarily related to health care but no longer confined to intensive care units, acute care hospitals, or any health care institution.

Author Affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Klevens, Carey, and Fridkin and Mss Morrison, Zell, and McDougal and Mr Fosheim); California Emerging Infections Program, Oakland (Ms Nadle); Connecticut Department of Health, Hartford (Ms Petit); Colorado Emerging Infections Program, Denver (Dr Gershman); Grady Memorial Hospital, Atlanta (Dr Ray); Maryland Emerging Infections Program and Johns Hopkins Bloomberg School of Public Health, Baltimore (Dr Harrison); Minnesota Department of Health, Minneapolis (Dr Lynfield); University of Rochester, Rochester General Hospital, Rochester, New York (Dr Dumyati); Oregon Health & Science University, Portland (Dr Townes); and Tennessee Department of Health, Nashville (Dr Craig).
RELATED ARTICLES


This Week in JAMA
JAMA. 2007;298(15):1733.
FULL TEXT
Antimicrobial Resistance: It's Not Just for Hospitals
Elizabeth A. Bancroft
JAMA. 2007;298(15):1803-1804.
EXTRACT | FULL TEXT
MRSA Infections
John L. Zeller, Alison E. Burke, and Richard M. Glass
JAMA. 2007;298(15):1826.
EXTRACT | FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES


Community acquired MRSA in Europe
Ferry and Etienne
BMJ 2007;335:947-948.
FULL TEXT
Invasive MRSA Infections
JWatch Emergency Med. 2007;2007:2-2.
FULL TEXT
The Epidemiology of MRSA
Journal Watch Dermatology 2007;2007:1-1.
FULL TEXT
MRSA in the U.S.
JWatch Infect. Diseases 2007;2007:2-2.
FULL TEXT
New Worries About Multidrug-Resistant Bacteria
JWatch General 2007;2007:2-2.
FULL TEXT
Antimicrobial Resistance: It's Not Just for Hospitals
Bancroft
JAMA 2007;298:1803-1804.
FULL TEXT


Be Safe, Wendy

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