Letters

Monroe Local Schools, Ohio

October 25, 2007

Dear Parents/Guardians:
Many parents are concerned about recent news accounts concerning methicillin-resistant Staphylococcus aureus (MRSA), a type of "staph" infection that can cause skin infections that are difficult to treat. Please know all district buildings are taking precautions regarding prevention of MRSA, including proper cleaning of school and athletic facilities and athletic equipment. Specific steps we have implemented at Monroe are to:

" Encourage students to wash hands with soap and water frequently and upon arrival to school
" Instruct teachers to provide bandaids to any student with a cut, abrasion, or open wound after the student washes the wound with soap and water. Students with wounds that look infected or appear to be of a more serious nature are referred to the school clinic
" Clean buildings, athletic facilities, and athletic equipment on a regular basis using approved techniques and cleaners
" Instruct athletes on proper hygiene and provide information about MRSA prevention; handouts about MRSA prevention were provided at school sponsored sports physicals
" Instruct athletes to inform coaches of any wounds incurred; athletes with wounds are sent to the athletic trainer for inspection and proper bandaging. Questionable wounds are referred to a physician
We also are assisting the Ohio Department of Health with education efforts by sharing some of the agency's answers to frequently asked questions about MRSA:

What are typical symptoms of MRSA?

Common signs of a skin infection include redness, warmth, swelling and tenderness. Often a MRSA infection will look like a spider bite, boil, abscess or pimple. If left untreated, it could progress into a more serious illness. How is MRSA spread?
In outbreak situations, the environment has not played a significant role in the transmission of MRSA. Studies in health care and community settings show skin-to-skin contact, direct contact with infected wound drainage or contact with contaminated surfaces or things such as sports equipment as the likely sources of transmission. MRSA skin infections are not spread through the air.

How can students protect themselves?
Students can protect themselves from infections by:
" Practicing good hygiene (e.g., keeping their hands clean by washing with soap and water or using alcohol-based hand rubs, and showering after games and practices)
" Applying a clean, dry bandage to any open wounds such as abrasions or cuts
" Not sharing personal items such as towels or razors
" Using barriers (e.g., clothing or towels) between skin and shared equipment
" If they have open wounds, NOT using whirlpools, hydrotherapy pools, cold tubs, swimming pools and other common tubs
" Wiping surfaces of equipment before and after use
" Getting tested if they think they may have MRSA.
We share your concerns about the health and safety of our students. Please learn as much as you can about MRSA, be aware of possible symptoms and seek medical attention promptly if needed. For more specific information about this infection, please visit the Ohio Department of Health's Web site at: www.odh.ohio.gov.

Sincerely,
Arnol Elam
Superintendent

Judy Lavash
School Nurse
Stu Wilson
Athletic Trainer





ASSISTANT SUPERINTENDENT of ADMINISTRATION ROANOKE, VA
5937 Cove Road, N.W.
Roanoke, Virginia 24019

October 17, 2007

Dear Parent/Guardian:
As many of you are aware, there have been several recent reports about a type of staph infection, called Methicillin Resistant Staphylococcus Aureus ("MRSA"), in schools in our area. This letter is to provide an overview of the steps that are being taken in the Roanoke County Public Schools to prevent a MRSA outbreak.

MRSA is a serious public health concern because it is resistant to the antibiotics that are generally used to treat Staph infections. MRSA causes boils and skin infections; the infected area usually starts out as a small bump that resembles a pimple, which becomes redder and often develops drainage, swelling, tenderness, and warmth to the touch. If MRSA is diagnosed promptly, most infections can be treated successfully.

The Roanoke County Public School system is taking the following actions to prevent MRSA:
• Since proper hygiene is the single best way to prevent the spread of MRSA, we are cleaning our buses and schools – classrooms, restrooms, athletic facilities, and cafeterias regularly with an EPA approved antimicrobial. In light of the recent MRSA outbreaks in other school divisions, these cleaning protocols are being reinforced with our custodial staff.
• Good hygiene measures are routinely reinforced with the general student population and will continue to be reviewed with athletes on an ongoing basis.
• Coaches are monitoring the laundering of game uniforms and practice attire and are encouraging showers after games and practices.
• Waterless hand sanitizers are available in all locker rooms at the secondary level.
In the event we do have a confirmed MRSA outbreak, the following will be our protocol:
• We will report the case promptly to the Roanoke County Health Department.
• Any students who are confirmed to have MRSA will be permitted to attend classes only if they have been cleared to do so, in writing, by their physician. Affected skin areas must be covered with an appropriate bandage at all times.
• Athletes who are confirmed to have MRSA will not be allowed to play until they have been cleared to do so, in writing, by their physician.
If your child displays symptoms consistent with MRSA, or if you have a concern about your child's health, please contact their health care provider.

If your child is diagnosed to have or is suspected of having an infectious condition, it is important that you report this to their school nurse. You should also notify your child's coach if she/he participates in sports.

Please take a moment to review the MRSA Questions and Answers Sheet on the back of this letter, developed by the Virginia Department of Health, which provides additional insight about MRSA and its prevention. This can also be found on the Roanoke County Public Schools website, along with other information from the Department of Education. If you have questions, or require further information, please contact your school nurse or athletic trainer.


Sincerely,
Allen Jounell, LaVern Davis


CENTRAL HIGH SCHOOL, MARTINSBURG, PA
RD# 1, BOX 420 MARTINSBURG, PA 16662
(814)793-2111 FAX (814)793-4942
http://springcove.schoolnet.com
David A. Crumrine, Dennis W. Detwiler

October 23, 2007

Dear Parents/Guardians of CHS Students:
As you may have heard by now, we recently became aware of the existence of one case of MRSA (Methicillin Resistant Staphyloccous Aureus) within the school population. MRSA is a skin infection spread by physical contact. It is a type of staph infection that is resistant to common treatments. In rare cases, it can progress to serious blood or bone infections.

Once we became aware of the situation within school several steps were taken, and have continued, to ensure the disinfection and cleanliness of school desks, locker rooms and weight room. All athletic teams, coaches and physical education instructors have been reminded of instructing students of the importance of cleanliness, and reminders on proper hand washing techniques and stopping the spread of infections have been posted.

We are also continuing to widen our efforts in the area of communication and education. To prevent the spread of all infections, we continue to urge all athletes and students to wash hands frequently, shower after practice and games, never share personal hygiene items, cover any open scratches, blisters or chafed areas of skin, check skin daily and report any suspicious sores to parents, coaches, trainer or school nurse. We also recommend that you consult your doctor about any suspicious sore.

Additional information regarding MRSA and stopping the spread of the infection can be found at www.cdc.gov/Features/MRSAinSchools . Mrs. Theresa Martin, CHS school nurse is also available to answer questions at 793-2111.

Sincerely,
David A. Crumrine
Principal


SPRING COVE SCHOOL DISTRICT, ROARING SPRING, PA
1100 E. Main Street
Roaring Spring, PA 16673
http://springcove.schoolnet.com
Phone: (814) 224-5124
Fax: (814) 224-5516

October 24, 2007

Dear Spring Cove Families,
In the past few days, we have had numerous inquiries about a school health issue. In response to those questions, we would like to take a few minutes of your time to provide you with factual information on the recent health issue that has been identified at Central High School.

On Monday October 22, 2007, a single case of MRSA (Methicillin Resistant Staphyloccous Aureus) was diagnosed in a CHS student. Although the MRSA diagnosis was determined on Monday, the student had been receiving appropriate treatment and is doing fine. For your information, MRSA is a skin infection spread through direct physical contact with an infected person. However, it is a type of staph infection that is resistant to common treatments. In rare cases, it can progress to serious blood or bone infections. For more information on MRSA we recommend that you look at the MRSA web site at: www.cdc.gov/MRSAinSchools/.

The school district has been in consultation with local and state medical officials. We have moved quickly and responsibly to properly address the MRSA issues in a school setting. For example, we have scheduled additional sanitation procedures, especially for classroom and locker room areas. We are also in the process of installing hand sanitizer dispensers in all cafeterias and computer labs throughout the district. The MRSA infection is not likely to be transmitted by contact with surfaces of furniture, walls, etc. However, we are providing hand sanitation because we want our students to practice good hygiene whenever possible. Educational information regarding MRSA has also been given to all staff, coaches, and students to help alleviate any fears or anxieties.

MRSA infections can occur almost anywhere for a very simple reason: most of us already carry the staphylococcus bacteria in our body. Therefore, it is important for people to follow basic hygienic practices. We want to emphasize to our families that the “best practice” of hand washing is still the best deterrent to slow the spread of many infectious diseases. Hand washing and hand sanitizers do kill the MRSA bacteria.

Finally, many of you have asked the simple question, “Is it safe to send my child to school?” The answer from all the experts is a resounding YES. We do not have a health situation that would warrant excluding anyone from school. We will continue to emphasize good hygiene routines, and we will also keep you informed of any new developments with this issue. Education and vigilance is the best way to control these types of infections. We appreciate your concern, and we value your support.

Sincerely,
Rodney L. Green
Superintendent


TUSD Letter To Parents Regarding MRSA Concerns
Oct 18, 2007 07:46 PM EDT
Tucson Unified School District
Roger F. Pfeuffer
Superintendent

Dear TUSD Parents or Guardians:
You may have heard rumors of an infection that has afflicted Tucson Unified School District students in the past two weeks. It appears to be the same infection currently affecting several school districts in other parts of the U.S.

We have had one confirmed case of methicillin-resistant Staphylococcus aureus (MRSA), which is a type of staph infection. There is a second student with a probable case of MRSA. Both students are being treated by physicians. One student is back at school as approved by the physician and the other student is still under the care of their physician. At no time was there any instance of surgery or disfigurement, as has been rumored.

Suzanne Boyd, TUSD's Health Services Nurse for Infection Control, is consulting with the Pima County Health Department on this matter. According to the health department, the bacteria primarily is spread through skin to skin contact with someone who is infected. These are the precautionary measures being taken at our high schools:

* The locker rooms have been cleaned and sanitized, as have the dance rooms, weight rooms and wrestling rooms with approved products effective against MRSA. * Our athletic teams have been addressed regarding good hygiene practices and periodic self body checks.
Please discuss with your children the importance of proper hygiene. The health department says that good hygiene is an important factor in preventing the spread of MRSA.

On the back of this letter is information from the health department on preventing MRSA infections.

If your child has a concern regarding this or areas of his or her body that exhibit a rash or redness, please consult with the school nurse, your personal physician and/or the Pima County Health Department, whose telephone number is 243-7797.

Sincerely,
Roger F. Pfeuffer
Superintendent


MARYLAND SCHOOLS
www.montgomeryschoolsmd.org
850 Hungerford Drive,Room, Rockville, Maryland 20850 (301-279-3381)
October 17,2007

Dear Parents:
We are writing to inform you of a health issue that recently has received considerable attention in the media and is understandably a concern for parents.A number of school systems in the region,including Montgomery County Public Schools (MCPS),have reported cases of students with a bacterial infection of the skin that is resistant to the more common forms of antibiotics.

Th e infection is called Methicillin-Resistant Staph Aureus or MRSA.Th e skin condition most commonly looks like an infected pimple or boil and can worsen to include redness,warmth,swelling,pain,and discharge.It can be mistaken as a spider or insect bite.MRSA is spread by skin-to-skin contact,contact with drainage from the nose of a person infected,or contact with contaminated objects such as razors,soap,clothing,or towels.

At this time,approximately 13 MCPS students,the majority of them student athletes,have been diagnosed with MRSA.A few of the reported cases include elementary students.All have received treatment with appropriate antibiotics and are recovering. Please be assured that MCPS and the Montgomery County Department of Health and Human Services are using appropriate preventive measures to limit the spread of MRSA.All principals are receiving prevention information and school nurses also are working with school staff on this issue.Schools with suspected or confi rmed MRSA cases are receiving additional cleaning with a 1 to 10 bleach solution in locker rooms,weight rooms,and physical education areas.Disinfectant wipes have been provided to students for use before using weight room equipment.

You and your family can help prevent the spread of MRSA by following good hygiene practices:
Wash hands thoroughly with soap and water or use an alcohol-based hand sanitizer •
Keep cuts and scrapes clean and covered with a bandage until healed •
Avoid contact with other people ’s wounds and bandages •
Avoid sharing personal items such as towels or razors •
Wipe surfaces of exercise equipment before and aft er use •

Early treatment of suspected MRSA is important.If you are concerned about a wound or sore on your child consult your health care provider.Th e Montgomery County Health Offi cer recommends that any draining sore or wound be cultured for MRSA.If you have any questions,contact the health nurse or technician at your child ’s school or your family physician. Health situations such as this can cause anxiety for children and parents.As parents and educators,we want to protect our children and ensure their safety.One of the most eff ective t hings t hat we can do is to remain calm and positive.Our chi ldren need to know that we are dealing with this situation proactively and they are safe.Please monitor your child ’s feelings and behavior for any signs of anxiety.Additional information to help you support your child is available on our website at www. montgomeryschoolsmd.org.

Respectfully,
Jerry D.Weast,Ed.D.Ulder J.Tillman,M.D.,MPH
Superintendent of Schools Montgomery County Health Offi cer
and Chief of Public Health
JDW:spm


Southern Connecticut Schools
October 30, 2007

Dear Parents,

Many parents are concerned about recent news accounts concerning methicillin-resistant Staphylococcus aureus (MRSA), a type of "staph" infection that can cause skin infections that may be difficult to treat. Common signs of a skin infection caused by MRSA include redness, warmth, swelling and tenderness. Often a MRSA infection will look like a spider bite, boil, abscess or pimple. If left untreated, it could progress into a more serious illness.

MRSA skin infections are not spread through the air. People are more likely to get a MRSA infection through skin-to-skin contact, direct contact with infected wound drainage or contact with contaminated surfaces or things such as sports equipment.

Most MRSA can be effectively treated with antibiotics. Many staph skin infections may also be treated without antibiotics by draining the sore. However, if antibiotics are prescribed, students should complete the full course and call their pediatricians if the infection does not get better.

Several surrounding school districts, including Stamford Public Schools, have recently reported cases of MRSA. At this time, only one student within Stamford Public Schools has been confirmed with this skin infection. The student is currently under treatment with antibiotics. Please be assured that all principals, head custodians, and athletic directors in the Stamford Public Schools have received detailed packets of information on MRSA in order to keep students and staff healthy and safe. Although it is believed the reported case was contracted in the community and not in school, all buildings will receive a heavy duty cleaning beyond our routine daily cleaning procedures.

There are ways to protect students from this infection:
• Wash hands frequently with soap and warm water and/or use an alcohol-based hand sanitizer
• Shower after strenuous physical activities
• Never share personal items such as towels, soap an clothing
• Cover any open sore on the skin with bandages
• Avoid skin contact; do not touch other people's cuts or bandages
• DO NOT using whirlpools, swimming pools and other common tubs if there is an open wound
• Wash all clothes and towels that might be carrying MRSA in hot water
• Report any suspicious sores, pimples, boils, or open areas to parents, coach, or school nurse

We share your concerns about the health and safety of our students. Please learn as much as you can about MRSA, be aware of possible symptoms and seek medical attention promptly if needed.
If you have any additional questions, please contact Dr. Tsung-Wen Kuo, epidemiologist at Stamford Health Department at (203) 977-4390 or your child's school nurse for more information.

Sincerely,
Johnnie A Lee, M.D., M.P.H. Joshua P. Starr, Ed.D
Director of Health & Social Services Superintendent of Schools
and School Medical Advisor
cc: Olga Brown, Director of Nursing Services
Dr. Tabitha Fortt, School Health Consultant
Dr. Tsung-Wen Kuo, Epidemiologist


GILES COUNTY PUBLIC SCHOOLS
151 School Road
Pearisburg , Virginia 24134
Dr. Terry E. Arbogast, II
Division Superintendent

October 17, 2007

Dear Parent / Guardian:

Due to recent news media coverage regarding skin infections, this letter is to provide you with factual information about the situation, and what it means for students, parents, and staff at Giles County Public Schools. Staphylococcus aureus (or "staph") bacteria are commonly found on human skin and in nasal passages. Methicillin-resistant Staphylococcus aureus (or "MRSA") is a form of staph that has developed some resistance to commonly-used antibiotics. All forms of staph, including MRSA, are most commonly transmitted by direct skin-to-skin contact, and introduced into the body through a break in the skin, such as a cut or a scrape. These illnesses are present in our community, and have been for years. We've all become much more aware of them recently, and this awareness gives us the opportunity to educate ourselves about the risks of infection, and ways to prevent its spread and protect ourselves.

Giles County Public Schools has two laboratory confirmed cases of MRSA. To our knowledge, both students have been treated by a physician. We are taking all the precautionary hygiene measures to clean the schools and athletic team locker rooms. This practice has taken place since the beginning of school and will become a regular practice throughout the school year at all schools. We are following guidelines set by the Virginia Department of Health and will continue to implement proper hygiene protocol as directed by the Health Department.

Staph bacteria are one of the most common causes of skin infections. While up to 30% (estimated) of us carry these bacteria in our noses, only about 1% (estimated) of us carry MRSA. Staph is not considered an "airborne" bacteria and therefore spreading should not be expected to occur by sitting in a classroom with an infected individual or from passing them on the street. Most infections are spread by material from another person's wet or draining infections that get on a break in someone else's skin. This is why it is very important to cover any infection with a bandage to help prevent other people from contracting the germs that are in the draining infection. The illnesses caused by MRSA are the same as those caused by other staph, but they are treated differently. MRSA can occur in people who have direct or skin-to-skin contact with a person carrying the beacteria or by touching objects contaminated with MRSA (e.g., clothes, towels, bedding, athletic equipment, benches in saunas or hot tubs, bandages). Symptoms include redness, warmth, pus and a wound that does not heal, with the sores often being mistaken for "spider bites".

One of the best ways to protect yourself against MRSA and other skin infections is by practicing good hygiene and covering up exposed cuts and wounds.. There are many effective ways that are recommended for minimizing the risk of skin infections, with some being listed below:

* Wash your hands often, especially when exposed to someone with an infection or when you touch objects that may be contaminated.
* Keep cuts and scrapes clean and covered.
* Avoid sharing personal items such as towels, sports equipment, razors, water bottles, etc.
* Shower after any contact sports or after working out in a public facility, change into clean clothes and wash practice or workout clothes after each use.
* Children that have draining wounds that cannot be easily contained by dressings should be excused from sports participation and in some cases should be kept home from school until the draining stops or is easily contained, particularly if MRSA infection is known or suspected.
* If a sore or cut becomes red, oozes, causes pain or isn't healing, see a doctor.
* Don't insist on antibiotics for colds or other viruses.
* If prescribed antibiotics, take all the pills, even if you feel better before they are all gone.
* Report any suspicious wounds to the coach, athletic trainer, or school nurse immediately.

While thoroughly cleaning the school environment is important and helpful for many reasons, it does not reduce or eliminate the need to practice these good health habits. These remain important for everyone, all the time!

In otherwise healthy people, most minor wounds, even infected ones, will heal on their own and do not need antibiotics. Wounds can be helped to heal by keeping them clean, changing dressings when they become soiled and, if needed, periodically applying a dry heat compress over the dressing. If you have a wound that is not healing or you think you have a staph or MRSA infection, contact your health care provider. Most often your doctor will want to culture the wound to identify the germ. Wound cultures are becoming increasingly important so doctors can identify what is causing an infection that is not healing well on its own. Sometimes your doctor may recommend an antibiotic but many of these infections will heal themselves without antibiotics as long as any pus is drained and good hygienic wound care is practiced.

If you are interested in obtaining additional information on MRSA, it can be found on the Virginia Department of Health's Web site at: http://www.vdh.virginia.gov/Epidemiology/factsheets/Methicillin.htm. If you have any questions, please let us know.

Sincerely,
Dr. Terry E. Arbogast, II
Division Superintendent