21 schools closed after teen dies of staph infection

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21 schools closed after teen dies of staph infection 
Officials took action when students protested unsanitary conditions

 All 21 school buildings in Bedford County, Va., were being scrubbed and sanitized Wednesday after the death of a 17-year-old high school student from a powerful drug-resistant strain of staph bacteria.

The schools, all in Bedford County, Va., were closed after students there launched a protest over unsanitary conditions Monday, using text messages and social networking sites.

The students took Bedford County Schools Superintendent James Blevins on a tour Tuesday of Staunton River High School to show him how unclean it was, in particular the sports locker rooms.

One of its students, Ashton Bonds, died Monday after being hospitalized for more than a week from Methicillin-resistant Staphylococcus aureus, or MRSA, a strain of staph bacteria that does not respond to penicillin and related antibiotics. Blevins subsequently ordered the schools closed for cleaning.

The Centers for Disease Control and Prevention said Bond's death is not an isolated incident and that MRSA infections are a major public health problem, more widespread than previously thought.

This was underscored in a stunning report by CDC researchers published in the Journal of the American Medical Association that says MRSA infections ultimately could kill more people annually than AIDS. The report says the deadly strain killed nearly 19,000 Americans in 2005 and suggests such infections may be twice as common as previously thought, according to its lead author, Dr. R. Monina Klevens.

In recent years, so-called superbug staph infections have been spreading through schools, hospitals, prisons and athletic facilities, CDC officials said, and more than 90,000 Americans get potentially deadly infections each year from MRSA.

The bacteria often is carried on the skin and in the noses of healthy people and can be spread by skin-to-skin contact or sharing an item used by an infected person, particularly one with an open wound.

"Essentially, what has happened here is that MRSA was, at one time, pretty much confined to patients in hospitals, and these were patients that were seriously ill," said Dr. Pascal James Imperato, the former commissioner of public health for New York City. "Now we know, there’s also a community-acquired strain of MRSA. That doesn’t mean that it hasn’t always existed. It’s just that now, we have become knowledgeable about it."

The MRSA strain is believed to have evolved through several biological mechanisms, including the overuse of antibiotics, said Imperato, chairman of the Department of Preventive Medicine and community health director of the Master of Public Health program at SUNY Downstate Medical Center.

Reports surfaced Thursday showing Bonds to be one of three youths to die as a result of the disease over the past week.

The New Hampshire Union Leader reported Thursday that two others died last week including an 11-year-old in Vancleave, Miss., who died Friday, and a 4-year-old preschooler from New Hampshire.

Boscawen Elementary preschooler Catherine Bentley of Salisbury, N.H., died after the MRSA strain she contracted triggered a lethal case of pneumonia.

Michael J. Martin, superintendent of schools for SAU 46, which includes Boscawen Elementary, told the Union Leader that once they were advised of the child's illness, the district worked closely with the state department of health to make sure students were not at risk.

"Initially they said there was no reason to be concerned. Then we heard about the report of the death in Virginia, so we contacted the department of health again. They reassured us there was no change," Martin said.

Shae Kiernan, 11, was buried on Monday. Family and friends told Mississippi-based NBC15 News the little girl died of a staph infection. The funeral took place in Kiernan’s hometown of Vancleave, a small community in Jackson County, Miss.

In the majority of cases, children are at no higher risk for the infection than the general population, Imperato said. But the bacteria does thrive in locker rooms and gymnasiums, he said.

"This scenario sets up the perfect scenario for the organism to invade the skin," he said. "In this setting, you have sweat and good exposure to skin. With youths who play football or lacrosse, the skin might also be cut or scraped, making the skin more vulnerable."

The best method of prevention is staying clean. Frequent hand-washing is a good way to prevent the spread of MRSA. And youths, as well as adults, who participate in sports or any type of physical fitness program should shower immediately after.

"Good old-fashioned cleanliness serves as the best barrier to these organisms," he said. "Just washing with ordinary soap and water is enough to remove any of the organisms that may have colonized in the skin."

About one-quarter of invasive cases of staff infection involve patients in hospitals and more than half are related to the health care industry, occurring in people who recently had surgery or were on kidney dialysis, according to the CDC study.

Officials still do not know how the infections were spread that killed the three youths. Ashton Bonds played football at one time, which would have required him to use the school’s locker room and athletic facilities, but school officials said he was not playing this year.

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'Superbug' kills more Americans than AIDS 
Staph once confined to few hospitals now has spread

Severe infections by an antibiotic-resistant "superbug," known as methicillin-resistant Staphylococcus aureus, are at least twice as high as researchers previously believed and now kill more Americans than AIDS, researchers reported Wednesday .

The bacterial infections, commonly called MRSA (pronounced "mersa"), were once confined to a few hospitals, but a new study by the national Centers for Disease Control and Prevention found that in 2005 they made an estimated 94,000 Americans seriously ill and killed almost 19,000, compared with 17,000 who died of AIDS complications.

"Certainly, MRSA now has to be viewed as a very important target for prevention and control," said Dr. David A. Talan, an infectious diseases specialist in Sylmar, Calif., who was not involved in the study.

The infections have been a growing concern, particularly over the past decade, as they have spread outside hospitals, popping up in prisons, athletic fields and locker rooms.

The study reported that nearly 14 percent of new antibiotic-resistant staph infections are not linked to hospitals or other medical facilities, indicating that the disease is now comfortably ingrained in the wider community.

The finding, reported in the Journal of the American Medical Association, is but the latest evidence of a widespread pattern of increasing drug resistance among a variety of infectious agents, including multi-drug-resistant tuberculosis, antibiotic-resistant Clostridium difficile and other once-innocuous organisms.

The emergence of these superbugs has not been accompanied by the development of new drugs to combat them.

The spread of resistant organisms is "astounding," wrote Dr. Elizabeth A. Bancroft of the Los Angeles County Department of Public Health in an editorial accompanying the report.

Bancroft said the reported incidence of resistant staph infections is just "the tip of the iceberg" because the CDC researchers studied only blood-borne infections that find their way into internal organisms.

Several studies have found that such infections represent only 6 percent to 9 percent of all MRSA infections, which can also thrive on the skin in a more innocuous form, waiting for the opportunity to enter the body.

"It appears that the total burden of MRSA is much greater than what was estimated in this study," she said.

Most forms of the staph bacterium are easily killed with common antibiotics, such as amoxicillin. But beginning in 1968, researchers began to see variants that required treatment with stronger antibiotics.

Experts attribute the emergence of the superbugs to indiscriminate use of antibiotics, the failure of patients to complete their antibiotic regimens and the use of antibiotics in animal feed. In each case, incomplete eradication of the bacteria leads to mutations that increase resistance to the drugs.

Today, the most resistant require treatment with powerful and expensive antibiotics like vancomycin, and as many as one in five patients still succumb to the infections.

Confined to the surface of the skin, the bacteria do minimal damage. But in hospitals, nursing homes and dialysis centers, they can hitch a ride inside the body, spreading through the bloodstream and causing severe illness.

In the same fashion, they can be spread by tattooing and drug use in prisons and by cuts and abrasions on the athletic field.

While doctors were aware of the growing staph problem, there were no hard data to document it.

The new results were obtained by Dr. R. Monina Klevens of the CDC and her colleagues as part of the agency's ongoing Active Bacterial Core surveillance program, which monitors infections in nine regions of the U.S., including San Francisco, Baltimore, Atlanta and Denver. All infections were laboratory-confirmed.

The group observed 8,987 cases of blood-borne MRSA infections in the survey area, which was extrapolated to come up with a nationwide estimate of 94,360 cases. There were 1,598 deaths in the area, corresponding to 18,650 deaths nationwide.

Only 26.6 percent of the cases were infections that occurred in hospitals, but 58.4 percent were infections that occurred in the community but were linked to hospitalization or medical procedures. Infections unrelated to medical procedures accounted for 13.7 percent of cases.

Infection rates were highest among those older than 65, and blacks were twice as likely as whites to suffer an infection. In both groups, Klevens said, the higher rates were most likely due to a higher incidence of chronic diseases, which both weakens patients and sends them more often to the hospital, where they come in contact with the bacterium.

For infants, the rate was four times as high in blacks as in whites.

Health-care advocates argue that hospitals need to improve hygiene. Some studies, for example, show that hospital workers wash their hands only about half as often as guidelines recommend.

Other critics say hospitals should screen all newly admitted patients for MRSA and isolate those who are found to be positive. Hospitals, however, say such isolated patients are likely to receive less care because of the inconvenience associated with entering their rooms.

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6 states report 'superbug,' 3 youths have died 
Staph infection doesn't respond to penicillin, other antibiotics

 School districts in at least six states Thursday reported students infected with MRSA, a super strain of drug-resistant staphylococcus bacteria that is responsible for the deaths of at least three children.

Ashton Bonds, 17, of Bedford, Va., died Monday as a result of the infection. Preschooler Catherine Bentley of Salisbury, N.H., and Shae Kiernan, 11, of Vancleave, Miss., both succumbed to the infection last week, officials said.

In addition, six football players at a North Carolina high school, seven students at three different West Virginia schools and at least two teens in Connecticut were diagnosed with the potentially deadly infection.

School officials in upstate New York, Connecticut and New Hampshire sent letters home to parents informing them of recent cases. Meanwhile, cases have prompted schools in Indiana, Virginia and West Virginia to sanitize facilities, particularly locker rooms and gyms where the germs are most easily spread.

The concern is due to the fact that MRSA doesn't respond to penicillin and other antibiotics. It can be spread by skin-to-skin contact or by sharing an item used by an infected person, particularly one with a cut or abrasion. A number of the cases have involved student athletes.

The Centers for Disease Control and Prevention reported this week that MRSA infections are a major public health problem and more widespread than previously thought. A government study out this week said more than 90,000 Americans could get the "superbug" each year.

This was underscored in a stunning report by CDC researchers published in the Journal of the American Medical Association that says MRSA infections ultimately could kill more people annually than AIDS. The report says the deadly strain killed nearly 19,000 Americans in 2005 and suggests such infections may be twice as common as previously thought, according to its lead author, Dr. R. Monina Klevens.

In recent years, so-called superbug staph infections have been spreading through schools, hospitals, prisons and athletic facilities, CDC officials said.

The bacteria often is carried on the skin and in the noses of healthy people and can be spread by skin-to-skin contact or sharing an item used by an infected person, particularly one with an open wound.