Staph Infection: The Pandemic Next Door
By Carolyn Nicolaysen

Whether the threat to our health is an exotic avian flu from a remote province of Asia, or a staph infection from the school locker room — the illness or loss of just one loved one is a pandemic to that person's family. Time once again to prepare.

Until recently, the subject of “pandemics” usually conjured fear of bird flu, SARS, HIV, tuberculosis, Ebola, or manmade biological weapons. But pandemics can come in localized forms — even at your neighborhood high school — in the form of staph infections. The recent emergence of staph means laymen such as you and me should study up so as to protect our families and communities. We cannot prepare to act, without the facts.

Staph infections are caused by the bacteria “Staphylococcus aureus” — take that to the spelling bee.

Some strains of Staphylococcus aureus are resistant to the class of antibiotics that are frequently used to treat staph (such as methicillin), and thus are called “methicillin-resistant Staphylococcus aureus” — or “MRSA” for short. Hospitals have been dealing with MRSA at least since the 1980s, but it wasn't until the mid-1990s that doctors began diagnosing serious MRSA infections in people that never had any contact with a healthcare system.

At any given time, 20-30% of healthy people carry staph bacteria on their skin, or in their noses without getting sick. When the skin is punctured or broken, or when skin is affected by conditions such as eczema or the immune system is compromised — a staph infection can take hold. Staph infections can lead to more serious health problems.

How Staph Infections Spread

Staph can spread through the air, on contaminated surfaces, and from person to person. Staph bacteria can be transferred from one area of the body to another on dirty hands and under dirty fingernails. They can be spread through contact with an object used by an infected person, such as a towel, comb, gym equipment, bedding, backpacks or eating and drinking utensils.

Cases of MRSA infection have been associated with recent antibiotic use, sharing contaminated items, having recurrent skin diseases, using locker rooms, and living in crowded settings. Clusters of skin infections caused by MRSA have been described among injecting drug-users; aboriginals in Canada, New Zealand and Australia; Native Americans in the United States; in prisons; participants in contact sports; homosexual men. Most of the transmission in these settings appear to come from people with active MRSA skin infections.

Nursing mothers may also be more at risk of contracting an infection.

Symptoms

Symptoms of staph infection may include chills, severe pain, difficulty or pain when walking, rash, well-defined area of swelling and redness (similar to a pimple), being extremely tired, a fever lasting more than 5 days, pus coming from an infected area, and yellowish crusting of the area.

Call the doctor immediately if two or more of these symptoms are present, if skin infections seem to be passing from one family member to another, or if two or more family members have skin infections simultaneously. Always err on the side of caution and contact your doctor if you have any suspicion that you may have been exposed to staph bacteria.

How is MRSA Diagnosed?

A sample of the infected wound (either a small biopsy of skin or pus taken with a swab) must be obtained to grow the bacteria in the microbiology lab. Once the staph is growing, it is tested to determine which antibiotics will be effective for treating the infection.

Complications of Staph Infections

Staph bacteria can cause folliculitis, boils, scalded skin syndrome, impetigo, toxic shock syndrome, cellulites, conjunctivitis, acne, boils, and styes. Staph can also be associated with mild blocked tear ducts in newborns. “Scalded skin syndrome” is a severe skin disease caused by staph.

Staph can cause infections in the ears, nose, and throat. And staph can cause swimmer’s ear — an infection in the ear canal.

Staph infections also occur in lymph nodes. Staph blood infections can lead to pneumonia, infective arthritis, bone infections, and even meningitis.

Impetigo

Impetigo is a skin infection that can affect skin anywhere on the body but commonly occurs in the area around the nose and mouth. It is most common among preschool and school-age children — especially during the summer months.

Impetigo caused by staph bacteria is characterized by large blisters containing fluid. The blisters may burst, and develop a honey-colored crust. Impetigo may itch, and it can be spread by scratching. Typically, impetigo is treated with a prescription ointment — or, depending on the severity, oral antibiotics.

Folliculitis and Boils

Folliculitis is an infection of hair follicles, under the skin where hair strands grow. In folliculitis, tiny white-headed pimples appear at the base of hair shafts, sometimes with a small red area around each pimple. Children with fine hair that is often worn tightly pulled back are particularly at risk for folliculitis.

Without treatment, folliculitis can progress to become boils. With a boil, the staph infection spreads deeper and wider. During the early stage, often going unnoticed, the skin either begins to itch or becomes mildly painful. Next, the skin turns red and begins to swell over the infected area. Finally, the skin above the infection becomes very tender and a whitish blister may appear. This may break, and drain pus, blood, or an amber-colored liquid. Boils can occur anywhere on the skin, especially under the arms or on the groin or buttocks in children.

To help relieve pain from a boil, try warm-water soaks, a heating pad, or a hot-water bottle, for 20 minutes, three or four times a day. Without treatment, boils may heal once they drain; however, treatment makes them heal faster and may prevent the staph infection from spreading to other skin areas.

Scalded Skin Syndrome

Scalded skin syndrome (SSS) most often affects newborns and children under age 5. The illness usually starts with a localized staph skin infection, but the staph bacteria manufacture a toxin that affects the entire body. The child has a fever, rash, and sometimes blisters. The rash begins around the mouth and spreads to the trunk, arms, and legs. As blisters burst and the rash passes the skin surface becomes red and raw, like a burn.

Scalded skin syndrome is a serious illness that needs to be treated and monitored in a hospital. It affects the body in the same way as serious burns. After treatment, most children experience a full recovery.

Treating Staph Infections

Most localized staph skin infections can be treated by washing the skin with an antibacterial cleanser, applying an antibiotic ointment prescribed by a doctor, and covering the skin with a clean dressing. To keep the infection from spreading, either on the patient or to others, use a towel only once, then wash it (or use disposable towels).The doctor may also prescribe an oral antibiotic. If an oral antibiotic is prescribed, always administer it on schedule for as many days as your doctor directs.

Treatment of a skin infection does not always get rid of staph bacteria that may be living in the nose or throat. Even if all of the bacteria were removed during treatment, because other family members may have the staph bacteria in their noses and throats, you may become re-infected. Ask you doctor about treatment routines that can help remove drug-resistant staph bacteria from all members of your family.

Preventing Staph infections

You can help prevent a staph infection by following these steps:

Armed with the right health information and a keen eye for health trouble spots, we can guard against staph infection in all its forms. Your doctor is the right person to consult if you have questions — any questions. Time once again to be prepared for whatever comes your way.