Sunday, December 2, 2007

Coaches on alert due to MRSA


— By
Staff Writer
Ten years ago, Kip DeVoll would have looked at you strangely if you asked about infectious diseases in high school wrestling. There was more concern for injuries than a skin rash or a potentially lethal staph infection.
Now DeVoll, the longtime Noble High wrestling coach, can rattle off a list of precautions he and his staff take in dealing with and preventing skin-borne infections among wrestlers at his school. Washing practice clothing. Issuing multiple uniforms. Requiring showers after competition and practices.
DeVoll's vigilance is understandable. With heightened local and national attention on methicillin-resistant staphylococcus aureus (better known by its acronym, MRSA), high school coaches, athletic administrators and medical professionals are taking measures to prevent the spread of the ''superbug'' staph infection, which is resistant to most antibiotics.
Since September, there have been several incidents across the country involving MRSA.
A 17-year-old high school student in Virginia died in October. At Severna Park (Md.) High, six athletes, including the football captain, developed MRSA. Parents and coaches attributed the outbreak to the locker rooms, which some claimed were poorly maintained. At Mt. Lebanon High in suburban Pittsburgh, officials confirmed 10 cases of MRSA infections, all afflicting athletes.
MRSA made news in Maine earlier this fall when a Gardiner High athlete tested positive for the infection. The athlete was treated and recovered.
Then, two days before the Class B state championship game in November, five Gardiner football players were closely monitored for signs of MRSA. All five eventually tested negative and played after being screened for MRSA and skin infections prior to kickoff.
Gardiner Principal Chad Kempton said the school worked with MaineGeneral Medical Center in Augusta, the Maine Center for Disease Control and Prevention, and with trainers, coaches and parents to identify students who might have a staph infection.
As a precaution, locker rooms and football equipment were sanitized and continue to be cleaned, and trainers and coaches at the school were advised to look for the signs of skin-borne infections on a regular basis.
''Skin infections happen every year with athletes, because of sweating and physical contact with other athletes,'' Kempton said.
''There's more of an awareness (now), which isn't a bad thing. Sometimes people panic and we understand why. This situation (at Gardiner) wasn't a panic situation, but it was important to take precautions. If you know how to prevent this, that's the best step you can take.''
Staph bacteria are commonly carried on the skin or in the nose of about 25 percent of the general population, according to the Centers for Disease Control in Atlanta. The bacteria pose no problem unless they enter skin tissue -- often through wounds or cuts -- or the bloodstream and cause an infection.
Most staph infections can be treated with a variety of antibiotics, such as penicillin, but MRSA is resistant to all but three types of antibiotics: tetracycline, linezolid and vancomycin. Vancomycin is commonly known as a ''drug of last resort,'' used after treatment with other antibiotics has failed.
The most common transmission of MRSA is through skin-to-skin contact, according to the CDC.
It also could be picked up through the shared use of towels and exercise equipment.
But decreasing the spread of any kind of staph infection is simple.
''The real way to stop transmission is to keep good personal hygiene,'' said Dr. August Valenti, the head of epidemiology and infectious diseases at Maine Medical Center.
''This is a time when personal hygiene needs to be emphasized, and respiratory etiquette (disposing of used Kleenex or covering your mouth when you cough), as well.''
MRSA, Valenti said, is nothing new. He recalls seeing the first cases more than 20 years ago, and said 10 to 15 years ago it was relegated to nursing homes and prisons.
But it has increased because of a newer strain of the bacteria that has been found in communal settings such as locker rooms, health clubs and even schools.
''It's one of the things we should teach youngsters, keeping personal items clean on a regular basis,'' Valenti said. ''Second, we should teach a lot of good hand hygiene, using running water and good antibacterial soap.''
Valenti also recommended frequent laundering of uniforms and practice clothing, and said if an athlete does have an open sore or a lesion, he or she should be withdrawn from competition until treatment of the infection is completed.
Skin diseases aren't new to wrestling. Ringworm has been more prevalent at Noble than staph but DeVoll, in his 22nd year as the Knights' coach, acknowledged that many coaches have had wrestlers with a skin-borne disease ''at one time or another.''
In 1999, five Deering High wrestlers contracted herpes simplex 1 but since then, Coach Al Kirk said his team hasn't had a problem with any kind of outbreak. He's seen fever blisters, impetigo, chicken pox and cauliflower ear (fluid buildup and swelling of the outer ear) in his wrestlers, but staph is relatively new.
''It's elevated itself over the past 15 years,'' Kirk said.
At Noble, each of the wrestlers are required to shower every day after practice and after meets; in the case of a tournament, in which a wrestler can compete in up to seven matches, they must shower after each match. Look in any Noble wrestler's equipment bag at a day-long tournament and you'll find no less than five singlets -- one for each match he or she wrestles in.
Wrestling mats at Noble are washed every day with a high-concentrate bleach and for each practice; freshly laundered shirts, shorts and socks are issued to wrestlers and collected after practice to be laundered for the next day.
At Deering, Kirk takes similar steps to prevent the spread of skin-borne diseases.
The wrestling room at Deering is cleaned on a regular basis, and wrestling mats are cleaned before and after each practice. Wrestlers are also responsible for cleaning and sanitizing their personal lockers, and they must shower before and after each practice and meet.
They are not allowed to share towels, and they must practice in freshly laundered clothing every day.
DeVoll, however, sees fewer high school athletes outside of wrestling taking proper hygienic measures such as showering after competition and practices, and routinely doing laundry. Some athletes may be crunched for time while others may not be comfortable with the idea of a locker room having a communal shower, as opposed to individual shower stalls.
''Hygiene,'' said Kirk, who was an associate professor and the campus environmental health and safety director at the University of Southern Maine until the end of the 2006-07 school year, ''is very important.''
At Biddeford High, Athletic Director Dennis Walton said there is a protocol in place for any athlete who may have a rash or a lesion, which could potentially be a skin-borne infection such as ringworm or staph. If a skin-borne infection is diagnosed by a doctor, an athlete is not allowed to compete until receiving medical clearance.
At a recent meeting of SMAA athletic directors, Walton and his counterparts were briefed on what a staph infection is and the measures that can be taken to prevent the spread of infectious and skin-borne diseases such as MRSA.
The education that athletes, coaches and administrators are receiving, as well as the preventative measures they are taking, is simply a sign of the times.
Walton played football and ran track at Biddeford, and said preventing injuries was a much more significant concern than possibly contracting an illness in sports nearly 20 years ago.
''It's a serious matter,'' said Walton, who graduated from Biddeford in 1988. ''We laugh about how people wouldn't wash their jerseys because we were winning, because of supersitition. We never were told, 'You need to wash your stuff because (the possibility of an infection) is an issue.' ''
Staff Writer Rachel Lenzi can be reached at 791-6415 or at: