Preventing MRSA Spread in Football: Good Personal Hygiene in Locker Room, School, Home Helps

The best way to prevent the spread of staph infections such as the antibiotic-resistant skin infection or "super bug" known as methicillin-resistant staphylococcus aureus ("MRSA") among football players is to maintain good personal hygiene and avoid direct contact with skin lesions of other athletes.

Everyone associated with football teams, including players, coaches, teachers, parents, and administrators, can help prevent sports-related skin infections and should be aware of the prevention measures set out below.

MRSA prevention tips: CDC

The Centers for Disease Control (CDC) recommends that:

• Sports team administrators be encouraged to provide facilities and equipment necessary to promote good hygiene, such as clean facilities and adequate supplies of soap and towels.
• Football coaches and parents should: 
  • Encourage good player hygiene (e.g. keeping hands clean by washing with soap and water or using an antibacterial hand sanitizer) 
  • Teach players to avoid sharing towels, razors or other personal items that come into contact with bare skin, use a barrier (e.g. clothing or towel) between their skin and shared equipment such as weight-training benches, and inform coaches about active skin infections; 
  • Be taught to administer proper first aid; 
  • Practice appropriate hand hygiene themselves; and 
  • Implement a system to ensure adequate wound care and to cover skin lesions appropriately before play.

MRSA prevention tips: football

The CDC also recommends the following specific steps to prevent the spread of skin infections among football players:

• Launder personal items such as towels and supporters after each use. The water should be at least 160 degrees; washing time should be 25 minutes or more.
• Clean and cover all wounds. If an football player's skin is injured, it should be washed immediately with soap and warm water, dried and covered with a clean bandage. If a wound cannot be covered adequately, the program should consider excluding players with potentially infectious skin lesions from practice or competition until the lesions are healed or can be covered adequately;\
• Encourage good hygiene, including washing hands often, using soap or a antibacterial gel or lotion, showering and washing with soap after every practice and game;
• Ensure availability of adequate soap and hot water;
• Discourage sharing of towels and personal items;
• Establish routine cleaning schedules for shared equipment. Shared athletic equipment, such as pads or helmets, should be cleaned or laundered at least once a week, but ideally after each use;
• Train athletes and football coaches in first aid for wounds and recognition of wounds that are potentially infected (remember that the MRSA risk is increased by playing on artificial turf);
• Encourage athletes to report skin lesions to coaches; and
• Encourage coaches to assess athletes regularly for skin lesions. 

MRSA prevention: schools

Some particularly pro-active school systems are going even further in their efforts to prevent the spread of MRSA, including:

• Having students apply an anti-bacterial hand sanitizer when getting on school buses;
• Requiring students to apply anti-bacterial hand sanitizer provided by their teachers first thing in the morning, before lunch, and after using the bathroom; 
• Supplying hand sanitizer to support and maintenance staff; and
• Installing hand sanitizer dispensers in all classrooms.

MRSA prevention and treatment: home

There are a number of steps parents can take at home to prevent the spread of communicable skin diseases such as MRSA, and to treat the infection, including

• Regularly cleaning commonly touched areas, such as doorknobs, light switches, computer keyboards and games, with a disinfectant (an inexpensive disinfectant can be made by mixing one tablespoon of bleach to one quart of water)
• Requiring that everyone in the household use his or her own towel (no sharing);
• Instituting a rule requiring that hands be washed before and after making contact with someone or their personal possessions; and
• Cleaning any cut with soap and water and then applying a topical over-the-counter "maximum strength" or "triple antibiotic" anti-bacterial ointment.* 
• Discouraging nose-picking. The bacteria that causes MRSA thrives in many people's noses, so if you see your child picking his nose, make sure he immediately washes his hands.
• Trimming nails to help prevent growth of bacteria under nails and cut down on spread of germs from scratches and nose-picking.
• Thinking twice about asking a child's pediatrician to prescribe antibiotics for the flu, or another virus, an ear infection, or adolescent acne. Why? Because, health officials say, the overuse of antibiotics has contributed to the resistance staph bacterium have developed to the most common antibiotics. Indeed, the growing public concern about MRSA has prompted many dermatologists (fifty percent, according to one report) to cut back on the use of antibiotics to treat acne.

*While there are, as of yet, no clinical studies to confirm the results, a laboratory study conducted at the College of Pharmacy at Oregon State University (OSU) presented at a December 2007 meeting of the American Society of Health-System Pharmacists found that an ointment containing benzethonium chloride with tea tree and white thyme oil worked best against all four tested MRSA strains, while ointments containing neomycin, polymyxin, and gramicidin also had some antibacterial effectiveness.

"We know that it takes a large number of bacteria to ultimately produce an infection, and antibacterial treatments can greatly reduce their number" said David Bearden, a clinical associate professor at OSU. "It's reasonable to believe that these products, which are inexpensive and easily available, have a place in protecting a nasty cut or scrape and trying to prevent a more serious infection."