Kokomo Tribune; Kokomo, Indiana

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October 15, 2008

School confirms case of MRSA

Parents were informed Bon Air student had localized case

Kokomo-Center School officials have confirmed that one corporation student has a localized case of MRSA, while another student has viral meningitis.

Superintendent Chris Himsel said he learned Oct. 9 that a student at Bon Air School might have MRSA. After talking to the parents and health officials, Himsel ordered over the weekend precautionary measures, even though lab tests had not yet confirmed the child had MRSA, or methicillin-resistant Staphyloccus Aureus, a form of staph infection that is resistant to many antibiotics.

“We went ahead and cleaned the building as if there was a confirmed case,” he said.

School officials also sent home a letter to parents telling them it was possible a child in the school had the disease.

Late Monday, lab tests confirmed that the child had localized MRSA, and another letter went home to parents.

Dr. Radcliffe Jones, of North Central Indiana Pediatrics, who is the school corporation physician, said localized MRSA means the child had an abscess and not invasive MRSA, in which the infection enters the blood stream.

“Those cases are the ones we are all very concerned about,” Jones said.

He said most cases of invasive MRSA are caused by an infected abscess that is not treated. If a child has an abscess, or collection of pus, swelling, redness and pain, “that child needs to be evaluated,” he said. “Don’t just pop it and clean it. See your physician and have it tested.”

Jones said MRSA is caused by a common pathogen found all over the world, and that many people have it on their skin all the time. It becomes a problem when it enters the skin through a break in the skin.

The infected student was seen in a clinic last week and a culture was taken of the abscess to test it for MRSA, Jones said. Even before it was confirmed, the child was given the antibiotic most likely to clear the infection. Two days later the child’s parents brought the child back to the clinic, saying the abscess was not clearing as much as they thought it should, and doctors added a second antibiotic to the treatment.

After the lab results confirmed that the child had MRSA, Jones said, the second antibiotic was stopped, because the first was the most appropriate to treat it, and two days later the abscess was much better.

Jones said the child’s case is not the first seen in Kokomo.

“North Central Indiana Pediatrics has seen at least 20 cases in the last year or two. All cases we have treated have been abscesses that respond to drainage and the proper antibiotics. Nearly all the cases have been treated as outpatients.”

He said the easiest way to prevent MRSA is “proper hand washing.”

Himsel said the confirmed case of viral meningitis was at Kokomo High School.

Jones said viral and bacterial meningitis present the same symptoms of headache, fever and stiff neck, but doctors cannot tell which it might be without a spinal tap to test spinal fluid. For most viral meningitis cases, he said, relieving the pressure through the spinal tap will alleviate symptoms.

Bacterial meningitis would require an appropriate course of antibiotics.

Jones said a child who has headaches, fever and a stiff neck should be seen by a doctor to be sure he or she does not have meningitis.

He said if the KHS student had bacterial meningitis, students who had been in contact with that student may have had to be given a prophylactic dose of an antibiotic.

Himsel said because the student had viral meningitis, rather than bacterial meningitis, “it does not require any additional action as a school. The kind [of meningitis] the child has does not impact the health of any other child.”

Danielle Rush may be reached at (765) 454-8585 or via e-mail at danielle.rush@kokomotribune.com

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