Health Care Resources for Arizona’s Low Income andUninsured Families 

                                                                     
 

these bacteria on their skin or in their nose. However, sometimes they can cause infection and serious illness. Some strains of staph are resistant to the antibiotic called methicillin, and to other antibiotics. These staph are known as methicillin resistant Staphylococcus aureus (MRSA).

What is community-acquired MRSA?

However, some MRSA strains spread readily between people in the community, and these are known as community acquired MRSA (CaMRSA) infections. CaMRSA strains are often quite different to MRSA strains associated with hospitals and may cause infections in people who are otherwise healthy.

What are the symptoms?

Just like ordinary staph, CaMRSA infections can cause:

• infections of the surface of the skin such as boils and impetigo (school sores)
• infections under the skin that can be tender and increase in size (abscesses and cellulitis)
• infections of the bone, blood, lungs and other parts of the body

How is it spread?

CaMRSA can get into the body through broken skin or sores, resulting in redness, pimples, swelling, tenderness or boils. Infections can become serious leading to blood infections or pneumonia. CaMRSA can be spread by:

• touching or squeezing an infected body area, such as a boil or open wound
• using towels, clothes or bed sheets that have been used by a person with a MRSA infection
• using grooming items that have been used by a person with a MRSA infection
• not washing your hands carefully

Who is at risk?

CaMRSA skin infections can affect anyone. Crowding and frequent skin to skin contact can increase the risk of infection, so outbreaks tend to happen in schools, dormitories, military barracks, households, jails, and childcare centres. Cuts or abrasions, contact with contaminated items and surfaces, and infrequent washing increase the risk of infection. People who have health problems such as diabetes or a poor immune system or who have broken skin due to wounds, or dermatitis are also more likely to get an infection.

How is it prevented?

1. Hand washing is important to prevent the spread of CaMRSA. You should thoroughly wash all parts of your hands with soap and running water for 10-15 seconds
   • before & after touching/dressing an infected area
   • after going to the toilet
   • after blowing your nose
   • before handling or eating food
   • after touching or handling unwashed clothing or linen
2. Cover boils or other skin infections with a waterproof dressing. People who handle food must make sure that they don't contaminate any food and keep any sores or skin infections completely covered with a waterproof dressing
3. Don't share personal items such as clothes, towels, or bed sheets (if you share a bed with someone, keep sores or wounds covered overnight) or grooming items such as nail scissors, tweezers, razors and toothbrushes.

MRSA in childcare and schools 
In addition to general hygiene, specific measures to prevent spread in schools and childcare include:

• teachers, children and families should understand the importance of hand washing, covering coughs and staying home if sick
• hand washing products (soap dispensers, running water and paper towel) should be available and accessible
• activities should allow time for hand washing (before eating and after going to the toilet)
• if open skin wounds cannot be kept covered, temporary exclusion from child care or school may be considered until the wound is healed or drainage of pus from the wounds can be contained using an sealed bandage
• surfaces such as counters, desks and toys that come in contact with uncovered or poorly covered infections, should be cleaned daily with detergent, and whenever visibly contaminated

MRSA in sporting groups
In addition to general hygiene, measures to prevent MRSA spread in sporting groups should include:

• People who have skin infections or open wounds that cannot be kept covered should not participate in contact sports until the wound has healed or drainage can be contained
• People who have skin infections or open wounds should be excluded from common spas or saunas
• People who have uncovered skin wounds should not share towels or sports equipment that is in contact with the skin

How is is diagnosed?

Staph infections are usually diagnosed on the basis of their appearance and the presence of any related symptoms (eg fever). To diagnose an infection of MRSA, your doctor will need to take a swab or sample from the boil, wound, or other site of infection, for laboratory testing.

How is it treated?

Your doctor will advise on the best treatment for your infection. Many CaMRSA skin infections can be treated by draining the abscess or boil. Letting the pus drain out safely is often the only treatment that is needed and the person often feels better once this has happened. Drainage of skin boils or abscesses should only be performed by a doctor or trained nurse or health worker under sterile conditions. It is important to keep the wound well protected with a waterproof bandage so that you don't spread the infection to others.

In some circumstances CaMRSA is treated with special antibiotics. If you are given an antibiotic, take all of the doses as instructed by the doctor or pharmacist, even if the infection is getting better, (unless your doctor tells you to stop taking it). It is possible for a CaMRSA skin infection to come back after it appears cured.

Noroviruses are a group of viruses that cause the “stomach flu” or gastroenteritis in people.

What are the symptoms?

The symptoms usually include nausea, vomiting, and diarrhea, and can also include stomach cramps, fever, muscle aches, and a general feeling of tiredness.

How are Noroviruses spread? Noroviruses are found in the stool and vomit of infected people. Others can be infected by touching objects that have been contaminated with stool or vomit and then placing their hands in their mouth, having direct contact with someone who is ill with norovirus, or by eating or drinking food or water contaminated with norovirus. Spread has also been documented through aerosolization of droplets during vomiting.

How long after exposure do symptoms begin?

Symptoms usually begin with 24-48 hours after exposure, however documented illness has begun in as little as 12 hours and as long as 72 hours after exposure.

Are Noroviruses contagious? Yes. Noroviruses are extremely contagious and can be spread easily from person to person.

How long is a person contagious with Norovirus? Most people are contagious from when symptoms begin until 3 days after symptoms end. However, studies have shown that virus can be shed in stool for up to 2 weeks after infection.

Is there any treatment for Noroviruses? There is no specific treatment for Norovirus infection. People ill with Norovirus who have diarrhea and vomiting should drink plenty of fluids to prevent dehydration.

How can Norovirus infection be prevented? The key to preventing Noroviruses is proper sanitation and good hygiene. Wash hands thoroughly with soap and warm water before eating/preparing food and after using the bathroom or after diapering/toileting a small child. Contaminated surfaces should be thoroughly cleaned and disinfected with a bleach base household cleaner, and clothing or linen that may be contaminated with the virus should be washed in hot soapy water.

It is recommended that schools use hand washing as the primary method of hand hygiene during an acute gastroenteritis outbreaks. Alcohol-based hand sanitizers are still highly effective against many other germs, and so their use is still recommended when a gastrointestinal outbreak is not occurring

Inflammation of the tissue that covers the brain and spinal cord.

               *It is generally severe and can cause serious complications i.e. brain damage, hearing loss, or learning disabilities

What organisms cause it?

Several pathogen most common to United States are Haempphilus influenza, Strept pneumonia, GroupB strept, Listeria monocytogenes, and Neisseria meningitides * most common in adol. and adults

Most at Risk:

Age (> incid in infants, Community setting (residence dorms), certain medical conditions, work exposure (microbiologists) and travelers ( sub Saharan Africa (dry season esp.) and Mecca during pilgrimages

Transmission:

Germs that cause it can be spread though the exchange of respiratory and throat secretions (i.e. kissing not casual contact ) but are not as contagious as viruses that cause cold or flu

People in close contact with someone who has bacterial meningitis may need preventative antibiotics

A person with a weakened immune system or head trauma is more susceptible to acquiring bacterial meningitis

You can get Listeria monocytogenes by eating contaminated food. (Pregant women are especially at risk and can have serious complications)

Symptoms:

Sudden onset of fever, headache, stiff neck, nausea, vomiting, and increased sensitivity to light confusion

How Diagnosed?

Analysis of Blood and CSF

Treatment:

Antibiotics* started ASAP

Prevention:

Receive recommended vaccines

MCV4 protects against 3 forms of bacterial meningitis- Neisseria Meningitidis, Strept. Pneumonia, and Haemphilis influenza type b

Inflammation of tissue that covers brain and spinal cord

What viruses cause it?   

Non polio Enteroviruses (most common) mumps, herpes, measles. Influenza, arboviruses, and lymphcytic choriomeningitis virus

Most at Risk:

Children younger than 5 yo

People with weakened immune systems (those receiving chemo, bone marrow or organ transplants

• Infants <1 mth and people with weakened immune systems more likely to have severe illness

Transmission:

If you are in close contact with person who has illness you may become infected with the virus but you are unlikely to develop meningitis. You may begin to develop symptoms up to week after exposed to someone who is ill even if they are not showing symptoms

Symptoms:

* Infants: Fever, irritability, anorexia, sleepiness, difficulty waking from sleep, lethargy (weakness)

* Adults: Fever, Headache, Stiff neck, sensitivity to bright light, Nausea, Vomiting, Anorexia, Lethargy, and sleepiness or trouble waking up from sleep

How Diagnosed: Lab swab (rectal naso-oropharangeal, stool), and CSF, blood and serum

Treatment: None most recover on their own 7-10 days. Those caused by influenza and herpes virus may benefit from antiviral medication

Prevention: No vaccine available.

Wash hands, Avoid touching face, Avoid close contact with sick people, Cover cough, sneezes with elbow or arm not hand, clean frequently touched surfaces often, and stay home when you are sick

Avoid insect mosquito bites and control rodents

Vaccinate on schedule (re prevent measles, mumps, influenza, chicken pox which can lead to viral meningitis)

Impetigo is a common bacterial skin infection caused by Group A Streptococcus (GAS) or "strep."

How does impetigo spread?

Group A Streptococcus (GAS) or "strep" can be transmitted through direct person-to-person contact with someone who has the infection. GAS can also be picked up indirectly through contact with an item (such as a wrestling mat, gear, towel, razor, or cell phone) that is contaminated with the bacterium.

What are the symptoms of impetigo?

• Symptoms usually began 1-3 days after infection.
• Sores (lesions) begin as small red spots, usually on the face (especially around the nose and mouth), but can appear anywhere on the body.
• The sores are often itchy, but usually not painful.
• The sores develop into blisters that break open and ooze fluid -- this fluid contains infectious bacteria that can infect others if they have contact with it.
• After a few days, the ruptured blisters form a flat, thick, honey-colored (yellowish-brown) crust that eventually disappears, leaving red marks that heal without scarring.
• There may be swollen glands (enlarged lymph nodes), but usually no fever.

What should students do if they think they have impetigo?

While mild cases of impetigo may be treated without seeing a health care provider, athletes are recommended to have a medical professional determine what type of infection they have, how to treat it, and if it is contagious.

If the infection is contagious, athletes should keep area covered and they should not share personal items or linens. They should not touch area and they should wash hands frequently and especially after any contact with affected area.