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EPIDEMIOLOGY

 

Communicable Disease Reporting Hotline
PHONE (772) 794-7472
FAX (772) 794-7482
(24 / 7 / 365 Accessibility)

Epidemiology has been defined as the study of the distribution and determinants of disease and injury in human populations. Epidemiologists study variations of disease in relation to such factors as person (who), place (where), and time (when). Also of concern are temporal distributions of disease, disease trends, and the interval between the exposure to causative factors and onset of disease. The scope of the field extends from study of the patterns of disease to the causes of disease to the control or prevention of disease.

Epidemiologists are involved in a wide range of activities. These activities include:

  • the health needs of the population

  • investigation and control of disease outbreaks

  • study of environmental and industrial hazards

  • evaluation of preventive or curative programs or treatments

  • evaluation of the effectiveness of the interventions or control strategies

The Indian River County Health Department Division of Epidemiology offers the following services to our community:

  • Surveillance of mandatory reportable diseases

  • Prevention of disease through contact follow-up and health education

  • Educational materials

  • Bioterrorism preparedness

EPIDEMIOLOGY NEWS: MRSA INFORMATION

 

On October 17th, 2007, the Journal of the American Medical Association (JAMA) published an article and an editorial that stated that the annual number of severe, invasive MRSA cases in the U.S. is approximately 90,000.  Among these severe cases, there are as many as 19,000 deaths per year.  Also published in the news at the same time was a report of an MRSA death of a Virginia teenager.  There was an unusually strong reaction by the local school district, which closed 21 schools for one day for cleaning.  The combination of these two events prompted a wave of public concern throughout Florida.  

In response to the public concern, the Florida Department of Health and Department of Education have been working together to provide the public with a consistent message addressing their concerns.  

The following are points and recommendations from the Florida Department of Health:

Some important points:

  • MRSA is primarily transmitted person to person through close contact. 
  • Rates of MRSA are lowest in school-age children, compared to persons of all other ages. 
  • There is no current epidemic in Florida of Staph infections in general, nor of MRSA, as judged by hospitalization and mortality data.
  • We are seeing a long-term increase (over several years) in the proportion of Staph aureus that are antibiotic resistant, along with an increase in the aggressiveness of these infections, and there maybe some increased morbidity as a result.
  • As stated in the JAMA article, 85% of the MRSA infections are in people who have had contact with a heath care facility and only 15% are in people that have not been sick lately.
  • Many people can carry the MRSA bacteria without knowing it.  Focusing on individuals with an infection is not sufficient to address the problem and halt transmission.
  • Transmission of MRSA can occur both within and outside of the school setting.   MRSA is a community problem and not confined to the school setting.
  • MRSA infections are not new.  The county health departments and school health nurses have been working with this problem for several years.   
  • The typical classroom environment is not a high risk environment for the transmission of MRSA.  Sports, where there is a lot of physical contact, potential for skin abrasions and cuts, and sharing of equipment between players, is where transmission can occur.  Sharing of towels, uniforms, razors and other equipment should be avoided.  Routine cleaning of locker rooms and sports equipment with a disinfectant is recommended.
  • MRSA has been reported from a number of schools in Florida.  While it is mainly found in sports teams, especially football teams, anyone can get MRSA. 

 

Concerning the issue of school closures and Florida Department of Health recommendations:

The Florida Department of Health does not recommend closing schools for cleaning.  Rather it recommends that schools have an emphasis on good hand hygiene among students and staff.  This includes making sure opportunities for hand hygiene are readily available.  Schools should have a scheduled cleaning program which emphasizes areas that are most likely to get contaminated such as locker rooms, weight rooms, whirlpools, and other sports equipment that are shared.   

We do not normally exclude students from school that have a MRSA infection, but they may be prevented from participating in activities that would increase the chance for spreading the infection.  This would primarily be physical education and sports. 

School staff should receive basic education about MRSA and other infections and know when to refer a student for health screening or medical care.  School health coordinators can facilitate discussion and link school officials, school nurses, and local public health officials for prevention, referral, treatment and public education related to MRSA. 

Please read these Center for Disease Control and Prevention's (CDC) articles on MRSA for more information:
Questions and Answers about Methicillin-Resistant Staphylococcus aureus (MRSA) in Schools
Have you been diagnosed with a Staphylococcus aureus or MRSA infection? (Adobe Acrobat file, Size: 211Kb) 

In addition, here are some more useful resources for the Florida Department of Health's and Department of Education's MRSA response:

 Florida Department of Health Web Site
 Florida Get Smart Program, which
promotes the appropriate use of antibiotics among the school community
 
Florida Department of Education Web Site

 

MORE INFORMATION ON MRSA

 


General MRSA

Centers for Disease Control and Prevention: Community Acquired-MRSA 

CDC Background and General Information
CDC Information for the Public
2002 Article from Morbidity and Mortality Weekly Report (MMWR)

Centers for Disease Control and Prevention: Healthcare Associated-MRSA 

CDC Background and General Information


MRSA in Schools -
The EPA provides a list of EPA-registered products effective against MRSA

MRSA in Athletics


MRSA in Jails/Correctional Facilities 

Federal Bureau of Prisons

MMWR Report on Facilities in Georgia, California, and Texas

MMWR Report on Facilities in Mississippi

Florida Department of Health Antibiotic Resistance Programs

Florida Department of Health Infection Control Guidelines 1999

Outpatient Staphylococcal Infections in Florida: Descriptive Epidemiology of Methicillin Sensitive and Resistant Infections

Florida Department of Health 5th Guy

Hand Hygiene

 

 


For more information on Epidemiology Health Services, please call (772) 794-7400.

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