MRSA Q&A with Dr. Tooker

KALAMAZOO (NEWSCHANNEL 3) - Dr. Richard Tooker of the Kalamazoo County Health and Community Services Department sat down and answered viewers' questions about MRSA. Below are the questions and responses.

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My son was just diagnosed with a Staph infection yesterday, after he finally complained of his toe hurting yesterday morning, and having been ill the entire day before with fever, chills, and vomiting. When he showed me his foot, I gasped, as the infection was running all the way up his leg, and branched off just under his knee.

When I took him to the Pediatrician, I was told it wasn't MRSA, as there were no "boils"? The initial site of the infection seemed to come from the area on the side of his toe (see attached pictures), that looked like a blister that had burst, and become infected. He had also just recovered from having had Chicken Pox (Varicella), a week and half ago. I was told that this made him more susceptible to the cellulitis that had developed.

My real question is, are the boils the tell tale sign of MRSA? Or could what he has still be MRSA?

He is on 500mg of Keflex every 8 hours, and seems to be doing well. His fever has broken, and the cellulitis seems to be calming down (color and swelling is less severe), however the toe is still purple, and very sore.

MRSA can look like things other than boils - we encourage docs to culture all infections like this. As long as he is resolving his infection - OK!

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My mother died of staph @ spectrum hospital in 2000. It was a staph that was resistant to vancomycin. The staph infection ate away at her skin and caused her kidneys to fail. Why should I not be afraid of my children contracting MRSA? People do not know what a long, prolonged horrible death staph can be.

Sorry to hear that - as opposed to that infection MRSA is still very curable with several antibiotics so if properly diagnosed it is easily cured.

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I am from Galesburg, MI. I am curious if I might have something that may result in mrsa. I had a baby almost a year ago. My hormones are now just starting to get weird and for the last month I've been experiencing a lot of acne. I have one sore on the back of my right arm that is a little sore, and red. My daughter, my husband, and myself are scheduled for flu shots tomorrow in Richland pro-med at 3pm. Could this be a staph infection? I am worried. My husband works in Battle Creek. I'm not sure if it's just a puffy blood pimple or something maybe worse as in MRSA. Thank you.

The only way to know is to have the sore seen by a physician. If it is weeping or draining it definitely needs to be seen

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Hello I was wondering if there is a web site to find out what the MRSA looks like. I seen on WWMT tonight of a father talking about his son having it and said it looks like a mosquito bite. I work in a public school as a janitor and wondering what it looks like? Thank you.

CDC.GOV and also by googling Massachusetts State Health Department and that will give you pictures.

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I know a homeless person who claims to have MRSA.

She said she went to the hospital where they diagnosed it, but, because she didn't have money or insurance, she can not get treatment.

Is she contagious and a threat to others? Does she need to be treated? If so, is there a place she can get treatment?

She can go to the Free clinic in Kalamazoo for diagnosis and treatment. The shelter can assist with her care as well.

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I am a pregnant teacher in a school where a student has been diagnosed with MRSA. The student was in my classroom last week talking about how he popped his boil in school. What special precautions should I take since I am in my ninth month of pregnancy, since the bacteria is at the school and more students may become infected?

Follow all of the advice online about staying clean and avoiding the risks that are mentioned. Keeping your hands clean with antibacterial hand sanitizer is always best. Wash hands for at least 15 seconds and make sure it has at least 61 percent alcohol.

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I'm a teacher in a school with a confirmed case of MRSA. My husband is immuno-suppressed due to a double lung transplant. I was my hands before I leave the building, and am careful not to touch anything until I get into my car. Providing I continue to use good hygiene, can I transmit MRSA to him without actually having it myself?

It is possible to be "colonized" with MRSA but not infected. You are careful so I don't think you pose much risk. His risk is for the health care system more than you

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What do you think of the theory children have been too antiseptic and not allow to develop resistance to any bug. I personally think they should be allowed to get dirty and even eat dirt if they choose to while playing outside. They certainly can wash before meals and at the end of the day instead of every five minutes.

Sure - public health officials agree.

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What can I do to keep my toddler grandson safe at day care?

As the day care provider for their infection control guidelines. Watch your grandson for sores that don't heal and get them checked out.

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Can you catch this infection from sharing paddles, duct tape, and cookware?

It all depends on who you kayak with! Always choose you kayak partners with care!! Actually kayakers need to be careful if getting skin breakdown from rubbing clothing and gear. Who is this - you must know I'm a WMCKA kayak instructor!

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About a month ago, my daughter had 'lesions' all over her legs, we took her to the doctor and he told us she has a 'bacterial staph infection'. He gave her both internal and external antibiotics and almost immediately the infection started clearing up. My question is, was this MRSA? Since it reacted to antibiotics, was it the 'superbug'? Should I let the school know about it?

This sounds like regular staph, however, the only way to know is to culture the infection. No need to contact school in this case.

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My son has a small rash on his cheek that looks like a heat rash. He had a mosquito bite in that area before that, should he have it checked? Also there is a student in the elementary school that has this infection and his band aid keeps coming off...( I think he plays with it) should he be in school?

Keep an eye on that rash. If it becomes a pimple or boil get it checked. Warm, red and especially draining pus - get it evaluated. The child in school is probably ok if he has been on an effective antibiotic for at least 3 days.

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I was told on Sunday that I have MRSA and they put me on meds I have 3 sores that are open and running. The doctor told me I could not be around people like my 20 month old grandson, my father that is dying and so on and so on I called my sons school and told them I have it and they said oh thats ok as long as I have been taking my meds I am ok to be around people so I'm not sure now what to do. The nurse said I'm ok the doctor said tell they tried up so what is right all so I have the runs bad is that part of it?

The key is to keep your sores covered until they heal. In general it is safe to be around others with covered sores and at least 3 days of an effective antibiotic.

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I was wondering why no one has mentioned the hand sanitizers as an infection control option while reporting on the MRSA infections? Thanks for keeping this topic in perspective for the viewers. That is a great service.

Hand sanitizers have been mentioned in some reports and we discuss them in our public helath lectures as a good second option when used properly.

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Do you recommend alcohol based hand sanitizers for use in places like schools and stores? I noticed some grocery stores now have hand sanitizer gel or wipes for the grocery cart handles. Do you think this helps reduce the spread of infections, including Staph infections?

When soap and water are not available hand sanitizers are the best option the must be at least 61 percent alcohol (like Purell.)

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Yesterday on WWMT news, a health official stated that it's a no-brainer to get a flu shot because it will prevent pneumonia, which is a side effect of staph. What does getting a flu shot have to do with a staph infection? Shouldn't you get a pneumonia shot andwill this prevent a staph oriented pneumonia?

The pneumonia shot protects us from several strains of the STREP bacteria but not staph bacteria. Getting both Flu and Pneumonia shots is the way to go.

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My son has been on Remicade for Ulcerative Colitis for one and a half years now. Is he more at risk for MRSA than the general population? Thanks.

Sorry Evan - I don't have a reference on Remicade here in the studio. If it is a drug that blocks the immune system then it does increase risk for infections in general.

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My son is a high school wrestler and with an approaching wrestling season we are naturally very concerned about how MRSA will impact this sport. In the past, we have experienced many skin conditions from wrestling with we wouldn't normally experience (i.e., ring worm. impetigo, etc). How do you feel that MRSA will impact teenage wrestlers this year and what advice can you give parents to help avoid the risk of infection?

More information - wrestlers will probably alway be at risk for MRSA nowadays. We are working with coaches and trainers to help them keep environments clean and assess kids for suspicious sores. Early diagnosis and proper treatment is key to keeping athletes safe.

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Hello, recently at my school, a kid was diagnosed with staph infection, but hes says he does not have MRSA yet. Hes is taking meds for it, but he says the sore is getting worse. I myself have a heart condition (disease), and sit right behind him. I am sort of a germa-phobe, so I was my hands constantly which should help. I also have a pretty good immune system, as i am hardly ever sick, and I drink plenty of orange juice for breakfast. Am I more prone to get this infection? it kinda freaks me out, and I try to stay away from him. I know he doesn't cover it up with a band-aid either. Thanks!

You are low risk as long as you avoid direct ski-to-skin contact with him.

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Is it possible to get MRSA from another person and my daughter goes to a private school. What can we do to keep an outbreak from happening in her school. I will pass your information on to her.

Most persons get MRSA from another person. Schools need to follow published guidelines for sanitation and cleaning and teach students and staff how to avoid the spread of skin infections. Call your local health department for details.

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Antibacterial soap does not kill the MRSA germ right?

Antibacterial soaps are effective as long as you are washing properly. You have to wash hand for at least 15 seconds with a lot of scrubbing and running water.

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Hi , my stepson is in prison in West Virgina and he called home to tell us that the mrca staph is going wild in the prison system there and he would like to know how he can prevent himself from getting it. can you tell me what he can do?

He needs to wash his hands as often as he can, shower daily and report any sores that don't heal to the clinic.

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Hello. After just watching the news report and hearing the parent interviewed say "lesion like a mosquito bite", I have a question. My son showed me what appeared to be either a pimple or bug bite on his arm yesterday. It looks more like a pimple to me - it almost has the appearance of having a "whitehead" under the skin, but I don't think it's real common to get a pimple by your elbow. Should I be concerned? He did have an open wound about a week ago that we treated with antibiotic ointment. That wound is now scabbed over.

This sore can be consistent with MRSA - best to have it evaluated by a doctor.

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Read about this in August, any comment?

July 13 edition of the Proceedings of the National Academy of Sciences

New Cure For Drug Resistant Bacteria At The Horizon

Drug resistant bacteria (like MRSA, methicillin resistant Staphylococcus aureus) have developed in many hospitals and have caused more than 2 million infections in the US alone of which 90,000 people died. Yet so far research regarding this problem has been very slow and unsuccessful. In Canada there was an outbreak of E.coli in September of 2006, which left 14 people severely ill and simultaneously there was a similar outbreak in the US leaving three people dead.

Dr. Redinbo, PhD in biochemistry and biophysics, from the University of North Carolina at Chapel Hill made an astounding discovery in his lab. He tested some of the older medications used for osteoporosis treatment, the biphosphonates clodronate and etidronate, to see whether they would have an effect on stopping the multiplication of these harmful bacteria. Dr. Redinbo’s work was published in the July 13 edition of the Proceedings of the National Academy of Sciences. Dr. Redinbo’s team found that an enzyme, called relaxase, is at the center of the development of antibiotic resistance. When resistance develops, there is a genetic transformation that takes place, like a mini Darwinian selection process where the most resistant bacteria survive and multiply. The resistant bacteria mate with each other and with bacteria that are not yet resistant. This process involves the relaxase enzyme system, some DNA stranding and a strand exchange. In this way new resistant bacteria are formed. Experiments under the supervision of Dr. Redinbo found that this process can be stopped by the phosphate-rich compound, biphosphonates (clodronate and etidronate). Other chemicals were found to not be as effective. The relaxase system is found in a number of problem bacterial strains, Staphylococcus strains, drug resistant Acinetobacter strains and others. Unfortunately the biphosphonates have some side-effects like stomach soreness and birth defects. The researcher said that he hopes that these drugs and perhaps others with less side-effect will offer new treatments for antibiotic resistant bacteria.

The CDC has a list of several new disinfection and sterilization agents and methoods. New antibiotics are much lesss common but this one looks promising.

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My mother is a librarian at a local elementary, She just came and stopped by to see me and she has cold sores on her lip, probably about 3-4. Is this any symptom of MRSA? What should she do if it is? Or if not what should she do so she doesn't get MRSA?

These are probably herpes cold sores. If they don't heal in several days or ooze puss, get seen by a doctor.

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What are the symptons for MRSA infection? Do they include: Mild temperature, moderate stomach upset, moderate diareha, moderate muscle ache??? What is the time to onset from exposure? What is the most optimal way to catch MRSA?

These are not MRSA symptoms. The time from exposure is quite variable. MRSA comes mostly from skin contact with someone who has it.

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My 12 year old son goes to Bloomingdale Middle School and last week the gym and the athletic building had signs on them telling people to stay out until further notice that staph infection was found. No letters went home to the parents to notify them with any information; no mention on the news about the school here. Why is this? Also it;s to my understanding that MRSA in highly contagious and not your everyday antibiotics work. and mostly IV antibiotics have to be used, so with this being said wouldn't it make more since to close the school and give the school a serious cleaning and not put other kids at risk of getting this staph infection?

Check with the school system to see what their policy on infections are. They may have had a student with Staph but not MRSA. MRSA does respond to many oral antibiotics

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I recently moved here from Oceana County and my daughter had 3 outbreaks of MRSA 2 of the times the doctor had to cut the lesion open and drain the pus and put packing in. My son has had it one time and it cleared up with bactrium. Since moving here they have not had one outbreak, My question is since they have already had it do they continue to have it the rest of their life do i notify my sons school?

It sounds like the kids have been treated effectively. It is possible their skin still has MRSA in places but this is likely to decrease over time. No need to notify school

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PSA recently jumped to 4.5 from 2.0 last year. I'm shunning biopsy due to the staph mess occurring recently. Will an ultrasound scan be sufficient? NO family history!

I wouldn't avaoid a biopsy if recommended by your Doc.

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I had what started like a painless pea size spider bite on my forearm. Turned dry and flaky about 4 days later.

As long as its getting better your OK - if it gets bigger, red or oozing, get it checked.

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I am a 59 year old woman with M.S. I recently had what I thought to be a cyst or boil on my cheek, it has finally drained and is very sore. Now I have small white bumps all through my scalp that start draining. Is there a blood test or something I could have done to check for MRSA?

It would be a good idea to have your doctor culture these and determine if it is staph

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I have a few questions and concerns, 1st I just took my daughter to the Doctor today and the cultures they took from her leg last week came back positive for MRSA. Getting the nurse and Doctor last week to diagnose her properly was like pulling teeth but that is another story. My questions are these:They put her on an antibiotic last week but have switched it today for precautionary measures since the virus is already on it's way out. The antibiotic, they said, is resilient to staph and is having no effect on it whatsoever yet from last week to this week is a HUGE difference. I asked if I should inform the school and they told me No because they said there was no need for me to scare people since she is not contagious anymore and that it is nothing for me to worry about and is a common thing. The other thing is the medicine they have put her on which is SMZ-TMP which is the generic form of sulfamethoxazole-tri, I have not given to her as of yet. Everything I have read on the Internet about a staph infection says your body will become immune to the meds. If she takes the one medicine that can kill this bacteria when it is already dying off-- what happens if she contracts it again in a couple of years and the meds don't work because her body has already taken them to fight it the first time.

Good to hear she is getting better. She can take SMZ-TMP more than once it will continue to work in the future ( unless the Staph mutates again!)

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I do a lot of spiritual hospital and nursing home visits. When I see contact precautions on the door of a room I always ask the nurses what it means and usually the answer I get is "Oh, it's just mrsa." What precautions do you suggest?

Avoid skin-to-skin contact with these patients and wash your hands before and after your visit.

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I apologize I ran out of time responding to so many emails. We thank you for your concern and questions. If you would like more information on MRSA you can visit www.CDC.gov or by searching Massachusetts State Health Department, this site will show you great pictures of this sores.

Thank you for watching News Channel 3.

Sincerely,

Dr. Richard Tooker

Kalamazoo County Health and Community Services Department