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Dear Parents/Guardians:

 

     The memorandum below prepared by Dr. Kenneth A. Sobel, physician for the Elmira and Horseheads School Districts, clarifies many of the misrepresentations regarding Methicillin Resistant Staphylococcal Infections (MRSA.)  Mrs. Mary Zink, Elementary School Nurse, and Mrs. Barbara Gibson, High School Nurse, asked that this memorandum be distributed to all parents/guardians of students attending Waterford-Halfmoon UFSD.

 

     Please call one of the school nurses if you have questions or concerns regarding MRSA.

 

James H. LaGoy, Ed. D.

Interim Superintendent of Schools

 

 

SOUTHERN TIER PEDIATRICS

Hoffman Medical Building * 302 Hoffman Street *

Elmira, N.Y. 14905 * (607) 734-2264

 

Kristen M. Chimileski, M.D. Mary B. Muse, M.D. Regina Carter-Farmer, CPNP

Jon R. Homuth, M.D. Tina M. Nichols, M.D. Sharon T. Coughlin, CFNP

John D. Juriga, M.D. Alan B. Roessler, M.D. Marylou O. Losinger, CFNP

Kurt L. Krause, M.D. Kenneth A. Sobel, M.D. Janice D. Rhodes, CFNP

Laura J. Leonard, M.D. Amy L. White, M.D. Diane J. Rossi, CFNP

Monta B. Wagner, CFNP  Judene W. Witt-Martin, CPNP

 

October 25, 2007

 

To: Parents and caregivers of children in the Elmira and Horseheads School Districts

 

Re: Methicillin Resistant Staphylococcal Infections (MRSA)

 

As school physician, I feel that it is necessary to clarify the recent local and national reporting regarding cases of MRSA infection in the schools. I am sure many of you have been following the news regarding these infections with interest and probably some element of concern. Unfortunately, I feel the news coverage has been somewhat misrepresentative of the facts and is alarmist regarding these infections.

 

Staphylococcal aureus is a common bacteria which lives normally on human skin – many people are colonized with this bacteria. MRSA is a type of Staphylococcal aureus which has several unfortunate characteristics – it is resistant to many of the common antibiotics used for skin infections and it has the tendency to progress (worsen) rapidly. The most common types of infection caused by Staphylococcus and MRSA are cellulitis, abscess and folliculitis (all skin infections).

 

Here are facts regarding MRSA:

  • MRSA is not a new infection! Current press reporting leads one to believe MRSA is a new phenomenon. In fact, MRSA has been present in our communities for years. Your health professionals have been aware of MRSA for years and have adapted their diagnosis and treatment of skin infections accordingly.

  • Some press reports equate MRSA with “flesh eating” bacteria, which has also been reported upon. This is not the case. MRSA is not the same infection.

  • MRSA is not exclusively a school problem as news reports seem to indicate. In fact, MRSA is common throughout our local and national communities. Taking this into account, the reaction of the school district in Virginia (closing and cleaning the schools) makes no medical sense. People carry MRSA on their skin – sterilization of the school will interrupt education of our children but will not eliminate the presence of MRSA infections.

  • There is effective antibiotic treatment for MRSA, though choices are limited. Most MRSA infections are treated successfully without need for hospitalization. It is true that in some cases, some of these infections can rapidly progress and require hospitalization. The few cases involving death reported in the media is very unusual – this is not the norm for this type of infection.

  • People who have MRSA and are being adequately treated do not need to be restricted from work or school!

If a person has signs of a skin infection that seems to be worsening rapidly despite good hygiene and topical antibiotic use, they should seek evaluation by a medical professional. This medical advice does not

differ from what you already know. The current media reports have elicited an unfortunate, somewhat hysterical response from our community which is unjustified.

 

I would encourage anyone interested to look up more information on the CDC web site, which has excellent information on this infection. Look up key words – Community Associated MRSA.

 

 

Sincerely,

Kenneth A. Sobel, MD

 

Kristen M. Chimileski,        M.D. Mary B. Muse,M.D.    Regina Carter-Farmer, CPNP

Jon R. Homuth, M.D.        Tina M. Nichols, M.D.        Sharon T. Coughlin, CFNP

John D. Juriga, M.D.         Alan B. Roessler, M.D.       Marylou O. Losinger, CFNP

Kurt L. Krause, M.D.         Kenneth A. Sobel, M.D.     Janice D. Rhodes, CFNP

Laura J. Leonard, M.D.      Amy L. White, M.D.          Diane J. Rossi, CFNP

Monta B. Wagner, CFNP    Judene W. Witt-Martin, CPNP

 
 

 

SCHOOL HEALTH SERVICES

 

IMMUNIZATION AND PHYSICAL EXAMS

 

Before a student enters school, proof of the following immunization must be shown:

 

1. Diphtheria Toxoid - DPT or TD - 3 or more doses.

 

2. Tdap booster if born after 1/9/94 and entering 6th grade.

 

3. Polio vaccine - TOPV - 3 or more doses

 

4. Live Measles Virus Vaccine - 1 dose administered after 12 months

 

5. * Second measles administered more than 30 days after the first but after 15 months of age.

 

6. Live Rubella Virus Vaccine - 1 dose administered after 12 months of age.

 

7. Series of three hepatitis B vaccines.

 

8.  Varicella (chicken pox) - born on or after 1/1/98 or after 1/9/94 and enrolling in 6th grade.

 

Transfer students within NYS must also show proof of same. Students transferring from out of state have 30 days to show proof of these immunizations.

 

Health Physicals are required each year in grades 2, 4, 7 & 10 by the school physician on all students who have not returned their own doctor’s reports by October 1st. Special forms are available in the office.

 

Vision screening is provided for students in grades K, 1, 2, 3, 5, 7 & 10.  Hearing screening is provided for students in grades K, 1, 3, 5, 7 & 10.  Referrals are made in accordance with screening results. All students in grades 5 - 9 are screened for scoliosis. Referrals are made in accordance with screening results.

 

EXISTING HEALTH CONDITIONS OR PROBLEMS

The school nurse should be aware of any health problems the child may have (ex. asthma, diabetes, etc.) If new health problems should occur during the school year, please notify the nurse.

 

All communicable diseases are to be reported to the school nurse as soon as the parent knows the diagnosis. For other illnesses or conditions, please notify the nurse if your child will be absent for three or more days.

 

MEDICATION POLICY

If a child must receive medication during school hours, New York State law requires that the school nurse must have a written order from a physician and a parent written request to give the child the medication. Parents must deliver the medication to school (no medications should be brought on the bus with students). Students are never to keep medications of any kind (this includes cough drops and aspirin) on them or in any of their belongings unless a self medication form has been completed by the parent and physician for age appropriate students.

 

Medications cannot be dispensed without:

The written order of your physician specifying diagnosis, medication, (possible side effect), dosage, frequency and the time for giving this medication.

 

The written request of the parent, requesting that school personnel administer the medication as ordered.

The original, labeled bottle from the pharmacy that indicates date, name of child, name of physician, medication dosage and frequency. You might want to ask the pharmacist for a second bottle for school so that medication can be left in school and not be transported daily.

Medications administered on Field Trips School Personnel, other than the nurse, are not allowed to dispense medication. If your child is on a daily medication, please contact the nurse to discuss how this will be handled when the class has a scheduled field trip.

 

ILLNESS DURING SCHOOL HOURS

If your child becomes ill at school, the nurse will notify you or the person designated on your emergency card. We do not transport children home unless it is a true emergency. Please notify the people you indicate on your emergency card that they have been listed for emergency care. Note: It is very important to notify the office of any changes in phone numbers or names of persons to be notified.

 

Please be aware that the school nurse has the responsibility only for immediate and temporary first aid. In all emergency situations, the responsibility for care, treatment and transportation of the child will be transferred to the parent, guardian or parental designate as soon as possible. The nurse is obligated to treat only injuries that occur on school property or school buses. A dressing (bandage) applied by the family physician or parent may be reinforced, if necessary, but not changed

 

GENERAL GUIDELINES FOR PARENTS

Please do not send your child to school if you suspect a fever, rash or other signs of illness. If your child exhibits the following symptoms at home, please follow these guidelines:

Rash: Any child with an unexplained rash or eye inflammation must be kept home until a diagnosis is made by a physician.

Fever: If a fever is present during an illness, the child should be kept home until the temperature is normal for at least 24 hour, and all symptoms have disappeared.

Cold: A student with acute early symptoms of a common cold should stay at home to prevent serious developments and also to protect classmates from exposure to illness. If this practice is followed, fewer absences due to respiratory illness will occur.

Stomachache: A child complains of this in the morning, keep child at home. If nothing further develops, the child should return to school the following day. Note: Any child who is nauseated or has vomited during the night should be kept at home for observation.

Head Lice: If your child is sent home because of head lice or nits (eggs) please follow these directions for returning to school. 1. Child must be transported to school by a parent or responsible adult to be checked by the nurse. 2. The empty bottle of treatment shampoo must accompany the child. 3. If the child is free of lice and nits he/she may return to school. If the problem persists the procedure for re-admittance must be repeated until the child is lice and nit free.