MRSA: Closing Schools Just Window Dressing

The key to infectious disease control is striking an appropriate balance between overreaction and underreaction; not quarantining people unjustifiably and not exposing people to risk. This balance can sometimes be hard to find given the penchant of infectious disease to foment panic. However, sometimes it is easy to spot overreaction.

The community college in my hometown is one such example. 

Based on a single case of methicillin resistant Staphylococcus aureus (MRSA) infection the community college shuttered its doors. What strikes me as odd is the presumption that closing the school will have any substantial impact on MRSA at the school. While good sanitation and cleaning is important (and I don't know the particulars of this situation), it will not eliminate the risk of MRSA. The general population harbors MRSA are on the bodies at a rate of around 1% -- that means that the college with an enrollment of over 3800 students has at least 38 students who are chronically colonized with MRSA. Similar rates apply to the faculty and staff. The rate in healthcare workers is, by contrast, about 5% and those with chronic illnesses may have higher rates. Infection occurs primarily through skin-to-skin contact. This single case emerged amongst a larger group of MRSA colonized individuals and not from a school facility or structure.

MRSA is nothing new and no cause for panic. In most people it may cause a minor skin infection or boil (the "spider bite" for which there is no spider). Many people have minor MRSA skin infections that go unnoticed or undiagnosed and resolve on their own. Of course, MRSA can cause more serious infections such as pneumonia, bloodstream infections, infections of heart valves, or infections of bones/joints in certain contexts. 

By scrubbing down the school, a false sense of security will be instilled in the campus community and when the probable next case is announced a new round of panic and demands for more action will arise because the facts about MRSA's presence in the community (it can even be harbored by pets) were not part of the earlier discussion. 

While this may seem like an easy and straight-forward action and a "show of force" amidst the demands to do something, the negative repercussions of non-evidence based actions such as this will likely abound. This action will not substantially protect against or change the risk of infection as it is the campus community itself that harbors the microbe.