Protocol for staph weighed

State health officials are considering requiring health care providers to report to the Nevada State Health Division cases of a drug-resistant germ that recently has made national headlines.

Methicillin-resistant Staphylococcus aureus, or MRSA, is not now on the health division's list of reportable diseases, division spokeswoman Martha Framsted said.. Health care providers who report MRSA cases to the health division or Southern Nevada Health District do it voluntarily. Currently, more than a dozen states require such notification.

"We have taken some initial steps to find out if health care providers want to report MRSA,'' she said. "We are having discussions with the stakeholders.''

Those stakeholders include health departments, hospitals, medical facilities, health care providers, prisons and schools.

Framsted didn't know when health officials would reach a decision but, she said, there are two ways a disease can be added to the state's reportable disease list. The first would require a change in regulations.

That process would involve the state health officer holding public meetings, forums and workshops throughout the state to get public input.

The second option would involve the state's health officer meeting with health care providers and then collectively deciding to add MRSA to the list of reportable diseases. Framsted said this option, which likely would be quicker, was the route health officials took when dealing with West Nile virus.

News of the state's plans came a day after Clark County School District officials announced that a male student from Stewart School, an alternative school that serves about 200 special education students, was diagnosed with MRSA.

Diana Taylor, director of health services for the district, said Wednesday a teacher noticed a lesion on the student's body Nov 1. The boy visited a doctor the next day, and a the district received notification Monday that the student did in fact have what's being called a "superbug."

The district sent letters home Wednesday to parents of the nearly 309,000 students informing them what MRSA is and how to prevent it.

A letter also was sent home Tuesday by Stewart administrators informing parents that the student who was diagnosed would not be returning to school until he had a doctor's clearance. As a preventive measure, custodians on Monday and Tuesday cleaned areas of the school where the infected boy had been, Taylor said.

She added that Stewart was not closed because of the boy's infection, and no other students or staff at school had contacted MRSA. It is unknown how, or where, the student contracted MRSA, Taylor said.

Making MRSA infections reportable to state health officials would allow better tracking of the communicable disease and make it easier to inform the public should clusters of the infection be discovered.

MRSA is an infection caused by a bacteria often responsible for pimples and boils. It is resistant to many antibiotics, including methicillin, a type of penicillin. Health officials say MRSA is the result of overuse of antibiotics, which has allowed bacteria to adapt and become resistant. More than 90,000 Americans get the potentially deadly infections each year.

It usually is spread by direct physical contact with someone carrying the bacteria, regardless of whether they show signs of infection. However, it also can be contracted by contact with objects handled by an infected person, such as gym equipment or towels.

According to the Centers for Disease Control and Prevention, MRSA has been known to occur most frequently among patients who undergo invasive medical procedures or who have weakened immune systems and are being treated in a hospital. However, there is a community strain that has made national attention.

Some Southern Nevada physicians say they agree with adding MRSA to the state's list of reportable diseases.

"Absolutely,'' said Dr. Ivan Goldsmith, an internal medicine physician who admitted a patient into an area hospital Wednesday with MRSA. "We are seeing a lot of cases. ... A lot of people just overlook the fact that we are in close contact with people. Schools are overcrowded. You see this in wrestling and other athletics.''

Dr. Pisespong Patamasucon, director of pediatric infectious disease at University Medical Center and the University of Nevada School of Medicine, said the hospital treats at least one patient a week with MRSA. He also said about 60 percent of all skin infections treated at UMC turn out to be MRSA.

"It's here all the time, and it is usually something that is spread within the family,'' he said.

Review-Journal reporter Antonio Planas contributed to this report. Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.