The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72751

Carmela Mancini, MPH¹, Julia Gill, PhD, MPH¹, and Alan Rowan, DrPH, MPA². (1) Pinellas County Health Department, Florida Department of Health, 205 Dr. M.L. King St. N., St. Petersburg, FL 33701, 727-824-6932, Carmela_Mancini@doh.state.fl.us, (2) Bureau of Epidemiology, Florida Dept of Health, 4052 Bald Cypress Way, A-12, Tallahassee, FL 32399-1720

Background: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) outbreaks are rarely reported in the literature; however, recent investigations suggest that MRSA is an emerging pathogen in the community setting. In 2002 the Pinellas County Health Department investigated increased reports of individuals with purulent skin lesions. Methods: Active case finding was conducted to identify and interview individuals with skin lesions and/or a laboratory confirmed MRSA wound infection, resulting in the identificaiton of 12 cases. Local transitional housing and drug rehabilitation programs, emergency departments (ED), free clinics and the county jail assisted in case identification. In addition, thorough contact tracing was initiated. Results: Epidemiolgic links were confirmed for 10 (83%) of the 12 cases identified. Of the 10 linked cases, the median age was 32 years (range: 18-55), 70% were male and all were white. Seven (70%) cases presented to the ED, four (57%) of which were admitted as hospital in-patients. Three (30%) cases were diagnosed with MRSA-positive wound cultures. All 10 cases were associated with the same Alcoholics Anonymous (AA) meeting, six (60%) with transitional housing programs an four (40%) with a recent history of incarceration. Discussion: Community partners, including transitional housing programs, homeless shelters, drug rehabilitation centers and correctional facilities, should be consulted in MRSA outbreak investigations involving hard-to-reach populations. Collaboration with community organizations may be influential in characterizing the epidemiology of community-acquired MRSA infections and is of great public health importance for controlling future outbreaks.

Learning Objectives:

Learning Objectives: As a result of this presentation, attendees will be able to
• recognize the public health impact of a community-acquired MRSA outbreak,
• describe the investigative approach used by a county health department to identify and interview a difficult-to-reach popuatlion,
• recognize the need for cooperation between the healt department and community partners.

Keywords: Outbreaks,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.