Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104336

Jose Thier Montero, MD¹, Jody L. Schweitzer, MPH¹, Rachel N. Plotinsky, MD², and Elizabeth A. Talbot, MD¹. (1) Communicable Disease Control, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301, 603-271-0287, jlschweitzer@dhhs.state.nh.us, (2) CDC-Epidemiologic Investigation Officer, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301

Background: Reports of community-acquired methicillin-resistant Staphylococcus aureus (ca-MRSA) infections are increasing, including among members of competitive competitive sports teams. In 2004, an outbreak occurred in a university football team in New Hampshire. We investigated this outbreak to determine risk factors for infection and recommend control measures. Methods: Reported cases were confirmed, available isolates were typed, active case finding was conducted, and a cohort study was performed. The team was surveyed to gather medical history and information regarding risk factors. Case-patients were defined as any football player with culture-confirmed MRSA during August–September 2004. We recommended control measures based on study results, and continued surveillance after the investigation. Results: Seven cases were confirmed among 91 football players (8% attack rate); 100% were male, mean age was 20.6 years, and four (57%) required hospitalization. Isolates had matching pulsed-field gel electrophoresis (PFGE) patterns. Three risk factors for ca-MRSA infection were identified: irritation at a tape site (Risk Ratio [RR]: 5.3; 95% Confidence Interval [CI]: 1.3, 20.7); equipment cleaned once per month (RR: 13.5; 95% CI: 3.9, 46.9); and sharing balms or lubricants (RR: 4.8; 95% CI: 1.2, 19.6). Despite extensive recommendations and education, cases continued to occur. By the end of the five-month outbreak, 24 case-patients had 37 ca-MRSA episodes (26% attack rate). Conclusion: This cohort study disclosed risk factors for acquiring ca-MRSA within a football team setting. The high attack rate despite implementation of public health recommendations underscores the need for improved control measures for ca-MRSA transmission in high-contact environments.

Learning Objectives: At the conclusion of the session, the participant in the session will be able to

• Recognize ca-MRSA in a sports team.
• Assess the population for risk-factors for ca-MRSA disease.
• Apply methods to control a ca-MRSA outbreak in a sports team.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation