Population-based surveillance for methicillin-resistant Staphylococcus aureus infections among high school football and wrestling participants—Nebraska, 2008–2010

Background: Previous studies in Nebraska established methicillin-resistant Staphylococcus aureus (MRSA) as an emerging cause of infections among high school athletes. Incidence of MRSA infections among football players and wrestlers during 2007–08 was substantially higher compared with 2006–07, and further study was recommended to determine if this represents a rising trend. Methods: To determine statewide incidence of MRSA infection among football and wrestling participants during school years 2008–09 and 2009–10, we developed four Internet-based questionnaires to survey all 312 Nebraska high schools following each sport's respective seasons during both school years. We collected participation numbers and number of athletes with physician-diagnosed MRSA infections to calculate statewide attack rates per 10,000 participants. Results: Of 312 Nebraska schools, 239 (76.6%), 251 (80.4%), 177 (56.7%), and 251 (80.4%) responded to 2008–09 and 2009–10 football, and 2008–09 and 2009–10 wrestling surveys, respectively. Of respondents, 97.5% (233/239) and 98.4% (247/251) had football programs of which 6.4% (15/233) and 3.6% (9/247) reported ³1 MRSA-infected participant, and 78.0% (138/177) and 75.3% (189/251) had wrestling programs of which 7.2% (10/138) and 7.4% (14/189) reported ³1 MRSA-infected participant during 2008–09 and 2009–10, respectively. Incidence per 10,000 football players decreased from 19.0 to 11.5, and incidence per 10,000 wrestlers decreased from 60.8 to 50.0 from 2008–09 to 2009–10. Conclusions: Estimated MRSA infection incidence among Nebraska high school football and wrestling participants decreased substantially during 2009–10 compared with 2008–09 demonstrating that the apparent increasing incidence has not continued.