Safety First: Deadly Opponent

MRSA can be your team’s most dangerous adversary unless you take steps to prevent it.

In the last decade, a new and threatening disease has emerged in football programs everywhere – MRSA. What is MRSA, why are football settings especially vulnerable, and what can you do to minimize the threat to your athletes?

MRSA stands for methicillin-resistant Staphylococcus aureus, a strain of staph bacteria that does not respond to conventional antibiotics. The infection usually first appears as a rash, a pimple or boil on the skin that can be swollen and painful. If not detected and properly treated, it can rapidly expand in size, lead to serious complications such as pneumonia and even spread throughout the bloodstream with tragic results.

While MRSA had been known to primarily afflict patients in hospitals and nursing homes as long ago as the 1970’s, health professionals have seen an alarming rise recently in cases in the community, especially among athletes in contact sports such as football and wrestling. In the last several years, outbreaks of MRSA have been documented on NFL teams, universities and high schools nationwide. Just this past season, three players from the Tampa Bay Buccaneers were stricken with the infection. Reported incidents in high schools are too numerous to list.

In athletic settings, the infection is most commonly spread through contact with an open wound or skin abrasion which provides the opportunity for the bacteria to enter the bloodstream. MRSA can spread by direct person-to-person contact or by contact with contaminated items or surfaces such as shared towels, protective equipment, whirlpools or even bars of soap. So it’s no surprise that football players, with their high degree of player-to-player contact, frequent cuts and abrasions, and sometimes poor hygienic conditions in the locker room are prime candidates to get infected with the MRSA ‘superbug.’

The irony is that staph had for years been associated with sick or elderly patients and had seldom been seen in young, healthy individuals. Football players in peak condition are the last ones most people would think of as susceptible to diseases. And the “play with pain” philosophy or “it’s only a rash” attitude might have prevented some early diagnoses in the past. MRSA has changed that perception, and wake-up calls have been issued at all levels of the game

As frightening and potentially deadly as MRSA is, there are simple but important precautions that coaches, players, equipment managers and trainers can take to reduce, if not eliminate, the threat posed by this invisible scourge. Locker rooms can be breeding grounds for bacteria, fungi, mold and mildew so it’s critical that proper hygiene practices are enforced. Not sharing personal items or gear, regularly cleaning and sanitizing equipment and uniforms and making sure players shower following practice are important first steps in the battle against MRSA.

Wound care is just as critical, since open cuts and abrasions are the bacteria’s entry point into the bloodstream. Players need to know that every open wound, no matter how minor, needs to be cleaned and bandaged immediately. Equally important is keeping alert to any skin rashes and especially pimples or boils that may be first indications of infection. If diagnosed early, MRSA infections can be effectively treated. But if ignored, the consequences can be deadly.

One Case Leads to Many

If a case of MRSA strikes one of your players, it’s very likely that other players will be infected even if you take aggressive measures to stop it from spreading. In 2005 at Austin Peay University, after a first case was identified on September 1, strict rules prohibiting sharing towels and razors were imposed as were strict standards of washing and personal hygiene. All players were monitored and all wounds were carefully treated. Antimicrobial additives were used in the laundry. Equipment, training room tables and whirlpools were sanitized regularly and the weight room was disinfected. Despite these measures, nearly 10% of all football players were infected by MRSA over the next two months.

According to the National Athletic Trainers’ Association, good hygiene and avoiding contact with discharge from skin lesions are the best methods of prevention. NATA’s official statement recommends the following precautions be taken:

1. Keep hands clean by washing thoroughly with soap and warm water or using an alcohol-based hand sanitizer routinely.

2. Encourage immediate showering following activity.

3. Avoid whirlpools or common tubs. Individuals with open wounds, scrapes or scratches can easily infect others in this environment.

4. Avoid sharing towels, razors, and daily athletic gear.

5. Properly wash athletic gear and towels after each use.

6. Maintain clean facilities and equipment.

7. Inform or refer to appropriate health care personnel for all active skin lesions and lesions that do not respond to initial therapy.

8. Administer or seek proper first aid.

9. Encourage health care personnel to seek bacterial cultures to establish a diagnosis.

10. Care and cover skin lesions appropriately before participation.

To achieve additional protection for your athletes, consider using products designed to provide extra degrees of bacteria-inhibiting protection to surfaces and equipment between washings and disinfecting. Such “antimicrobial” products, usually available in spray form to apply directly to equipment or liquid that can be added to laundry or cleaning solutions, are designed to protect treated articles such as shoulder pads, helmets, uniforms or strength and conditioning equipment while they are being used.

Above all, be aware. MRSA is a growing threat to football players. Understand and practice the precautions. Share this article with your players and everyone involved with your program. Minimize your risk. And don’t let this opponent ruin your season.

For further information about MRSA, go to the National Athletic Trainers’ Association at www.NATA.org


Ed Fisher has been the executive director of NAERA since 2005. From 1997-2004 he was a high school administrator at North Central High School in Spokane (WA). Fisher was previously the head football coach at South Kitsap High School in Port Orchard (WA) from 1974-1996. He also coached at Klamath Union High School (OR) and was a graduate assistant at the University of Hawaii.