In fall of 2003, an outbreak of Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) occurred in Mecklenburg County involving athletes and non-athletes in the Charlotte-Mecklenburg School System. CA-MRSA is characterized by common skin infections such as abscesses or boils that are infected with a type of “Staph” bacteria that are resistant to some common antibiotics most notably penicillin. Recognition of CA-MRSA as an emerging pathogen in the community setting is critical for implementing prevention and control interventions. The emphasis on prevention and control versus eradication of the MRSA organism is particularly important in the community setting. Due to the prevalence of “Staph” organisms in the environment, high prevalence of skin infections among children, and controversial reporting status, CA-MRSA presents a significant challenge to health professionals and clinicians in identifying cases or outbreaks.

In response to this outbreak the Mecklenburg County Health Department developed an educational video, brochure, and website with a fact sheet to educate athletes, parents, athletic personnel, and the public about proper hygiene procedures used to prevent and control this type of infection. Pre and post tests were administered along with the video to a sample of high school athletes to assess current hygiene knowledge, attitudes, and practices. Pre/Post testing showed:

• 86.4% increase in knowledge and attitude of effectiveness of hand washing,
• 6.4% in showering,
• 240.4% in cleaning shared equipment, and
• 145.4% in reporting suspicious sores to their school nurse or healthcare provider.

The percent increase of knowledge and attitude toward personal hygiene behaviors and MRSA among middle and high school athletes in the Charlotte Mecklenburg School System, Mecklenburg County, NC before and after viewing the information video (n=125).
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Policy change where school administrators now require the use of this video and brochure as a part of all physical education and sports activities has greatly reduced the number of cases identified by school nurses in the athletic and school setting. The Health Department further defined its role in managing non-reportable, emerging community-acquired pathogens by developing and implementing a unique health communication strategy and intervention.

As a result of this effort, the educational video has been distributed to schools, universities, prisons and various other settings in more than 30 states around the country. Recently, the Health Department received its first international order for the MRSA video from a health organization in Toronto, Canada. The video has also been presented at several prestigious national and international conferences and is considered the leading educational tool available for preventing and controlling MRSA in the country.