The death of a 12-year-old boy in New York City this week led doctors and public health officials to again sound the alarm about a supervirulent and highly resistant strain of staph infection that is killing children across the country and is responsible for more deaths nationwide than AIDS.
Omar Rivera, a seventh-grader from Brooklyn, became the latest casualty of methicillin-resistant Staphylococcus aureus, or MRSA, a strain of drug-resistant bacteria traditionally found in hospitals and nursing homes but increasingly being found in schools and day care centers.
"In general, 3 percent of the population is carrying MRSA without even knowing it," said Betsy McCaughy, chairman of the Committee to Reduce Infection Deaths.
The Centers for Disease Control and Prevention estimates that 18,000 people died from the "superbug" in 2005, and health professionals estimate 94,000 people become infected every year.
"MRSA is transmitted through the skin and can live on inanimate objects for 90 days," McCaughy said. "In schools it is most often found in gym facilities and on keyboards."
McCaughy said school administrators, teachers and parents each have a role to play in reducing the number of MRSA infections in children.
Parents, she said, should send their children to school with a container of alcohol-based hand sanitizer and warn students of sharing gym shorts, bars of soap, towels and other personal items.
Schools, she said, should test surfaces like gym equipment and provide hand sanitizer in classrooms so students wouldn't have to regularly ask permission to go to the bathroom to wash their hands.
Though most MRSA child infections have been been linked to school locker rooms, Dr. Jaime Fergie, an infectious disease specialist at the Driscoll Children's Hospital in Corpus Christi, Texas, said "the problem is not in schools only. Every child, from babies to adolescents, is at risk."
The symptoms of MRSA resemble the flu and are often accompanied by a boil-like pustule.
"Many children come in with severe pneumonia, the infection already in their blood and bones. They can very often stay in the intensive care unit for four weeks," he said.
"If you think you have a spider bite, unless you saw the spider, it is important you get to a doctor and have a culture. The sooner you treat it, the better," he said.
Due to the infection's common symptoms, many children go undiagnosed for days.
Hunter Spence, a 12-year-old from the small Texas town of Victoria, left school early on a Monday in May, complaining of a cramp in her leg and running a low-grade fever. By Friday, after having visited two emergency rooms during the week and being diagnosed with the flu, she ended up in the intensive care unit.
In the first of five weeks in intensive care, she had seven surgeries in eight days, said her mother, Peyton Spence.
"When we got her to the last hospital she had a temperature of 107, was in septic shock and was dangerously close to cardiac arrest," Spence said.
Spence said Hunter never presented with the tell-tale boil and warned parents to press their children's doctors to run tests for MRSA.
Hunter is still recovering, but "her lungs are pretty damaged. If she is running and jumping she gets very winded and it's hard for her to get her breathing back on rhythm. We hope over time her lung capacity comes back and she won't need another surgery," said Spence.
"There is a lot of focus on athletes and locker rooms, but that's a misconception. My daughter did normal preteen things, but she wasn't in a locker room sweating."
Since Hunter's recovery, Spence said, members of her community have not responded as quickly as she would have expected. Despite trying to lead an effort to sterilize the school's cafeteria and gymnasium, parents and administrators have been slow to action.