Community Acquired Methicillin Resistant
Staphylococcus Aureus on the Rise
Siskiyou County Residents have been recognizing the need for medical
care for questionable staphylococcus infections. Despite community
awareness and medical treatment, community associated methicillin
resistant staph aureus (CA-MRSA) cases have increased. These infections
often appear like a bug bite or minor skin infections, such as a pimple
or boil. It also may begin as a cut that is swollen, or a blister filled
with fluid, later becoming crusty. Skin infections are the most common.
Although staph bacteria are common on skin and in the nose, the common
strain does not usually cause a serious infection. When a bacterium
becomes resistant to antibiotics, it is difficult to treat and can
spread to other people through skin-to skin contact. MRSA, first
identified in the 1960’s was mainly found in hospitals and nursing
homes. About ten years ago community acquired MRSA became more common.
This new type of MRSA is continuing to spread, especially among children
and adults who do not have medical problems. Although it is not a
reportable disease, Siskiyou County Public Health is monitoring the
status through physician reports. We are concerned that primary
prevention is needed.
Factors that have been associated with the spread of MRSA skin
infections include: close skin-to-skin contact, openings in the skin
such as cuts or abrasions, contaminated items and surfaces, crowded
living conditions, and poor hygiene. There are two ways you can have
MRSA. You can have an active infection or you can be a carrier. Health
Officer, Dr. David Herfindahl has informed schools, preschools, child
care providers, fitness clubs and karate clubs that persons infected
with MRSA can spread the disease to others with skin to skin and
indirect contact. Primary prevention begins by recommending that
individuals with skin rashes or open wounds cover the lesion with
clothing or a bandage when in contact with others. Persons with active
MRSA infections should not participate in contact sports until sores
have healed. It is recommended that persons with active MRSA do not
attend a public gym, sauna, hot tub or pool until sores have healed.
Manicures, massages and hair cuts should be postponed until MRSA sores
Equipment, personal items, clothing, toys, towels, bedding, telephone,
door knobs, or any surface that has been in contact with the bacteria
can be a source of transmission for up to a week. It is important to
clean them often and completely. In households and in public places
where MRSA staph is suspect, Public Health recommends the following
cleaning procedures to help prevent the transmission:
Use a disinfectant to regularly (daily) clean surfaces. Pay attention to
items that are frequently touched, such as equipment surfaces, benches
and chairs, doorknobs, toilets, sinks, counters, etc. Hand washing and
preventing others from coming into contact with your infection are the
best way to reduce spread to others. Households should be cautious not
to share towels, toothbrushes, razors, or other personal items. Wipe the
surface or object with an appropriate disinfectant and let it dry. We
recommend that you:
Put on disposable gloves,
Wipe up any fluids with a paper towel,
Throw the paper towel in the trash,
Clean the surface thoroughly using a disinfectant and a paper towel,
Throw the paper towel in the trash,
Wipe the surface again with the disinfectant and let it dry for at
least 30 seconds,
Throw the paper towel in the trash,
Remove your gloves and throw them in the trash, and finally
Wash your hands or use an alcohol-based hand sanitizer.
Persons suspecting antibiotic resistant staph should contact their
medical provider. Following a diagnosis, it’s critical to take
antibiotics as prescribed. Do not share antibiotics with others; this
can increase development of antibiotic resistant staph. If symptoms of
active skin infection continue after treatment, patients must contact
their medical provider to be re-evaluated. A second course of
antibiotics and or an antibacterial nasal spray may be recommended.
After the infection is healed you may still be a MRSA carrier. Notify
all future medical providers that you may be a MRSA carrier. Medical
providers sometimes refer to the carrier status as being colonized; this
means you still have MRSA bacteria on your skin and in your nose. You
may not get sick or have any more skin infections, but you can spread
MRSA to others.
MRSA is a serious infection that can become life-threatening if left
untreated. If you or someone in your family has been diagnosed with
MRSA, there are steps you need to take now to avoid spreading it to your
family and friends. MRSA carriers need to make adjustments in their
lifestyle to reduce these chances. The brochure, “Living with MRSA” can
be downloaded here:
The summer recreation season is upon us. County residents and visitors
are visiting our local waterways to enjoy camping, boating, kayaking,
and river rafting activities.
The Siskiyou County Public Health Department reminds residents and
visitors that Irongate Reservoir, Copco Lake and Lake Shastina are known
to have seasonal blooms of blue-green algae (cyanobacteria). Irongate
Reservoir and Copco Lake are currently experiencing a bloom. Blooms
typically occur between June and October when temperatures rise and
water conditions are favorable for algal growth.
Samples from Irongate Reservoir and Copco Lake taken in late July
indicate high algae cell counts and visible algal scums along the
shoreline. Sampling from previous years indicates that these algae are
capable of releasing toxins that are potentially harmful to human
health. Related to those blooms, Siskiyou County provided brochures at
the affected waterbodies and provided public service announcements about
potential health concerns.
Blue-green algal blooms are common phenomena that occur world wide. The
State of California has embarked upon a process to evaluate the
potential health risks associated with blue-green algal toxins,
determine appropriate water sampling and monitoring procedures, identify
strategies to control toxic blooms, and to better inform the public
about health and environmental concerns. Siskiyou County is an active
participant in this statewide effort and will continue to keep abreast
of information and issues concerning toxic blue-green algal blooms.
While there have been no documented cases of human illness associated
with blue-green algae in California, studies around the world show that
recreational exposures to toxic blue-green algae might result in eye
irritation, allergic skin rash, mouth ulcers, vomiting and diarrhea, and
hay-fever like symptoms. There is little information available about the
potential human health effects of long-term exposure to blue-green
The presence of blue-green algae in a water body does not necessarily
mean toxins are always present. However, identifying the presence of
toxins is an expensive and difficult process and one that may involve
many days to weeks before results are available. Therefore, it is
prudent for recreational users to adhere to the following precautions
with regard to blue-green algae blooms in Siskiyou County waterbodies:
Avoid wading and swimming in water containing visible blooms or water
containing algal scums or mats.
Carefully watch children to ensure that their exposure and accidental
water ingestion is minimized. Because of their small body size and
weight, children who ingest a small amount of water can receive a higher
relative exposure to toxic substances than adults who ingest the same
Do not drink, cook or wash dishes with untreated surface water under any
circumstances. In addition to blue green algal toxin concerns, open
surface waters can contain harmful bacteria and parasites.
If you accidentally swallow water from a bloom and experience one or
more of the following symptoms you should contact your physician and the
Public Health Department.
Fish caught in these reservoirs may be consumed after removing guts and
liver, and rinsing filets in tap water.
In addition, residents and visitors are reminded that domestic animals
and livestock can be affected by blue-green algal blooms. There are
documented animal poisonings and deaths associated with exposure and
consumption of algal toxins. Special care should be taken to ensure that
animals do not drink the water or swim through heavy scums or mats.
Consumption of algal toxins occurs when animals lick their fur after
wading/swimming in blue-green algal blooms.
The public may contact the Siskiyou County Public Health Department for
additional information by calling (530) 841-2100. For information about
the State of California’s activities related to blue-green algae blooms,
visit these web sites:
Department of Health Services: http://www.dhs.ca.gov/bga
Siskiyou County Public Health Officer, Stephen Perlman, M.D. advises
residents throughout Siskiyou County to be aware that air quality may be
extremely poor in many areas due to severe smoke. Residents with lung or
heart disease, and the elderly are advised to leave areas where levels
of particulate matter are high. The attached index will assist in
assessing the air quality based on the visibility in your area. To
Face away from the sun. Determine visibility range by looking for
targets that are at known distances (miles).
The visible range is the point where even high-contrast objects
After determining visibility in miles use the attached Wildfire Smoke
Visibility Index to assess air quality
Wildfire Smoke Visibility Index
Visibility in Miles
10 and up
6 to 9
Possibility of aggravation of
heat or respiratory disease
People with heart or lung
disease should pay attention to symptoms.
Unhealthy for Sensitive Groups
3 to 5
Increasing likelihood of
repiratory symptoms & aggravation of lung disease, such as asthma.
The elderly, children, and those
with respiratory or heart disease should limit prolonged exerition and
1 1/2 to 2 1/2
Increased respiratory symptoms
and aggravation of lung and heart diseases; possible respiratory effects
to general population
The elderly, children, and those
with respiratory or heart disease should avoid prolonged exertion and
stay indoors when possible; everyone else should limit prolonged
1 to 1 1/4
Significant increase in
respiratory symptoms and aggravation of lung and heart diseases;
increasing liklihood of respiratory effects in general population
the elderly, children, and those
with repiratory or heart disease should avoid any outdoor activity;
everyone else should avoid any outdoor exertion.
3/4 or less
Serious aggravation of heart or
lung disease and premature mortality in persons with cardiopulmonary
disease and the elderly; serious risk of respiratory effects in general
Everyone should avoid any indoor
and outdoor exertion; everyone should remain indoors whenever possible.
The official news release is available for download as a
distributable Microsoft Word document:
July 27, 2006
Stay Cool in Extreme Heat
Siskiyou County temperatures have slightly cooled this week and there
have been no reports of residents needing hospitalization related to the
heat wave. In the state of California however, Stanislaus and other
counties with record breaking temperatures have experienced some heat
related deaths. The California Health Alert Network has released an
extreme heat alert for the state.
Dr. David Herfindahl, Siskiyou County Public Health Officer, encourages
Siskiyou County residents to use common sense and watch out for family,
friends, and neighbors who may be at risk for heat exhaustion, heat
stroke, heat cramps, sunburn or heat rash. The following tips may help
you stay cool:
To sustain normal body temp of 98.6 F use fans, air conditioners
and/or frequent baths and showers.
Stay hydrated by drinking plenty of water. Avoid caffeinated and
alcoholic beverages. Sports drinks replenish salt and minerals, and are
recommended after exertion. People who have epilepsy, heart, kidney or
liver disease, may be on fluid-restricted diets and should consult a
doctor before increasing liquid intake.
Eat light, cool and easy to digest foods that support the body’s
When outside, protect face and head by wearing a wide-brimmed hat and
dress in loose-fitting, lightweight, and light –colored clothes that
cover as much skin as possible.
Avoid strenuous work during the warmest part of the day. Use a buddy
system when working in extreme heat, and take frequent breaks.
Never leave children or pets in closed vehicles.
Stay indoors as much as possible and limit exposure to the sun.
In addition to preventing heat related illness, early detection and
treatment is important. Those most prone to heat related illness are
people with high blood pressure, chronic illness, the elderly, homebound
people, and children under the age of 5 years. Onset of symptoms may be
hours to several days after exposure to high temperatures and inadequate
fluid replacement. The first sign could be confusion or acting strange
accompanying high body temperature (103 degrees or above). Additional
symptoms include: red, hot and dry skin, rapid, strong pulse, throbbing
headache, dizziness, and nausea.
In the case of heat related illness the first step is to reduce body
Begin by taking the person to a shady area.
Cool them rapidly with water or by whatever method is available. For
example immerse in cool water; place the person in a cool shower, spray
the person with cool water from a hose, sponge the person with cool
water. Continue to cool them with a fan while keeping them wet.
Monitor body temperature and continue cooling efforts until the body
Promote rehydration with electrolyte rich fluids like sports drinks,
Seek medical assistance as soon as possible.
For more information visit the following web sites:
Avian flu, also known as bird flu, is a respiratory disease that can
infect humans and birds. Avian flu is very contagious among birds and if
transmitted to humans can be deadly.
Outbreaks of avian flu are currently present in many Asian counties and
Russia. Because these viruses do not commonly infect humans, there is
little or no immune protection against them in humans. If the avian flu
virus changes to more easily infect humans and becomes easily spread
person to person, “influenza pandemic” (worldwide outbreak of disease)
could begin. At present, there is no vaccine available to protect
against avian flu.
Siskiyou County Public Health has developed an Influenza Pandemic
Response Plan which would be used to guide our response efforts should
the need arise.
The Health Department continues to encourage everyone to practice good
respiratory hygiene measures for any colds or flu like illness:
Wash your hands frequently
Cover your cough or sneeze
If you are sick, stay home from work or school
For current information and travel advisories related to avian flu visit
the Centers for Disease Control and Prevention website: