Infections – Hard to Avoid?

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Because of media coverage (a common trigger of parental concern) I have been asked, on occasion, about the risk of skin infections to children involved in sports. Primarily–wrestling, football, swimming, dancing, martial arts and gymnastics.  There are two infections covered here –the ones most people have heard of and seem to be worried about.

Athlete’s Foot (Tinea Pedis) This infection/rash is caused by a fungus that thrives in warm, moist environments.   You can get it from direct contact with someone who is infected.  It can be passed from person to person by sharing shoes and socks or by contact with wet/damp surfaces – the shower, steam room, sauna, locker room and pool.  It can also be spread by contact with a surface (ex: mat, towel) used by someone with this infection.  Symptoms of athlete’s foot include peeling and redness of the skin (often between the toes), itching, burning, cracking and/or stinging.  To prevent getting athlete’s foot at a pool or gym the mats should be wiped down with a cleaner (>60% alcohol content, or 1:10 bleach dilution) before use, flip flops or water shoes should be worn in the showers and on wet/damp surfaces and feet should be completely dry before clean cotton socks are worn.  Athlete’s foot is usually easily treated with over the counter creams and powders (ex: clotrimazole, terbinafine, miconazole, tolnaftate, etc.) and usually resolves within 7-10 days of treatment.

Staphylococcus/MRSA infections This is the infection that seems to worry parents the most.  It is important to know that Staphylococcus lives in the noses of up to 30% of the general population without causing illness.  One percent of the population has the more worrisome Staph- MRSA – in their noses – yet it also can live there without causing any symptoms at all.  Staph, like Tinea, thrives in warm, moist environments. The reason staph is making headlines is because of the one variety that is resistant to most standard antibiotics and so is potentially dangerous and difficult to treat.  This is known as MRSA – Methicillin Resistant Staphylococcus Aureus.  The chance of getting MRSA from a mat or towel at the gym is very unlikely.  Yet it can live on dry surfaces for long periods of time. There are a few things you can do to lower your child’s risk of infection:

  1. 1. Make sure that the mats are wiped down with a cleaner (>60% alcohol content or 1:10 bleach dilution are best).
  2. 2. Cover any scrapes or open sores on his/her body with a bandage. If your child is engaged in a sport that involves skin-to-skin contact, it is especially important to keep any scrapes, sores or wounds covered.
  3. 3. Your child can use a clean towel as a barrier between the mat and his/her body.
  4. 4. Do not use a sauna, hot tub, or steam room with open wounds.
  5. 5. If you notice a pimply rash or an open sore on your child’s skin apply a triple antibiotic ointment (ex: Neosporin) three times a day until it has healed.

Symptoms of MRSA are, initially, similar to any skin infection – small bumps, redness, pimples.  It’s also possible for the infected area to look like an insect bite.  If the rash does not look harmless or if you notice any of the following you should call/see a doctor immediately:

  1. 1. The rash has pus/drainage.
  2. 2. The rash progresses to boils or abscesses.
  3. 3. The rash does not heal within a few days.
  4. 4. The site becomes very red and/or tender.
  5. 5. There are red streaks coming out from the area of the initial rash.
  6. 6. There are symptoms of a body wide infection—fever, chills, nausea or shortness of breath.

As with most childhood ailments prevention is key. Washing hands regularly with soap and water or hand sanitizer, wearing shoes on wet floors, cleaning mats with an appropriate cleaner before using, and keeping scrapes and sores covered will almost always prevent both Tinea and Staph infections.

If your child does have symptoms of Tinea or Staph then follow the directions above to treat.  If your child has signs of MRSA contact your Pediatrician.  And, as a courtesy to other children and families, keep your child out of the gym, locker rooms, fields and pool, and off of the mats until the infection has resolved.

-Monique Araya, MD, FAAP

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