DENNIS ODA / DODA@STARBULLETIN.COM Cory-Alan Hinochi-Ishimine, left, and Mika Galiher wash the wrestling mats with towels soaked in disinfectant every day before practice at Iolani School.

Schools fight
invisible enemy

Sports departments
statewide endeavor to keep
infections safely at bay

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By Helen Altonn
haltonn@starbulletin.com

A quiet battle is being waged in Hawaii school athletic departments against an invisible enemy: microbes.

The spread of bacterial, fungal and other infections is a major concern, particularly in contact sports such as football and wrestling.

Infection control is essential in the locker room and on the field because of increasing problems with resistant organisms, stresses Dr. Alan Tice, infectious disease consultant at the University of Hawaii John A. Burns Medical School.

Tice and other infectious-disease specialists have warned that Hawaii is more vulnerable than many mainland areas because bacteria thrive in water, beaches and a climate that is hot and moist.

DENNIS ODA / DODA@STARBULLETIN.COM Kyle Muraoka, of Iolani, recently held a pair of shoulder pads that are sprayed with disinfectant and dried after every football game.

Staphylococcus aureus, a bacterium that exists in dust, air, sewage, water, milk, food, environmental surfaces, humans and animals, is a potential threat because of resistant strains.

"We haven't had it but it's all over. We could have it," said Dr. Andrew Nichols, University of Hawaii athletics team physician, assistant clinical professor in orthopedics and associate professor of family practice.

He cited as an example the outbreak of about 50 cases of MRSA (methicillin-resistant Staphylococcus aureus) among students in Pasadena, Texas, a suburb of Houston. Officials said the infection may have begun with some kind of team sport.

"The problem is, the standard antibiotics we use for skin infections often don't cover it," Nichols said, explaining intravenous treatments often are necessary.

When a few skin infections occurred earlier this season among UH athletes, he said elaborate measures were taken to make sure locker rooms and showers were clean.

Cultures are taken to identify organisms causing skin infections to make sure none is methicillin-resistant staph, he said.

It is largely a matter of luck that a serious case of staph infection has not occurred in the athletic program, Nichols said. "It really can strike anytime. It's real important to be aware of it so if it does happen, we're ready to treat with appropriate antibiotics."

Ross Oshiro, athletic trainer at Roosevelt High School, said, "We take pretty much the same precautions as UH training." The equipment is wiped down every morning, and if athletes have abrasions or cuts, they are cleaned with antiseptics or other medication, he said.

Roosevelt has not had any infections this year, but they have occurred in the past, he said. "Staph could easily grow in showers and in locker rooms. It's moist. We're all taught basically the same thing, to clean and disinfect everything."

At Iolani School, wrestling mats are cleaned daily before practice with special cleaning fluid mixed with water, said coach Carl Schroers.

The kids must have clean practice clothes every day, and anyone with an infection is not allowed on the mat until determined to be noncontiguous, he said.

Infections could occur in competition if wrestlers from another school are not as careful, he said. "If skin-to-skin contacts spread to one or more of your wrestlers, then you have a problem in the room. A child could be contagious before showing any lesions.

"So it's a desperate problem in that you do the best you can and you can still have infections on your team," Schroers said. "We work hard to minimize them as much as possible -- not so much staph and boils, but fungus attacks like ringworm."

Ringworm is a contagious fungal infection that affects different parts of the body.

Schroers said a herpes virus that can be spread in contact sports also has been reported among athletes on the mainland, but he has not seen it in Hawaii yet.

Stressing the importance of cleanliness, he said even helmets, which "get wet every day with sweat," must be washed and dried to protect the face from infections.

Iolani has a heavily ventilated drying room where football players store head gear and shoulder pads, he said. "A lot of it is just airing it out. In a locker room that's dark and dank, the potential for bacteria to grow is much higher."

Like Nichols, Schroers said it is largely luck that staph infections rarely occur among the young athletes.

In recent years, ringworm has been the biggest worry, he said. "In its classic sense, it's a little red spot in the middle and another reddish rash outside almost like a doughnut.

Schroers does not remember skin infections being a real problem here until late in the 1980s and 1990s when ringworm began appearing, he said.

It is under better control now because dermatologists work with the schools and a dermatologist does skin checks at every weigh-in, he said.

Iolani also has kayaking and canoe paddling and is next to the canal, a bacterial breeding ground, but no problems have been reported with the paddlers, Schroers said.

Outdoor showers were installed for the kids, and "they get a heavy warning from coaches about proper hygiene," he said.

Tice said sores have been reported among other paddlers, and the problem may be related to the water. "Probably it is a combination of paddling and scrapes or scratches."

A lot of staph and herpes outbreaks also occur among wrestlers because of "scrapping, biting and pulling," he said, advising cleaning and immediately treating wounds with topical antibiotics if there is any sign of infection.

"If you use good equipment, that helps. If you use old stuff and don't protect yourself, you're more likely to get sores," he said. Equipment used by someone with an infected sore also should not be used for anyone else, he said.