Schools seek hygiene rules for sports

HIGH SCHOOL wrestlers on Long Island and around the state might be at risk for illnesses because there are no regulations governing the hygiene of participants or the cleanliness of mats from which germs can spread.

Despite general guidelines, some schools do not properly sanitize mats, lack functioning shower facilities and have potentially dangerous sanitary protocols, coaches and school administrators said. That can lead to the spread of debilitating and even life-threatening bacterial infections such as methicillin-resistant Staphylococcus aureas, known as MRSA.

MRSA and other skin infections are common among athletes who have extensive skin-to-skin contact, including football players, rugby players and wrestlers.

Echoing almost a dozen coaches and administrators interviewed by Newsday, East Islip wrestling coach Guy Leggio said: "I believe the whole state should have a hand in this issue because we're seeing herpes and ringworm and impetigo. . . . It's a nationwide issue and we really need to tackle this problem."

Serious LI case

This month, Hauppauge High School wrestler Nick Mauriello Jr. was left fighting for his life after contracting MRSA and Lemierre's syndrome, an inflammation of the blood vessels.

No one has determined how he contracted the infection. Still, Mauriello, a junior who is now home and out of danger, had competed in 16 wrestling matches in the span of eight days in four locations.

The frightening case has spurred discussion about regulations, and a local wrestling official said it might spur reform.

"Unfortunately, could be something we can use as more of an answer," said Vinny Paolano, president of the Long Island Wrestling Officials Association. "The rules haven't been updated enough, and that's what we have to go to work on now."

Lack of regulation

Brentwood wrestling coach Ralph Napolitano, for one, said the lack of rules is a problem. Napolitano said he set and follows his school's protocol to help prevent the spread of infectious diseases.

"The first order of business is diligence," Napolitano said. "Every week we change the mop head, buy six canisters of Lysol wipes, wipe down the wrestling room walls, wipe down headgear, kneepads. But you can do everything right and something as tragic as this can still happen."

Even the bus drivers who bring athletes to the site have to take precautions in Brentwood. Before permitting a driver in the gymnasium recently, Napolitano made him dip his shoes in the disinfectant bucket outside the door and wipe them off on a piece of carpet.

Not even that, though, is an across-the-board requirement.

Spokesmen for the Suffolk, Nassau and state departments of health said additional requirements would have to come from the state Department of Education. The agency offers "comprehensive guidance to prevent the spread of MRSA in schools," but regulation would require an act by the state Legislature, said Education Department spokesman Jonathan Burman.

Suffolk public school athletics executive director Ed Cinelli said county coaches must attend meetings and seminars about mat cleanliness but added that regulations are "up to the schools." The situation is the same in Nassau County, said Rich Schaub, chairman of the Nassau athletics safety committee. There is no punishment for schools that don't adhere to the suggestions.

Assemb. Steven Englebright (D-Setauket), chairman of the committee on tourism, parks, arts and sports development, said he would favor legislation setting standards for mat cleanliness, but only if the impetus came from coaches.

"They're the first individuals you'd turn to for advice," he said. "They have the best interests of the athletes at heart."

Hard to track infection

Most state laws focus on preventing the spread of MRSA in hospitals, where it is most common, though Delaware requires each instance of MRSA in schools to be reported to its state department of health. In New York, only "clusters" - two or more instances of MRSA with a possible mutual infection source - must be reported, said Peter Constantakes, a spokesman for the state Department of Health.

That is a major obstacle in tracking numbers on infections such as MRSA. In its most recent study on the issue, the Centers for Disease Control and Prevention reported 94,360 instances of invasive MRSA infection in 2005 in the United States; 18,650 were fatal.

Dozens of Long Island school-related MRSA cases were reported from 2007 through 2009.

For Mauriello, it began with muscle spasms and limited mobility in his neck and arms, and trouble breathing. X-rays showed he had water in his lungs.

It took a team of doctors to figure out that the 16-year-old boy in peak physical condition had MRSA. It spread to the bloodstream and brought on Lemierre's syndrome, the rare inflammation that left a septic clot in Mauriello's jugular and threatened his life. Mauriello was placed in intensive care and was sedated for four days.

Rahul Panesar, one of the doctors treating Mauriello, said any attempt to pinpoint the exact location where Mauriello contracted the bacterial infection would be "irresponsible."

Mauriello now is on the mend. He hopes to get back to wrestling and qualify for the state championships next season.

Showers called key

Hauppauge wrestling coach Chris Messina wants to see change. "There have been orders to check showers, urinals, make sure things are washed. . . . You can't throw stones, but everyone needs to be on the same page," he said. "Let's make sure the showers work. Let's make sure the kids take showers."

At some meets, he said, "there's one shower with no hot water. Sometimes there are no showers. Enough is enough."

Still, even with adequate facilities, it is difficult to enforce showering, administrators said.

"Our wrestlers know it's protocol to shower. We encourage them to shower at school, but we all know that kids are kids and sometimes they want to run out [of practice]," said Hauppauge school Superintendent Patricia Sullivan-Kriss.

The state education "Manual of Planning Standards for Educational Facilities" dictates that all secondary schools with physical education programs must have showers, but the number of shower heads is up to the individual district, as is making sure the showers work.

"The most stringent rule or regulation we should enforce is regarding accessibility to adequate showering facilities," said Dr. Anthony Donatelli, an East Patchogue physician who cares for many Long Island wrestlers during the season. He was on site during the state championships in Albany last weekend.

"If these can't be provided by the host school, I believe the school shouldn't host the event."

Who's at risk

Skin infections such as MRSA, impetigo and ringworm are common among athletes who have skin-to-skin contact. However, anyone living in close quarters or sharing equipment where the MRSA bacteria lives could be at risk.

• Preventing infections: Hand-washing, showering after sports and wearing clean, dry clothes can help prevent the spread of MRSA and other infections. Cleaning and disinfecting athletic equipment and properly covering breaks in the skin are recommended.

• MRSA: Methicillin-resistant Staphylococcus aureus is a type of staph bacteria that is resistant to common antibiotics. Once contained to hospitals and health-care settings, the bacteria is now found in schools, gyms, day care centers and jails. Most MRSA infections are on the skin and are treatable, but they can be life-threatening when the bacteria enters the bloodstream. Skin infections begin as a pimple, boil or something that resembles a large, red spider bite. Infections commonly occur at breaks in the skin.

• Impetigo: A contagious skin infection caused by one of two bacteria: Staphylococcus aureus or group A streptococcus. It usually produces sores or blisters on exposed areas. The infection is spread by direct contact with lesions; scratching may spread them.

• Ringworm: A contagious fungal infection passed by direct contact. Ringworm thrives in moist areas and can be transmitted through contaminated personal items (clothing, combs), shower surfaces or pets. Symptoms include itchy scaly patches that may blister and ooze, crumbling toe and finger nails or bald spots.

Compiled by Candice Ferrette.

Sources: Mayo Clinic, New York State Health Department, U.S. Centers for Disease Control and Prevention, and Annals of Emergency Medicine.