Going to kindergarten or school with MRSA?

Question

Hello,

My son (CF) is 25 months old now and has been MRSA positive again and again since he was 3 months old.

There have been several eradication attempts, various iv therapies, antibiotics inhalation, and continuous oral therapy with co-trimoxazole. He is then negative for a few months and suddenly positive again.

All relatives have been tested, and all are negative. There are no pets. Our house was also tested – negative.

We are absolutely at our wit's end.

Next year, kindergarten is coming up and I would love to send my son there. We would also badly need the money if I could work more then.

He would be going to a regular kindergarten, not to an integrative one. I do not think that is necessary.

What about MRSA? Could it be that I will have to isolate my child forever? We are currently attending a playgroup and a music group. Would I have to indicate it there? Do I have to indicate it at kindergarten at all? What if I don't?

I just don't know what to do anymore.

Answer

[Translator’s note: this answer contains information predominantly valid for Germany only.]

Dear questioner,

Please note that this answer cannot and will not substitute a legal consultation for your individual case.

Generally, the obligation to report evidence of pathogenic germs is regulated in §7 of the German Infection Protection Act (IfSG). According to that, MRSA colonization would only have to be reported if the temporal and local frequency of occurrence of the evidence point to a serious danger for the general public.

However, with the regulation of May 26, 2009 to adjust the labs' reporting obligation, this obligation was extended to the evidence of MRSA in the blood and liquor. If MRSA is only evident in your child’s mouth and throat area, there would not be any obligation to report it.

Whether you should report it nevertheless in my opinion is not based on legal requirements. The risk your son poses for healthy children will probably not be higher as anywhere else in the outside world, so that a possible hysteria or marginalization should not be risked without reason.

Unfortunately I cannot provide any more binding information, since the local health authorities are in charge of the monitoring and execution of the IfSG. There you can get reliable information on how to deal with your son's MRSA colonization.

Concerning the problem of MRSA restoration, perhaps the MRSA-net project can provide useful information (www.mrsa-net.org).


I hope I could help you.

Kind regards
Annabell Karatzas, Mukoviszidose e.V. (German CF patient organization), in consultation with Dr. H.-G. Posselt

15.01.2013