"If you get in early, and I mean within a couple of days of thinking you have a 'spider bite,' things go just fine," he explains. "You start on antibiotics and everything goes well. But, all you have to do is add a health impairment that compromises your immune system or neglect the wound, and some pretty lousy stuff can happen."It pays to be smart
Because of the risks for severe infection and law enforcement's frequent contact with the bug, Tiffen says he believes authorities must consider implementing more stringent controls, using resistant and easily decontaminated materials, and establishing comprehensive training and education programs.
This is a far cry from what the retired police major recalls from his own days on the street. When Tiffen entered policing three decades ago, he says law enforcement officials didn't pay any mind to contaminants or blood-borne pathogens; awareness began to build in the final years of his career as concerns over AIDS and Hepatitis mounted. Departments at that time began placing more emphasis on gloving up and decontaminating patrol vehicles. But in today's environment he says this is no longer enough.
Effective standard operating procedures (SOPs), universal precautions (infection control techniques recommended following the AIDS outbreaks in the 1980s), and other protocols are quickly rendered ineffective when officers lack proper training and education, stresses Sgt. Eric Wilson of the Harrison County Sheriff's Office, located in Cadiz, Ohio. "For the protection of our officers, their families and the community, we need to educate our ranks to protect themselves and to fully understand how these diseases are transmitted," he states.
Wilson's rural county agency recently hosted a MRSA informational session for officers and the public. The hour-long program, presented by Bob Brems, an epidemiologist with MPH Zanesville/Muskingum County Health Department, defined MRSA, showed images of infections, and covered the bacteria's transmission and treatment. The discussion also centered on specific risks police officers face and the precautions they must take.
Effective educational campaigns include the entire community, emphasizes Parks, who notes Fresno public safety officials first developed comprehensive MRSA training to convince Fresno city officials that MRSA infections ought to be covered by worker's compensation. "We needed to explain that public safety officials must respond immediately, and that we can't dictate the emergency, the emergency dictates our actions," he says. "There isn't always time to 'glove up,' and we may not have all the information about whether the situation is safe or unsafe in advance."
Since then the associations' educational efforts have expanded. The associations' train board members to provide MRSA education to all city employees and the community at large. "We teach officers that whenever they are in contact with a subject or victim, they should wash their hands and inspect their skin for unusual bumps afterward," Parks says. "If city workers notice any unusual skin conditions, we start the protocol and get them tested for MRSA."
The city's protocal follows steps designed to eliminate concerns over reporting infections. "It's a tough thing to talk about. People don't say in general conversation that they have a bump or a rash," Parks explains. "They fear if they report it to their department, they'll be in violation of a 'fit for duty' requirement and lose their jobs."
Fresno assuaged this apprehension by developing a confidential reporting system that all city employees are well versed in. In the past, officers hesitated to have a rash inspected — especially if they needed to burn a sick day to do so. Now, Fresno public safety workers can see a doctor for such concerns on the city's time and dime.
Under the current protocol, an officer first expresses MRSA concerns to risk management officials within the police association. These administrators gather information on how the worker believes he was infected, how long he's been sick, and the symptoms he's had. Doctors culture the employee's wound and send the affected person home until the results are known. If it's not identified as MRSA, the employee returns to work immediately. If it is, doctors treat the individual with antibiotics and worker's compensation covers the patient's medical care and pay.