State and Deschutes County health officials have been investigating an outbreak of skin infections in Bend-area high school wrestlers this month and are working with local coaches to combat the problem.

Several minor staphylococcus aureus infections, commonly known as staph, were reported to health officials around the first of January, said Dr. Paul Cieslak, manager of the communicable disease program for the Oregon Department of Human Services. Five Bend High School wrestlers tested positive for the bacterial infection through skin cultures and a total of 15 tested positive for presence of the bacteria.

All of the wrestlers have been treated with antibiotics, Cieslak said, and are recovering well. He said the strain of staph associated with the Bend cluster caused skin infections known as impetigo and responded well to antibiotics, unlike some strains that can be antibiotic resistant.

”Staph usually lives in the nose. A recent large survey found that 32 percent of people are walking around with staph in their noses,” Cieslak said.

”Most people don’t get an infection because they don’t get a cut in their skin that gets infected with the staph,” Cieslak said.

In contact sports, like wrestling, skin infections can be easily spread through wounds, said Shannon Dames, communicable disease coordinator for Deschutes County.

”Nationally, wrestling is a sport that struggles with skin infections, period,” Dames said. ”Locally, we definitely are not immune to that. We’ve worked with the wrestling teams here to try and limit that as much as possible.”

All of the schools clean their mats with disinfectant solutions regularly and have protocols in place to prevent skin infections. Buck Davis, wrestling coach at Bend High, said his team’s mats are cleaned twice a day, once before practice and once after practice.

Wrestlers go through physical inspections at the time of their weigh-ins and are not allowed to compete if they have suspicious lesions on their skin, Davis said. He declined to comment on recent skin infections.

Ultimately, it’s up to coaches to make sure that wrestlers who have potential skin infections don’t compete, Dames said.

”If a team is having an outbreak that can not be contained, they won’t go” to a tournament, Dames said. ”It’s an understanding that the schools have with one another so they don’t make the other teams susceptible. It’s not something we mandate, but we make strong recommendations.”

Symptoms of impetigo include pimple-like lesions surrounded by red skin. The lesions can appear anywhere on the body but mostly form on the face, arms and legs. Lesions fill with pus, then break open after a few days and form a thick, honey-colored crust, according to the National Institute of Allergy and Infectious Diseases.

”It’s not terribly serious,” Cieslak said. ”It can go on for a long time and cause some pain.”

Impetigo is spread by direct contact with the lesions or contact with the bacteria left on other surfaces. Dames said the wounds sometimes weep, and skin infections can spread through shared towels and equipment.

”What we ask people to do, if we are seeing teams that are having large outbreaks, is to keep all of their wounds covered,” Dames said. ”Fluid from the wounds gets on somebody’s skin and causes the infection.”

Other precautions include using soap from liquid dispensers in showers rather than sharing bar soap, Cieslak said. Those dispensers can be filled with chlorhexidine soap, which kills staph, as an extra precaution.

”Any high school actively involved in wrestling is going to have this problem at one time or another,” Dames said. ”It is so hard to control. We rely a lot on the etiquette of teams to not compete if they’ve got infections.”

Tips for preventing skin infections in contact sports

* Cover all wounds. If a wound cannot be covered adequately, consider excluding players with potentially infectious skin lesions from practice or competitions until the lesions are healed.

* Encourage good hygiene, including showering with soap after all practices and competitions.

* Ensure availability of adequate soap and hot water.

* Discourage sharing of towels and personal items.

* Establish routine cleaning schedules for shared equipment.

* Train athletes and coaches in first aid for wounds and recognition of wounds that are potentially infected.

* Encourage athletes to report skin lesions to coaches and encourage coaches to assess athletes regularly for skin lesions.

SOURCE: The Centers for Disease Control and the National Collegiate Athletic Association