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NEW SCHOOL SPORTS FORM

Please be aware that there is a new New Jersey school sports form. All students playing high school sports and middle school intramural sports will be required to use this form as of January 1, 2008. The form includes a comprehensive medical history section, which must be filled out by the parent and student prior to bringing the form here. The physician is required to sign that they have reviewed the history. Therefore we can not complete forms that do not have this history completed. We will do our best to complete these forms in a timely fashion. Please keep this in mind as the busy sports physical season approaches. Due to the increased physician time and liability, the charge for form completion will be $25.

If you do not receive this form from the school, you may download it, print it and bring it in to our office, with your part completed. If you wish to do this, follow this link (from here or from our website):

New School Sports Form

UPDATED NEW JERSEY IMMUNIZATION REGULATIONS

New Jersey has some new immunization regulations which you should be aware of.

The administrative rules will require children attending licensed child care centers and preschools to receive annual influenza vaccinations and a pneumoccocal vaccine beginning in September 2008.

Also, children born after January 1, 1997 and enrolled in grade six or transferring into a New Jersey school from another state or country will be required to receive a booster dose of the diphtheria, tetanus and pertussis vaccine (Tdap) as well as one dose of meningococcal vaccine.

MRSA (METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS)

Staphylococcus aureus (Staph) is a bacteria that is normally on the skin and in the noses of healthy people. When the bacteria get underneath the skin, it can cause an infection. Most commonly it just causes a boil or abscess. Occasionally the bacteria can cause an invasive infection, such as pneumonia or a blood stream infection, which is more serious.

Community-Acquired Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) is a type of staph that is resistant to treatment with certain antibiotics, such as methicillin, amoxicillin and cephalosporins. This has occurred because of the overuse of antibiotics. It can still be treated by other antibiotics.

Staph infections are spread by direct physical contact with the bacteria, usually from person to person. However, it can be spread by contact with contaminated surfaces or personal items or equipment. Sports with skin-to-skin contact, such as football or wrestling may lead to exposure. Exposure can also be from surfaces in gyms or locker rooms.

If your child has a lump or rash that begins to look infected (redness, hot, swelling, drainage of pus, tender), they should be seen in our office. Staph infections are treated by opening up the site, draining it and usually treating with antibiotics. You should not try to open up the area and drain it yourself. We may tell you to use warm compresses or soaks before the visit here or after. If the area needs to be drained, we may need to send your child to a surgeon.

The best way of preventing spread of staph is through good hand washing, with soap and water. People also should not share personal hygiene items, such as towels, bar soap, clothing and razors. Any cuts or scrapes of the skin should be kept clean to help prevent infection. If a wound is infected, it should be covered. Schools should clean locker rooms and other surfaces, such as wrestling mats, with a disinfectant that is EPA registered as effective against MRSA.

PHARYNGITIS

Pharyngitis is an inflammation of the throat, which causes a sore throat. It can be caused by viruses, or by bacteria, such as strep. A sore throat is most often viral in origin, often as part of a cold, from a postnasal drip. Tonsillitis (swelling of the tonsils) can be caused by any throat infection, bacterial or viral. Children can also wake up with a sore throat if they sleep with their mouths open, which can be relieved by having something to drink.

Two common viral etiologies of sore throats are mononucleosis and Coxsackie pharyngitis (Hand, Foot and Mouth Disease). Mono can occur at any age, but is much more common in adolescents and young adults. We may test for mono if the pharyngitis is persistent. Please see the Fall 2007 newsletter for more information about mono. Coxsackie is mostly a summertime virus and usually causes blisters in the back of the throat. Please see our Summer 2007 newsletter for a more comprehensive article. These can be found on our website.

To diagnose strep pharyngitis, your child needs to be seen and a throat swab performed to do a rapid strep test and a throat culture. We do an overnight throat culture if the rapid strep is negative to be sure we don’t have a false negative, which can occur if the test is done too early.

Sore throats that are caused by viruses usually last 4-5 days and go away by themselves. Strep pharyngitis, which is treated with an antibiotic, will feel better within 24 hours of the medication being started. After 24 hours your child is no longer contagious and can return to school or day care.

To help your child feel better, you can give them lots of fluids to drink and ibuprofen or acetaminophen. Do not give leftover antibiotics from other family members, friends or the patient himself. They only help with strep pharyngitis and not with viruses and they can cause harm if not needed.

If your child is not improving, acting sicker or has difficulty swallowing or breathing, you should call us.