1. Stripping Away the Germs: A guide to staying safe.
Milisa Brzuska, Master in Public Health
Walden University PH
Instructor: Rebecca Heick
Winter, 2010
My Name is Milisa Brzuska and my project is aimed towards individuals in the exotic dance industry. The audience is geared towards the dancers but also is important for the employers. It is very important to understand the correct way to keep your place of work and business clean and safe from possible exposure to staph infections and other bacteria's.
11/16/2018

2. Exotic Dancers & Staphylococcus Aureus or MRSA infection
Stripping away the germs: A guide to staying safe
Exotic Dancers & Staphylococcus Aureus or MRSA infection
A lot of exotic dancers do not have medical insurance so they tend to seek treatment in the E.R. Over the years, the ER has seen an increase in the number of people with staphylococcus aureus infection coming in for treatment.
The staphylococcus aureus bacterium has become resistant to antibiotics thus proving to be difficult to treat. With proper disinfection and knowledge of how the bacterium is spread, this population will effectively reduce the incidence of the bacteria in their work environment.
Staph bacteria are quite common. Between 25 percent and 30 percent of all people carry it on their skin or in their noses but do not develop infections, according to the U.S. Centers for disease Control and Prevention. People can carry the bacteria without becoming infected because they develop immunity to it or because the bacteria does not come in contact with broken skin. Even a paper cut or nick from shaving can let it in. The bug can spread when an infected person touches a non infected person. But since staph can live for days on an inanimate objects, it can also spread when people touch a surface or object that an infected person has touched.
Dancers have not been informed about Staph infections and what to look for, when dancers arrive in the ER they are thinking the infection is simply a spider bite.
Resistance to antibiotics: Approximately one percent of people carry the antibiotic resistant type.
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3. Stripping away the germs: A guide to staying safe
Learning Objectives
At the conclusion of the training, participants will understand appropriate hand washing techniques according to the Centers for Disease Control and Prevention.
By the end of the slideshow participants will have a better understanding of how bacteria are spread through contact with everyday items.
Following the presentation, participants will posses the skills needed to effectively disinfect their work area against the bacteria
At the conclusion of the activity, participants will understand the importance of reducing the amount of bacteria they come in contact with through the use of simple disinfection.
The objectives of the program is as followed:
- At the conclusion of the training, participants will understand appropriate hand washing techniques according to the Centers for Disease Control and Prevention.
-By the end of the slideshow participants will have a better understanding of how bacteria are spread through contact with everyday items.
-Following the presentation, participants will posses the skills needed to effectively disinfect their work area against the bacteria
-At the conclusion of the activity, participants will understand the importance of reducing the amount of bacteria they come in contact with through the use of simple disinfection.
11/16/2018

4. CDC Podcast – Staphylococcus Aureus or MRSA infection
Stripping away the germs: A guide to staying safe
CDC Podcast – Staphylococcus Aureus or MRSA infection
What is staphylococcus aureus or MRSA?
Podcast about staphylococcus aureus
This is a 4 minute and 57 second podcast about Staphylococcus Aureus or MERSA describing the bacrteria.
[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC - safer, healthier people.
[Host] “MRSA” has been featured in the news and on television programs a great deal recently. MRSA stands for methicillin-resistant Staphylococcus aureus. This type of bacteria causes “staph” infections that are resistant to treatment with some antibiotics. For some expert advice about MRSA, we’ll be talking today with Jeff Hageman, an epidemiologist with CDC’s Division of Healthcare Quality Promotion.
Mr. Hageman, the topic of MRSA has been in the news quite a bit recently, especially related to schools. What exactly is MRSA?
[Mr. Hageman] Let me start by saying that CDC understands that parents and school officials are concerned and want to do everything they can to protect students and prevent the spread of MRSA skin infections. MRSA is a type of antibiotic-resistant bacteria called Staphylococcus aureus or simply “staph.” It’s resistant to commonly prescribed antibiotics. Now, while staph infections have been around for a long time, until recently, most people who got MRSA infections were in the hospital or other healthcare settings. But over the past several years, MRSA has emerged in the community as one of the most common causes of skin infections. These infections may appear as small pustules or boils, which are often red, swollen, painful, or have pus associated with them. They commonly occur at sites of visible skin trauma, such as cuts or abrasions, or can occur at sites commonly covered by hair on the body, like the back of the neck, groin, buttock, armpit, or the bearded area of men. It’s also important to mention that although rarely occurring in healthy people, more serious infections can occur, such as pneumonia, bloodstream infections, and bone infections. However, most of the life-threatening MRSA infections are associated with healthcare.
[Host] We sometimes hear MRSA referred to as a “superbug” in the media. Is that fair? Does that mean that MRSA has no cure?
[Mr. Hageman] Right. I think people commonly refer to MRSA as a “superbug,” however, MRSA still has a number of antibiotics available for treatment. You know, it’s important to emphasize that most of the infections we hear about happening in schools are MRSA skin infections and most of these infections may not need antibiotics at all. Usually, the first-line treatment for these skin infections is drainage. And of course, drainage of these skin infections should only be done by your healthcare provider.
[Host] How is MRSA transmitted?
[Mr. Hageman] MRSA is usually transmitted by direct skin-to-skin contact or contact with shared items or surfaces that have come into contact with someone else’s infection, for example, a towel you might use for bathing or used bandages. Certain factors have been associated with making it easier for MRSA to be transmitted. These factors include crowding; frequent skin-to-skin contact; compromised skin, such as cuts and abrasions; contaminated items or surfaces; and lack of cleanliness. Some settings where these factors are common include schools, dormitories, military barracks, households, correctional facilities, and daycare centers. Now while MRSA infections are commonly reported from these settings, it’s important to emphasize that MRSA is a prevalent cause of skin infections in the general community and can occur essentially anywhere.
[HOST] So, for the people that are listening and wondering what they should do to protect themselves, what do you recommend?
[Mr. Hageman] There are a number of things that people can do to protect themselves—many simple measures. First, they can practice good hygiene—that’s probably the most important. This includes keeping your hands clean by washing with soap and water regularly or using an alcohol-based hand sanitizer. It’s also important, if you participate in activities where there is frequent skin-to-skin contact, like exercise or sports, you should shower immediately after participating in those activities. Also, people should cover their skin abrasions, those cuts and abrasions, to prevent them from getting infected. They should be covered by clean, dry bandages until healed. Everyone should avoid sharing personal items that come into direct contact with bare skin, such as the towels and razors. Barrier-like clothing or a towel should also be used between skin and shared equipment like weight-training benches. And finally, high-touch surfaces or surfaces that you frequently contact with your hands should be kept clean, and also other surfaces that might come into direct contact with people’s skin should be cleaned routinely.
[Host] To summarize, MRSA infections are treatable and there are measures people can take to protect themselves. If people want more information about MRSA, where should they go?
[Mr. Hageman] They should go to the main CDC website,
[Host] Thank you for taking the time to talk with us today, Mr. Hageman.
[Mr. Hageman] You’re welcome. Thanks for having me.
[Announcer] To access the most accurate and relevant health information that affects you, your family and your community, please visit
11/16/2018

5. Stripping away the germs: A guide to staying safe
Distinctions between and incidence of healthcare-associated (HA) and community-associated (CA) MRSA infections, from CDC surveillance study¹
Healthcare-associate
(HA)
Onset Designation
Definition
Percent of MRSA infections
Community-onset
Infections that occur in people with prior history of the presence of an invasive device at time of admission; history of MRSA infection or colonization; and hospitalization, surgery or long-term care residence in the 12 months preceding culture date.
58.4
Hospital-onset
Cases with positive cultures isolated from hospitalized patients from a normally sterile body site obtained more than48 hours after hospital admission.
26.4
Community- associated (CA
Not specified
Infections that occur in the absence of any community-onset healthcare risk factors noted above.
13.7
For several decades, methicillin-resistant Staphylococcus aureus (MRSA) has caused infections in patients with
well-described risk factors, including hospitalization, surgery, residence in chronic care facilities, and injection drug use. Recently, MRSA has caused infections in patients lacking traditional risk factors for infection with MRSA. Many of these infections have occurred in the community and have affected children and young adults. Community-acquired MRSA (CA-MRSA) strains have a genotype and a phenotype that are distinct from those of hospital acquired MRSA.
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6. Primary Routes of Transmission
Stripping away the germs: A guide to staying safe
Primary Routes of Transmission
Found on skin and nasal surfaces of healthy people and animals
Spreads from person-to-person by direct skin-to-skin contact or by surface-to-skin contact.
Can also be spread by contact with the following surfaces: hands and skin, bar soap, towels, gym equipment, computer keyboards, lockers, door knobs and light switches.
Proper handwashing is the single most effective way to help prevent the spread of infection. It is important to wash with an alcohol-based hand sanitizer or by lathering hands with antimicrobial hand soap for at least 20 seconds and rinsing with warm running water. Infection spread can also be prevented by covering any open skin (such as abrasions or cuts) with clean, dry bandages, avoiding sharing personal items (such as towels or razors), using a barrier (such as clothing or a towel) between skin and shared equipment, and wiping surfaces before and after use with an appropriate EPA-registered disinfectant with an MRSA claim. Current infection control guidelines stress the need for meticulous cleaning.8 Recent studies support the recommendations for careful cleaning of environmental surfaces and disinfection of items. There is no convincing evidence that special cleaning agents are necessary. EPA does not recognize an efficacy difference between HA-MRSA or CA-MRSA and MRSA on disinfectant labels.
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7. Perceived Susceptibility and Severity
Stripping away the germs: A guide to staying safe
Perceived Susceptibility and Severity
One’s opinion of chances of getting MRSA in your work place as an exotic dancer.
One’s opinion of how serious the condition is.
Staph bacteria are one of the most common causes of skin infection in the United States and are a common cause of pneumonia, surgical wound infections, and bloodstream infections. The majority of MRSA infections occur among patients in hospitals or other healthcare settings; however, it is becoming more common in the community setting. Data from a prospective study in 2003, suggests that 12% of clinical MRSA infections are community-associated, but this varies by geographic region and population.
The exact number of infections caused by MRSA, or methicillin-resistant Staphylococcus aureus, is unknown, but a CDC study estimated in , nearly 126,000 people were hospitalized each year for MRSA infections.
Anyone can get a staph infection and is transmitted through close physical contact, for example professional football players, wrestlers, exotic dancers, and individuals who engage in high-risk sexual activities are those at greatest risk. Most staph infections are minor but some like MRSA are much more serious. Treatment involves antibiotics or draining the infection from the wound site.
11/16/2018

8. Perceived Benefits and Barriers
Stripping away the germs: A guide to staying safe
Perceived Benefits and Barriers
One’s opinion of the efficacy of the advised action to reduce risk or seriousness of MRSA
How, where, when
One’s opinion of the tangible and psychological costs of a sanitary work place.
We need to Identify and reduce barriers
By reassurance, incentives and assistance
Action to take: Sanitation in strip clubs, educate strippers regarding Staph infections and make available sanitizers. Provide resources and educational materials (fact sheet & pod cast) and provide skill training.
Discussing the fact sheet and pod cast, dancers will asses where their knowledge is pertaining to the bacteria and disinfection techniques. The dancers and facility owners who read the fact sheet and listen to the pod cast will realize their vulnerability to this aspect of bacteria.
A rise in the bacteria has raised concern in the industry, therefore prompting education on proper technique and disinfecting.
Once the exotic dancers and facility owners finish the service learning online presentation, the program will lead to more awareness and to a clean work atmosphere for the employees.
Once the importance of disinfection is realized, participants may wonder about the availability of the proper sanitizer and where to get the product.
The cost is very little, and we hope to encourage the facility to provide most of the products.
11/16/2018

9. Examples of Proper Sanitizing Techniques
Stripping away the germs: A guide to staying safe
Examples of Proper Sanitizing Techniques
Proper Hand Washing Techniques
Disinfection Gloves and Hand Sanitizers
Example proper hand washing techniques (next slide)
An example might be to take a normal cloth glove and a sanitizer of some sort (decorate if desired as a prop to be less discreet towards the audience) The exotic dancer can put on the glove and use the sanitizer by dispersing a quarter size amount on the glove and the dancer can sanitize their prop by moving the glove along the pole. Key is to remove as much bacteria as possible in a discreet manner.
11/16/2018

10. Stripping away the germs: A guide to staying safe
According to the CDC, Wash Your Hands: The Right Way
When washing hands with soap and water:
Wet your hands with clean running water and apply soap. Use warm water if it is available.
Rub hands together to make a lather and scrub all surfaces.
Continue rubbing hands for seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend.
Rinse hands well under running water.
Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.
Always use soap and water if your hands are visibly dirty.
If soap and clean water are not available, use an alcohol-based hand rub to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast-acting.
When using an alcohol-based hand sanitizer:
Apply product to the palm of one hand.
Rub hands together.
Rub the product over all surfaces of hands and fingers until hands are dry.
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11. Stripping away the germs: A guide to staying safe
Key Learning Goals
Increase awareness about the spread of staphylococcus aureus bacteria among strip clubs
Decrease the spread of staphylococcus aureus bacteria among strip clubs
-Proper ways to disinfect will decrease incidence
-importance of education and awareness of bacteria will decrease incidence
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12. Resources
CDC (general):
Fact sheet
MRSA Information Sheet for Patients
CDC (MRSA in the workplace):
Unsanitary and unsafe club conditions
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13. References
Center for disease control and prevention. (2009). Healthcare-Associated Methicillin
Resistant Staphylococcus aureus (HA-MRSA). Retrieved January 19th, 2010, from
Ecolab. (2010). MRSA - Staphylococcus aureus. Retrieved January 24,2010, from
Elston, D. (2006, June). MRSA: From the hospital to your office. Retrieved January 19th, 2010, from
Manning, A. (2007, January). Sex Spreads MRSAS infection. Retrieved January
19th, 2010, from USATODAY.com.
01-10-mrsa-usat_x.htm
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