School Health Issues: Contraceptives and Antibiotic-Resistant Infections Contraceptives A middle school in Portland, Maine, became national news in October after the school-based health center asked for and received permission from the school board to distribute contraceptives to female students aged 11 to 15 in grades six to eight. The health center, which is operated by Portland's Public Health Division, acted after a number of pregnancies among middle school girls; the three middle schools in the city have reported 17 pregnancies during the last four years, not counting miscarriages or terminated pregnancies that were not reported to the school nurse. Of 134 students who visited the King Middle School health center last school year, five said they were sexually active. The new policy provoked controversy in Portland and nationwide, as critics charged that providing contraception encourages children to have sex, and proponents argued that the students who need protection have already made the decision to be sexually active. The King health center requires parental permission for students to access treatment, but the center does not spell out the exact nature of the services that will be available. State laws in Maine, as in all other states, protect the confidentiality of reproductive health services provided to minors. State laws vary on the issue of contraceptives; some states prohibit provision of contraception at school by any entity. In a follow-up to the initial Portland School Committee's decision to allow contraceptive distribution, the committee is scheduled to vote this month on whether to limit access to prescription birth control to students who are at least 14 years old and to require that the center's parental permission forms spell explain more clearly the services that may be provided. Methicillin-Resistant Staphylococcus Aureus Public schools, alarmed by reports of illness and even deaths of students from a rash of antibiotic-resistant staph infections, are disinfecting their bathrooms and athletic facilities and testing staff and students for the bacterial strain, though the federal Centers for Disease Control and Prevention (CDC) says that it has no evidence of a nationwide surge in incidence of the infection. Like many bacteria, Staphylococcus aureus has become resistant to a number of the drugs such as penicillin that were most often used to treat it, though staph infections still respond to a range of other antibiotics. Infection is spread easily through skin contact or abrasions, and is most often seen in care facilities such as hospitals and nursing homes, where the compromised immune systems of ill or elderly persons are believed to heighten their susceptibility. In schools, sports activities that involve skin contact and injuries, plus crowding and humidity in locker rooms, are believed to contribute to infection. A best protection against staph is strict and consistent hand-washing, to prevent transmission from person to person, says the CDC. In hospitals, infection spreads when doctors fail to wash their hands between patients, and schools are vulnerable if soap containers are allowed to remain empty or students do not have easy access to bathrooms. Extensive fact sheets about Staphylococcus aureus are available online at www.cdc.gov/staph. |
