While health officials have declined to divulge the location of the third case, Scott County School's nursing coordinator says a Gate City Middle School athlete is infected. Earlier this month, Appalachia High School postponed its football game against Clintwood after a AHS player was diagnosed with staph.
And according to Dr. John Dreyzehner, director of the Lenowisco and Cumberland Plateau Health Districts, additional reports of staph are being investigated at another school.
"I can tell you we are investigating another possible outbreak in a sports team in a neighboring district, that being the Cumberland Plateau Health District," Dreyzehner said.
"It's an on-gong investigation into a possible case and several possible contacts."
Dreyzehner would not identify which athletic team was being looked at, or the county in which it's located.
Tazewell County Schools Superintendent Brenda Lawson tells timesnews.net that one report is within her county, though she declined to specify which school. She says opponents scheduled to compete against the undisclosed athletic team have been notified of the staph infection.
"Of course the person that has (staph) has been receiving treatment," Lawson said. "I don't think it's to the extent that we have to postpone (games). Of course, the individual won't be competing and practicing until it's cleared up."
Lawson says Tazewell County's School Nurse Practitioner has met with all students on the effected team, as well as the coaching staff and school administration. They were given information on how to stop and prevent the spread of infection.
Dickenson County Schools Health Education Nurse, Delechia Edwards, says a doctor at a local emergency room has taken cultures from two high school students in that district and confirmed more cases of staph. She said one infected student was an athlete.
Dickenson County Superintendent Judy Compton says the local doctor believes the cases to be isolated, and the schools are taking extra cleaning precautions, following guidelines from the Health Department.
"We have talked with the schools before we play and make sure our lines of communication are open," Compton said.
"I've alerted all our principals to make sure they're having their janitors do extra cleaning in the classrooms, cafeteria tables and bathrooms. We're using some extra product we know will be effective in containing that. I think we're in a prevention mode right now."
Dreyzehner says educating school staff -- particularly coaches -- on how to avoid staff is integral to combating additional infections.
"The most important factor, I believe, is leadership," Dreyzehner said. "This starts with the head coach deciding these practices will be adopted. The head coach decides his or her players are not going to share towels, they're not going to share water bottles and the like. Everybody from himself to his assistant coaches and his players are going to abide by that. That leadership is crucial. That's where athletes and students will decide it's important, because the coach has said this is for the good of the athletes and the good of the team."
"The kids care about what the coach says, what the coach wants them to do."
Such proactive steps were practiced and emphasized this football season in Russell County, Va. After experiencing two staph infections on athletic teams last year, School Superintendent Tommy Justus says they are all clear this season. He attributed avoidance to information provided to the school system by Dr. Dreyzehner, which he then forwarded to school staffs and coaches.
"I encourage and applaud coaches and school administrations that are taking proactive steps to help reduce the chance of transmission -- like emphasizing hand washing, hand sanitizers routinely available in all areas of the school," Dreyzehner said. "Or sanitizing practice jerseys and equipment daily. Those things are important, and hand washing is still the key to preventing transmission."
Individuals should also avoid sharing personal items such a towels, razors or eating utensils, as staph bacteria is commonly transmitted through direct contact and introduced through an opening or wound on the skin.
With Dreyzehner confirming a third staff infection within the Lenowisco Health District -- encompassing Lee, Scott, and Wise counties along with the City of Norton -- the situation has reached "outbreak" status, as defined by the Virginia Department of Health.
VDH public information officer Robert Parker offered no comment on the infections in the Lenowisco District, or reports of others in Tazewell and Dickenson counties.
"There may be an update to that information, but at this point nothing that can be shared," Parker said.
Dreyzehner believes staph infection "outbreak" is not where the emphasis should be placed. He said there is no "hard and fast number" of infections to qualify the term, despite the VDH definition.
"What I would consider an outbreak is a number of cases over what we would normally expect that is linked in time and space," Dreyzehner said.
When asked if three confirmed cases revolving around athletic teams in the Lenowisco Health District, along with additional reports being investigated in the Cumberland Plateau, were not linked in time and space, Dreyzehner replied, "Again, I don't want to focus on that. In fact, I'd say that we have MRSA outbreaks and we currently had one in the Lenowisco Health District."
MRSA is an acronym for methicillin-resistant staphylococcus aureus, a strand of staph that is resistant to traditional antibiotics.
"The most important things for you readers, regardless of where there may or may not be an infection in any moment in time: all of us now have risk for MRSA," Dreyzehner said.
VDH's Parker says individual reports of staph infections are becoming more common across the region and nation. In fact, last weekend the Johnson City Press reported two Elizabethton High School athletes had contracted staph infections.
In response, interim Superintendent Ed Alexander had new sanitizing equipment installed in the school's dressing rooms and other warm, humid areas where students were most likely to be exposed to the bacteria. Alexander said Principal Eddie Pless also obtained new athletic equipment that could safely be bleached to help prevent the spread of germs.
Public Information Officer for the Tennessee Department of Health, Teresa Roberts, says there have been no additional reports of staph in Northeast Tennessee since the Elizabethton case.