In Tewksbury, teachers are asking children to wash their hands for as long as it takes to sing the alphabet song.
Belmont student athletes have been reminded to shower after practice and games.
And in Harvard, the elementary school has been scrubbed inside and out.
All are precautionary efforts school officials are taking to prevent staph infections, which are a growing concern in Massachusetts schools this year.
Public health and education officials are stepping up prevention efforts in light of the increased awareness and are urging students to follow basic hygiene practices.
"We really want to stress prevention," said Donna Rheaume, a spokeswoman for the Department of Public Health.
Though there are several types of staph infections, the one causing concern among health professions is methicillin-resistant staphylococcus aureus, or MRSA, a bacterium that is resistant to certain types of antibiotics. Several cases of MRSA have been confirmed in Massachusetts this fall, including schools in Winchester and Wrentham.
Staph bacteria, including MRSA, can cause skin infections that may look x like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.
State public health and education officials have sent out advisories and recommendations to school districts, which have been passed out to nurses, teachers, and parents.
Al DeMaria, communicable disease control director for the DPH, said MRSA infections are common, particularly in hospitals and nursing homes, and are typically minor. Serious cases, he said, are "quite rare" among healthy children. The infection is spread by direct skin-to-skin contact.
Staph are also spread by contact with items that have been touched by people with staph, like towels shared after bathing and drying off, or shared athletic equipment in the gym or on the field.
The students most at risk are athletes because many come in contact through the course of a game or practice, DeMaria said. He said athletes are also prone to getting superficial cuts during the course of play.
School superintendents said they are taking the advisories seriously and many are focusing on prevention efforts with the athletes. Superintendents said they have met with principals, nurses, and teachers to help spread the word to students and parents about the importance of prevention.
Belmont Superintendent Peter Holland said the district's athletic director has met with all coaches and shared information with athletes.
He said the students have been reminded not to share towels, razors, or soap and to shower after practice and games.
"It's a question of being alert," Holland said. "Most of these things can be dealt with using normal hygiene lessons."
Holland said, for example, an extra effort is being made to stock bathrooms with liquid soap so it is always available for students.
Holland said the district has not done any additional cleaning, though it will consider a deep cleaning in a preschool classroom where a possible MRSA case has been detected.
Other school systems have been giving buildings an extra scrubbing as a precaution.
In Harvard, Superintendent Thomas Jefferson said the elementary school recently had a deep cleaning.
"It's a realistic and symbolic precaution," he said. "Just to be on the safe side, we're doing some extra disinfecting."
Jefferson said it is particularly important to make sure the elementary school is clean because the younger students are using shared playground equipment and are less vigilant about washing their hands. He said they also tend to put their hands in their mouth more than the older students.
Jefferson said the district may consider asking older students to carry sanitary wipes as a precaution.
"The reality is any dramatic change in the cleanliness of the school can't involve just the custodial staff," he said.
"It has to be one for all. Any solution has to involve the broader community." Andover Superintendent Claudia Bach said health teachers have been reminding students to wash hands and to avoid close contact with others. She said the school system has focused its cleaning efforts in locker rooms.
The key, she said, is prevention through good hygiene.
Tewksbury Superintendent Christine McGrath said the younger students are reminded to sing the ABCs while washing their hands, and they are encouraged to cough into their arms so germs don't get on their hands.
She said the nurses at the schools have encouraged health teachers to incorporate hygiene recommendations into classes.
"We don't shy away from talking about these things," McGrath said.
There are materials available for parents on the Internet to learn more about the infections, DeMaria said. He urged parents to read up on the information and not become alarmed if a case is confirmed at school.
DeMaria said the information also gives schools guidelines if a case is confirmed. He said it is not necessary to shut a school down if a case is confirmed. Students with MRSA can still attend school and participate in sports if the wound is properly bandaged, he said.
Rheaume said schools are not required to report MRSA cases to the state, so it's difficult to track exactly how many have been confirmed.
The website for the Department of Public Health is mass.gov/dph.
Jennifer Fenn Lefferts can be reached at jflefferts@yahoo.com.
