Sunday, July 6, 2008

Health

USN Current Issue

A Nasty Bug Breaks Out

Drug-resistant staph bacteria now stalk even students

Posted October 18, 2007

The trouble started in May, with a mild fever and what felt like a leg cramp. Within days, 12-year-old Hunter Spence had a temperature of 107 degrees and was fighting for her life in a hospital nearly 85 miles from her Victoria, Texas, home. There, doctors told her parents she had contracted methicillin-resistant Staphylococcus aureus and wasn't expected to live. Immune to common antibiotics, the MRSA infection had invaded her bloodstream, bones, and lungs. The seventh grader eventually got out of danger, but only after seven operations and five weeks in intensive care.

Hunter’s terrifying experience is not an isolated event. Once confined primarily to hospitals and healthcare institutions, antibiotic-resistant staph is now increasingly attacking healthy people in communities across the country. Schools nationwide have been reporting outbreaks: Last Monday, the MRSA-related death of a 17-year-old Virginia student—one of three such fatalities in recent weeks—spurred officials to close 21 area schools for cleaning; schools in other states have been evacuated for disinfection. Jaime Fergie, the pediatric infections specialist who treated Hunter at Driscoll Children’s Hospital, has observed exponential growth in such MRSA cases at the hospital in recent years, including three deaths since 2005.

"Young, healthy people who haven't been to a hospital since birth [are] getting sick," says Elizabeth Bancroft of the Los Angeles County Department of Public Health. Across all age groups, MRSA was the culprit behind more than 94,000 life-threatening infections and almost 19,000 deaths in the United States in 2005, researchers from the Centers for Disease Control and Prevention estimated last week in the Journal of the American Medical Association.

When detected early, even resistant staph is very treatable, says Neil Fishman, a physician and spokesman for the Infectious Diseases Society of America. The first sign of infection can be boils, which sometimes resemble spider bites and tend to become red, hot, and tender, or larger skin abscesses. While severe cases like Hunter's are rare, suspicious wounds should get medical attention. It's during treatment that MRSA can reveal its most frightening side: Unlike common staph, it's impervious to all but a few antibiotics. Specialized drugs can still kill it, however.

Staph microbes reside, usually harmlessly, in about 30 or 40 percent of the population. Infections typically occur when the bug comes in contact with a wound, and they can be transmitted by direct contact or via shared, contaminated items such as towels and bars of soap. Athletes who have cuts and scrapes may acquire it in locker rooms or during contact sports. Virginia's education department is recommending daily disinfection of objects that see heavy use—desks, countertops, drinking fountains, weightlifting machines, and basketballs.

While the growing threat of community-acquired infections is alarming, it still pales in comparison with MRSA cases linked to healthcare facilities. In last week's JAMA report, CDC researchers found that rates of the infection were highest among people 65 years and older, many of whom were in or had recently been in a hospital or nursing home. Says Bancroft: "It's Grandma I'm a lot more worried about than kids."

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Adam Voiland hopes to steer readers towards the best that medicine has to offer men.

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