Killer germ set to 'emerge in force'

My mom sent this article this morning. Quite interesting...

Sharon Kirkey
CanWest News Service
Tuesday, January 02, 2007

A superbug that causes infections from large, boil-like lesions to hemorrhagic pneumonia and, in rare cases, flesh-eating disease is poised to "emerge in force" across Canada, a new report warns. While the prospect of a flu pandemic has governments scrambling to develop emergency plans, an epidemic of community-associated methicillin-resistant Staphylococcus aureus, or CA-MRSA, is raging in the U.S. and beginning to entrench itself here, infectious disease experts report today in the Canadian Medical Association Journal.

In the U.S., clusters have been reported in groups from NFL players to toddlers in day care.
In Canada, outbreaks have occurred in Alberta, B.C., Saskatchewan, Manitoba and Ontario. The Calgary Health Region sees between 40 and 70 cases per month. Infections are also being reported in Toronto, Montreal and Quebec City. Doctors are now investigating the possible transmission of the community-acquired staph strain among a small group of Calgary hospital patients, which would be one of the first cases of CA-MRSA being transmitted between hospital patients.

"Not a day goes by where I'm in clinic that I'm not pulling out a scalpel to drain one of these things," says Dr. John Conly, co-author of the report and an infectious disease specialist and professor of medicine at the University of Calgary.

"We're seeing far too many of them." The organism is an "old foe with new fangs," a pathogen that is virulent, drug-resistant and has an uncanny ability to "disseminate at large," according to the CMAJ report. So far, its prevalence is thought to be low, but rising in most parts of the country.

"Front-line physicians need to be aware of the increasing prevalence and the potential severity of CA-MRSA infection," the researchers write. The germ killed a healthy 30-year-old Calgary man and a three-month-old baby in Toronto in 2005. Both died of necrotizing pneumonia, or lung abscesses. The infection begins with what looks like a spider bite, a red, very tender area that rises up and comes to a head just like a small boil. If not treated promptly, the lesions can develop into large, spreading abscesses in the soft tissues that can grow to the size of a baseball "or even a grapefruit in some settings," Conly said in an interview. People develop fever and flu-like symptoms. In some cases, MRSA can cause bleeding in the lungs.

"For some reason, there are people who are predisposed to develop what looks like standard pneumonia and very quickly they begin to cough up blood," Conly said. Previously confined to hospital patients, the staph infection is now occurring in healthy people. The community strain "doesn't carry as much genetic baggage" as the hospital strain and is sensitive to other antibiotics, Conly says.

"But it seems to have a propensity to cause very large abscesses in the soft tissues with copious drainage, and seems to spread much more readily than the hospital strain has done."
It's also moving out of the traditional risk groups, such as intravenous drug users, the homeless, First Nations, the military and people infected with HIV.

The staph infection is spread by physical contact, through open cuts and scrapes, poor hygiene and sharing personal items, such as soap, towels, creams, razors and clothes.
Athletes are particularly prone: It has affected college and high-school-aged football players, wrestlers and rugby players. A Miami Dolphins football player lost a season because of a severe MRSA infection. The Canadian Committee on Antibiotic Resistance and the Coaching Association of Canada has launched a campaign to educate coaches, parents and athletes about staph infections.

Pets, too, can be reservoirs for infection. New Canadian guidelines to control MRSA recommend regular hand washing, covering any draining skin lesion and not sharing potentially contaminated personal articles. Doctors are urged to report suspected outbreak to public health authorities and to limit the use of antibiotics, because their over-use drives resistance.
The guidelines recommend alcohol-based hand sanitizers in sports facilities where there are no sinks, showering after every game or practice, avoiding sharing towels or equipment, cleaning equipment regularly, ideally after every use. Anyone with an open sore should avoid contact sports, and should stay away from common whirlpools or saunas. Children with open or infected sores should also be kept away from day care or school until they're treated.