Posted by: Chris

Washington Blade
Feb 14, 2003
Page 1

CDC investigates staph outbreak

Clinics briefed nationwide on puzzling skin infections in Calif. gay men

By LOU CHIBBARO JR.

Dozens of gay men in Los Angeles and San Francisco have contracted a severe bacterial skin infection resistant to commonly prescribed antibiotics, according to the U.S. Centers for Disease Control & Prevention.

The skin infections, called Methicillin-Resistant Staphylococcus Aureus, or MRSA, have until recently stricken mostly elderly patients in hospitals and nursing homes. But since 1997, non-hospital population groups such as prison inmates, members of athletic teams, and most recently, gay men, have contracted the condition, raising concern by public health officials that a new, undetermined factor is causing the bacteria to flourish in a wider group of people.

CDC officials on Feb. 7 informed the heads of gay community health clinics in seven cities about the outbreak of MRSA among gay men in a telephone conference call. Among those participating in the phone conference was A. Cornelius Baker, executive director of D.C.’s Whitman-Walker Clinic.

A spokesperson for the D.C. Department of Health said no known cases of MRSA in non-hospital settings have been reported in the D.C. area.

The gay men who contracted the infections in L.A. and San Francisco have been treated for rapidly growing boils and abscesses on various parts of their bodies. There have been no reported deaths from the infections, CDC officials said. Those stricken have so far recovered from the infections after receiving potent antibiotics, some of which are used to treat anthrax infection.

CDC officials said the gay men were the latest “community” group to contract MRSA in a non-hospital setting. Since 1997, prison inmates, members of athletic teams, and Native Americans in the United States and Canada have contracted the infection, CDC officials said.

“This is not an issue that is exclusive to the gay community,” said Nicolle Coffin, an official with the CDC’s Division of Health Care Quality & Promotion who participated in the conference call to the gay clinics.

Bob Bolan, a physician with the L.A. Gay & Lesbian Center’s HIV clinic, said at least nine patients in the center’s clinic contracted MRSA since December. Although the nine have HIV, Bolan said the L.A. County Department of Health Services has reported that many gay men who have contracted MRSA in the L.A. area during the past year do not have HIV. He said most were in excellent health.

“We’ve seen some real nasty skin eruptions,” said Bolan.

Cause remains unclear

The CDC and L.A. County health officials have yet to determine the mode of transmission of MRSA among gay men. Bolan said the most logical theory is through sexual contact and possible contamination of equipment and other facilities in health clubs or sex clubs such as bathhouses.

A fact sheet released by the CDC says exercise equipment, towels, and other objects that come in contact with an infected person’s skin can pass the bacteria to others who come into contact with those objects.

Coffin of the CDC said that because the federal government doesn’t require doctors and state health departments to report MRSA cases to the CDC, the exact number of non-hospital related cases contracted by gay men or members of other groups is unknown. L.A. health department officials say they know of at least three-dozen gay male patients who have contracted the infection during the past year.

More than 1,000 cases have surfaced in the L.A. County prison systems, officials said. Bill Owen, a physician in San Francisco’s gay Castro neighborhood, told the San Francisco Chronicle he estimates there have been between 200 to 300 cases among gay men in the San Francisco Bay area.

Charles Ellison, a spokesperson for the D.C. Department of Health, said the department is not aware of any cases of MRSA among gay men or other population groups in the D.C. area outside of hospitals and nursing homes.

“When the case is truly MRSA, you are limited to a few drugs, including one that is administered intravenously,” Bolan said. “Most drugs can’t kill the organism. You must rely on a person’s immune system to kill it. The drugs only check it.”

Because of this, Bolan said, people with HIV who have weakened immune systems struggled to overcome the infections. He said many require long hospital stays and prolonged drug treatment.

Lou Chibbaro Jr. can be reached at [email protected].

STAPH INFECTION INFO

Staphylococcus aureus, often referred to as “staph,” is a form of bacteria commonly carried on the skin or in the nose of healthy people. Between 25 to 30 percent of the population have staph bacteria in the nose, the fact sheet says.

Infection occurs mostly when the bacteria enter the body through a cut or wound. In most cases, healthy people can overcome an infection of non-MRSA staph without treatment.

MRSA traditionally has been confined to hospitalized patients who are elderly or very ill and who have open wounds such as bedsores. Other hospitalized patients prone to MRSA infection have tubes entering their body such as urinary catheters or intravenous catheters used for kidney dialysis.

“MRSA is almost always spread by direct physical contact, and not through the air,” the CDC fact sheet says. “Spread may also occur through indirect contact by touching objects (i.e., towels, sheets, wound dressings, clothes, workout areas, sports equipment) contaminated by the infected skin of a person with MRSA or staph bacteria,” the CDC fact sheet says.

Infection can be prevented, the fact sheet says, by regular hand washing, keeping cuts and abrasions clean and covered with a proper dressing and bandage until healed, and treating dry, cracked skin with a moisturizer.

CDC officials say it is imperative that anyone being treated for MRSA completes the full course of their prescribed antibiotics. Not doing so, public health officials say, could cause the staph bacteria that causes MRSA to become resistant to the few remaining drugs that can be used to treat it.

Source: CDC

Tags: gay staph, MRSA, UCSF

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