Children With Flu at Risk of Death From Staph Infections

Results of a new government report recently released find that more children are dying from the flu because they also had diagnosed staph infections, a fact that makes it all the more important for kids to get their flu shot.

According to the data from 2006 to 2007, 73 deaths occured in children with both the flu and a staph infection, and officials are predicting that when the numbers are tabulated for this past flu season that the number will be higher.

In the majority of these cases, the children were healthy, and between 5 and 17 years of age.

Traditionally the flu will not kill a child, or a healthy adult for that matter, but when underlying health conditions are involved, the risk of serious problems can go up considerably.

Last year, the flu vaccine shot was not very effective, but despite this fact, health officials are urging Americans that it is worth it to get it.

“It’s an important message to say even healthy children develop complications and die almost before anything much can be done for them,” said Dr. Gregory Poland, a Mayo Clinic infectious disease specialist.

An estimated 20,000 children are hospitalized in the U.S. each year because of flu.

7 Babies, 4 Employees: MRSA Outbreak at New York Maternity Ward

October 30, 2008

Seven babies and four employees at a suburban New York hospital have been diagnosed with MRSA.

Officials at St. John’s Riverside Hospital in Yonkers, N.Y., became aware of the problem after the newborns developed skin rashes consistent with the drug-resistant staph infection, reported.

"We are assuming that all seven cases are connected," Jim Foy, St. John's Riverside Hospital President and CEO, told the news radio station. "The strain seems to be community acquired. It is a localized skin infection but again, any infection that comes from a hospital is something you're concerned with. You're supposed to get better when you come to a hospital, not have anything come and make it worse."

The first case was identified on Sept. 24 and the most recent case was found Sunday, according to Foy.

Since the outbreak, the maternity ward and nursery areas have been thoroughly scrubbed down and nurses and doctors have been asked to watch out for cases.

MRSA is an infection caused by a strain of Staphylococcus aureus bacteria that is highly resistant to antibiotics, the National Institutes of Health said on its Web site.

It’s a common bacteria that normally lives on the skin and sometimes in the nose. Infections occur with the bacteria enters the body through a cut or sore. Serious staph infections are most common in people with weak immune systems, usually patients in hospitals and long-term care facilities, according to the NIH.

C. difficile epidemic continues to worsen

WASHINGTON, Oct. 28, 2008: by Emily Walker, Washington Correspondent MedPage Today - The worst of the national Clostridium difficile epidemic is yet to come, researchers cautioned here. The current C. difficile epidemic strain, NAP1/027, has spread to all 50 states, said Clifford McDonald, M.D., of the CDC's Division of Healthcare Quality and Promotion.

And the epidemic is likely to get worse before it gets better, said others at the Interscience Conference on Antimicrobial Agents and Chemotherapy, held jointly with the Infectious Diseases Society of America (IDSA) meeting.

"I don't think we've peaked yet," said Lance Peterson, M.D., of the Evanston (Ill.) Northwestern Healthcare Research Institute.

C. difficile disease is thought to be the result of antibiotics that disrupt patients' normal gut flora, which makes them susceptible to the C. difficile bacteria on hands and hospital surfaces.

Discharge data showed a four-fold increase in C. difficile rates since 2001, when hospitals first began seeing a surge in patients being infected with the bacteria. Meanwhile, deaths caused by C. difficile have increased five-fold, said Dr. McDonald.

"The total burden of C. difficile infections probably exceeds 500,000 cases annually," said Dr. McDonald. "And from that, we're looking at at least 15,000 deaths caused by or contributed by C. difficile."

The IDSA, with the Society of Healthcare Epidemiology of America, recently published a practicum to prevent the spread of C. difficile, recommending, among other things, restraint when prescribing antibiotics, bleach to clean surfaces during outbreaks, and better hand-washing practices.

The NAP1/027 strain of the bacteria caused outbreaks in Canada during 2003 and 2004, leading to 700 deaths in Quebec province in one year. According to Jacque Pepin, M.D., of the University of Sherbrooke, the rates have now leveled off at about 400 deaths per year, but that's still four times the mortality rate from before the bacterial epidemic.

Current treatment hinges largely on two antibiotics -- vancomycin and metronidazole -- but the effectiveness of those drugs is waning, researchers said.

"[There has been] no improvement in 30 years, and we desperately need new therapies," said David Classen, M.D., of the University of Utah in Salt Lake City.

Slowing the C. difficile epidemic will take something more than current broad-spectrum antibiotic treatment, Dr. Pepin said.

That something may be a procedure called a "fecal transplant."

That is just what it sounds like: taking a fecal sample from a healthy relative of an infected person, filtering the sample, and infusing (usually via enema) the filtrate into the C. difficile patient.

In theory, whatever defenses were depleted from the infected person's intestines by antibiotic treatment will be restored through an infusion of healthy feces, said Dale Gerding, M.D., of Hines VA Hospital in Chicago.

The procedure is fairly rare, and is practiced just in Norway and several places in Canada. But it has led to success rates of about 90%, Dr. Gerding said.

Other future treatment options for C. difficile include developing a more focused, non-absorbable antibiotic that would target the gut and stay there, attacking the C. difficile bacteria while preserving the flora, said Dr. Gerding.

Dr. Classen said he is hopeful about a vaccine strategy, which he expects will move to human testing in early 2009, although Dr. Gerding said it would be "many years" before such therapies are available.

The Bugs We Can't Defeat

Jane Hansen | October 08, 2008

ANTIBIOTICS have been thrown at everything, from the most infectious diseases to the slightest cough. As well, in pursuit of higher profits, food producers have used them to fatten up chickens and pigs. As a result, bacteria are becoming immune to a depleted arsenal of the wonder drugs of the 20th century. And the golden era, in terms of controlling and curing illness and death caused by bacteria, is coming to an end.

David Paterson with E. coli at the University of Queensland; he says the bug produces an antibiotic-destroying enzyme.

"I've lived in the days before antibiotics, and they weren't pleasant," recalls Kathleen Calvert, a 71-year-old retired teacher based in Canberra. As a child she suffered dreadful middle-ear infections.

"You just had to endure the pain, wait for an abscess to form and then it would burst, time and time again, and I'm partially deaf in one ear as a result."

Then along came the miracle drug of the 20th century, penicillin, and Calvert finally rid herself of the ailment that had plagued her childhood. Now she is at the other end of the antibiotic golden age, battling a multi-drug-resistant bug she picked up in China.

"I have had a recurring urinary tract infection that flares up every six months, I can't get rid of it," she says of the common ailment that affects millions of women worldwide. For the past few decades, it has been treated by a simple three-day course of oral antibiotics, but those drugs are impotent against the strain Calvert acquired in Beijing.

"I've had four week-long intravenous courses with last-line antibiotics and it keeps coming back. I've felt like typhoid Mary. People avoid you and think they might be contaminated by you," Calvert says.

Sharing a bath towel with Calvert could pass on the infection, theoretically, but the bigger threat is that the rogue bacteria will swap its resistant gene with local bugs, giving birth to a home-grown resistant bug. There is good evidence this is happening.

"Bacteria are really good at having bacterial sex and swap their resistant genes at a rapid rate," says Peter Collignon, head of infectious diseases at Canberra Hospital and microbiologist with the medical school at the Australian National University.

Doctors believe travel to developing countries is one possible reason for the rapid emergence of drug-resistant E.coli and other gut bugs among healthy people who have had no previous contact with the hospital system.

Superbugs, those born and bred in hospital corridors in response to high antibiotic use, have plagued patients for years, but sister versions of these bugs are emerging at a rapid rate in the community, affecting the young and healthy.

"The doomsday scenario of a world without effective antibiotics is already playing out in countries like China," Collignon says. "They don't keep good data and the media is controlled, but people are dying regularly from complications of drug-resistant common bugs like E.coli, and golden staph, and tuberculosis."

Like most organisms, big and small, bacteria have forms of attack and defence, and some produce toxic substances that can kill other bacteria: we call them antibiotics. In response, other bacteria produce enzymes that can neutralise the antibiotics. The same battle is being waged on the human health front because of the overuse of antibiotics. And the resistant bacteria are winning.

Nasty bugs that cause tuberculosis have armed themselves to defy the drugs that cure often fatal ailments. A recent study published in The Medical Journal of Australia proved a multi-drug-resistant strain of tuberculosis, called MDR-TB, is already on our doorstep in the Torres Strait.

Of 60 patients from the Western Province of Papua New Guinea, 15 had MDR-TB and mortality was high. Islands of the Torres Strait are only 5km offshore and villagers visit each other frequently.

"It's a difficult ailment to treat at the best of times, requiring four separate oral antibiotics staggered over six months," says Christopher Coulter, one of the study's authors. "The MDR-TB needs 18 to 24 months of expensive oral and intravenous treatment with last-line drugs. The doomsday scenario is a return to the days where you can't treat it, which is already happening in South Africa."

The report calls for urgent intervention to stop the spread of MDR-TB to the mainland.

Next month, the federal Department of Health and Ageing in conjunction with Queensland Health will co-ordinate the building of a TB laboratory and clinical management project to diagnose and treat MDR-TB in PNG.

The other killer is the community version of resistant golden staph, or methicillin-resistant staphylococcus aureus. Once confined to hospitals, where it kills up to 2000 compromised patients a year, the community version emerged across the world at the same time in the late 1990s.

In Australia, the so-called Queensland strain has a flesh-eating toxin and it is more virulent than the hospital version.

"Not only does the community strain have a Kevlar vest on, it also has this Exocet missile attached that destroys flesh," Collignon says.

To glimpse the hellish world where antibiotics are powerless against such vicious bugs, you just have to walk into Julie Gray's Sydney home. The ashes of her "beautiful, strapping young son" Reis sit in a polished wooden box on the mantelpiece, his precious guitar in a stand nearby.

A year ago this month, Reis had what everyone thought was a bad dose of the flu. The GP gave him antibiotics, but after three days he was taken to hospital.

"I just didn't like the colour of his skin," Gray recalls.

"At the hospital they found his pulse was so low, they had to put him on life support. Before he closed his eyes he asked me, 'Will I be OK, Mum?' I said, 'Of course you will.' But he never woke up. I just never thought a simple bug could kill a healthy 16-year-old who'd never been to hospital in his life." He died from the community version of MRSA: the flesh-eating toxin "just ate his lungs", Gray says, shaking her head in disbelief.

Community-acquired MRSA causes boils and abscesses, but in rare cases it can go to the lungs and kill, Collignon says.

"That is a real worry when one in 10 staph infections are now attributed to community-acquired MRSA," he says.

Now E.coli, the most common germ known to cause infection in humans, also has become drug resistant outside hospitals.

"They can defy almost every antibiotic," says David Paterson, an infectious diseases consultant to the Royal Brisbane & Women's Hospital and a world authority on so-called gram negative bacteria such as E.coli. "The bug produces enzymes called beta lactamase and they physically destroy antibiotics."

The overuse of antibiotics throughout the world has caused the problem, especially in developing countries, where you can buy second and third-generation antibiotics - the so-called last-line antibiotics - over the counter. Farm producers also feed them to chickens and pigs.

"In the US and Brazil, every chicken, before it has even hatched, is injected with a third-generation antibiotic," Collignon says. "The antibiotics aren't in the food, the resistant bugs are. So food, if not washed or cooked properly, can become a source of contamination." Collignon proved his point by culturing his own faeces before and after a recent trip to China. Despite being fastidiously clean, what he ate produced a drug-resistant strain of E.coli on his return.

With the international trade in food, the bugs have spread. In the US in 2006, Paterson, then with the University of Pittsburgh's school of medicine, cultured bacteria from chickens bought in a variety of supermarkets. Most carried the enzyme that makes them drug resistant.

Australia does not import fresh chicken and recent attempts by food producers to do so were quashed. We do, however, import fresh fruit and vegetables.

In a 2007 Australian Quarantine Inspection Service imported food survey, 97 samples were tested for E.coli.

"E.coli was detected in 14 samples, mainly in exotic leaf crops. These leaf crops are usually washed and/or cooked prior to consumption. E.coli was also found in some vegetables: taro, baby corn, asparagus and mushrooms. Again, these vegetables are generally washed and/or cooked prior to consumption. Health authorities in Australia recommend washing and cooking vegetables as a risk-mitigation step for the presence of micro-organisms, including E.coli," the report says.

Food Standards Australia advised at the time that the levels of E.coli found in the products would not seriously affect human health. But they were there nonetheless.

The other big problem is that there is little or no investment in future antibiotics, Collignon says.

"Antibiotics are a bad investment for drug companies. For a start, they are drugs that cure, so it's much better from a drug company's perspective to pour money into drugs that control symptoms for things like diabetes and heart disease, drugs that patients have to take for life," Collignon says.

Says Paterson: "Then you've got doctors like Professor Collignon and myself telling everyone not to take these precious drugs, keep them in reserve unless absolutely necessary." Antibiotics have been the one true miracle drug, stopping people from dying in large numbers. But the miracle is fast fading. Paterson likens the present climate to the heady, hedonistic days of the late 1970s.

"It is like San Francisco and Sydney in the late '70s, when no one gave thought to any controls over what we might do if HIV came along, but when that horrific epidemic happened, for many people it was too late."

Concerned Parents Seek Answers

ORLANDO, Fla. - Three new cases of MRSA have been reported, bringing the total throughout central Florida into the double digits.

Many parents are very concerned; one parent said that they have considered removing their child from school and home-schooling them. "I don't want to say it's an epidemic, but there's a breakout in Central Florida," said concerned parent Shannon Elkins.

The staph infection has spread throughout Orange County schools with the total now at five. Orange County schools have been taking swift actions to prevent the infection.

Superintendent Ronald Blocker contacted parents with this recorded message: "Hello parents, this is Orange County Schools Superintendent Ron Blocker. Some of you may have heard recent news accounts of Central Florida children contracting MRSA, a skin infection caused by the common bacteria known as staph," said Blocker.

One case is at Dover Shores elementary.

Principal Dr. Randall Hart sent a letter home to reassure parents. "We should be concerned about it, but we are doing everything we can to make sure that it's controlled here," said the Hart in the letter.

Two other cases are at Memorial Middle school and Pine Hills Elementary.

Elkins said she does not have much faith in the schools' efforts in preventing MRSA so she is doing what she can to protect her child. "We're doing our part to make sure that he's taking care of as far as hand washing, and not touching other kids with open wounds," said Elkins.

So far there has been one case in Marion Co., one case in Volusia Co., five cases in Orange Co., two cases in Osceola Co. and four cases in Brevard Co.

The best way to prevent MRSA is to keep good hygiene, wash hands frequently and clean cuts and wounds.
Dr. Jaime Carrizosa specializes in infectious diseases.

He said the 13 cases of MRSA that have hit Central Florida are not a surprise. Carrizosa said things could get worse if it's not managed properly, and the number of MRSA cases keeps increasing.

Peyton Manning's Staph Infection

Here is the scary note of today.

It turns out that part of the setback in Peyton Manning's recovery from his knee injury was a staph infection.

With the controversy over Kellen Winslow's medical problem and with Tom Brady reportedly having multiple procedures to clean out a knee infection, this has officially become an epidemic in sports.

Last week it was reported that Kenny George, the 7-foot-7 center for UNC-Ashville had part of his foot amputated from a staph infection complication.

George developed MRSA, a form of infection that could be life threatening and has become a particular concern in locker rooms.

Bob Kravitz of the Indianapolis Star reports that the Colts superstar had a staph infection attack his bursa leading to two procedures on his knee complicating Manning's return to the field.

"Staph infections are an issue across our country in all walks of life,'' NFL spokesman Greg Aiello told Kravitz. "Our medical staffs are well aware of the national issue. They heard a presentation on it in Indy at the combine in 2006 from the CDC (Centers for Disease Control). And our medical staffs have discussed it at other meetings over the past several years and have shared information on prevention and treatment of staph.''

THE COLTS STATEMENT JUST ADDED: “Peyton Manning developed swelling in his left pre-patella bursa in late February. The swollen bursa was treated conservatively beginning in February with drainage and anti-inflammatory medication. The first signs of infection occurred while he was in New Orleans in July. It should be noted that infection developed prior to any surgery. Upon manifestation of the signs of infection, he immediately had surgery to remove the bursa sac. Concurrently, he was treated aggressively with antibiotics, and the infection was eliminated. The second procedure (tacking of the skin to eliminate the bursal space) was designed to ensure the complete and swift resolution of the bursal problem. The procedure was successful.

The second procedure was in no way, shape or form, related to the infection. The second procedure did not delay his rehabilitation or recovery materially. It also should be noted emphatically that, at no time, did he have MRSA. It is clear from consultation with our physicians, including infectious disease specialists, that staph is a societal medical problem. There is no empirical evidence that indicates to our physicians there is a problem related to resistant staph (MRSA) with respect to the Indianapolis Colts.”

Here is at least some good news. Noted doc James Andrews says Tom Brady is getting better and Patriots dispute stories that they are mad at their QB.

Community MRSA Getting More Dangerous, CDC Says

By Anne Zieger

Until recently, the healthcare industry was primarily focused on fighting the spread of MRSA within hospitals and other health facilities. However, community-acquired MRSA is becoming increasingly common, and causing far more serious illnesses than in the past, according to a new study.

MRSA is increasingly showing up in settings like schools or among players on sports teams, according to a study by the CDC. To examine this trend, researchers tested samples of the most common community MRSA strain, USA300, in a network of hospitals in nine cities and states over the last few years.

The CDC study suggested that 10 percent of the common community strains of staph infection are now resistant to antibiotics, and not just penicillin and drugs of its type. These 10 percent could also evade clindamycin, tetracycline, Bactrim or other antibiotics. In some cases, antibiotics that are so old that their patents have expired are being pulled off the shelf to fight the staph infections. These drug-resistant staph bacteria cause 95,000 serious infections and 20,000 deaths every year.

Worse still, when these infections come into hospitals, they are able to swap gene components with other bacteria-and become even more drug resistant. Doctors are saying that it's becoming a major epidemic in this country.

Staph Germs Harder Than Ever to Treat


Drug-resistant staph bacteria picked up in ordinary community settings are increasingly acquiring "superbug" powers and causing far more serious illnesses than they have in the past, doctors reported Monday. These widespread germs used to be easier to treat than the dangerous forms of staph found in hospitals and nursing homes.

"Until recently we rarely thought of it as a problem among healthy people in the community," said Dr. Rachel Gorwitz of the Federal Centers for Disease Control and Prevention.

Now, the germs causing outbreaks in schools, on sports teams and in other social situations are posing a growing threat. A CDC study found that at least 10 percent of cases involving the most common community strain were able to evade the antibiotics typically used to treat them.

"They're becoming more resistant and they're coming into the hospitals," where they swap gene components with other bacteria and grow even more dangerous, said Dr. Keith Klugman, an infectious disease expert at Emory University. "It's really a major epidemic."

The germ is methicillin-resistant Staphylococcus aureus, or MRSA. People can carry it on their skin or in their noses with no symptoms and still infect others — the reason many hospitals isolate and test new patients to see if they harbor the bug. MRSA mostly causes skin infections. Cleveland Browns tight end Kellen Winslow was just hospitalized for a staph infection, his second in recent years, and the team reportedly has had at least six cases in the past three years.

But the germ can be life-threatening if it gets into the bloodstream, lungs or organs. Pneumonia, sinus infections and even "flesh-eating" wounds due to MRSA are on the rise, doctors reported Monday at an infectious diseases conference in Washington.

About 95,000 serious infections and 20,000 deaths due to drug-resistant staph bacteria occur in the United States each year.
To treat them, "we've had to dust off antibiotics so old that they've lost their patent," said Dr. Robert Daum, a pediatrician at the University of Chicago.

The CDC used a network of hospitals in nine cities and states to test samples of the most common community MRSA strain, USA300, over the last few years.

MRSA usually is resistant only to penicillin-type drugs. But 10 percent of the 824 samples checked also could evade clindamycin, tetracycline, Bactrim or other antibiotics.

"The drugs that doctors have typically used to treat staph infections are not effective against MRSA," and family doctors increasingly are seeing a problem only hospital infection specialists once did, Gorwitz said.

Even more worrisome: many of these community strains had features allowing them to easily swap genes and become even hardier.

Also at the conference:

Doctors from Spain reported the first hospital outbreak of MRSA resistant to linezolid, a last-resort drug sold by Pfizer Inc. as Zyvox in the United States and Zyvoxid in Europe. A dozen intensive care patients got pneumonia and bloodstream infections last spring and the outbreak was controlled after use of the antibiotic was severely curbed, said Dr. Miguel Sanchez of Hospital Clinico San Carlos in Madrid.

Georgetown University saw a spike in sinus infections due to MRSA. The germ accounted for 69 percent of the staph-caused cases in the hospital between 2004 and 2006 compared with 30 percent from 2001 to 2003.

Henry Ford Hospital in Detroit found that more than half of staph-caused pneumonia cases from 2005 through 2007 were due to MRSA.

Doctors from Case Western Reserve University and the VA Medical Center in Cleveland found that by the time hospitals isolated and tested new patients to see if they harbored MRSA, many had already contaminated their skin and surroundings. Within about a day of being admitted, roughly a third had already started to spread the germ.

Hospital screening is controversial, and has had mixed success, said Dr. M. Lindsay Grayson, an infectious diseases expert at the University of Melbourne in Australia.

The nation's Veterans Affairs hospitals began universal MRSA testing in 2007. Illinois and some other states have adopted or are considering laws requiring hospitals to test high-risk and intensive-care patients for MRSA.

The conference is a joint meeting of the American Society for Microbiology and the Infectious Diseases Society of America.

NFL Stars No Match for Bacteria

By Elizabeth Landau

A 6-foot-4 football player is more than a million times the size of a typical Staphylococcus bacterium. But under the right conditions, that athlete could find himself defenseless against the microscopic bug.

Kellen Winslow recently had a second staph infection and has accused his team of covering it up.

The problem came to the forefront last week with Cleveland Browns player Kellen Winslow, who recently had his second staph infection. He is reportedly the sixth player to acquire staph among the Browns in five years.

Winslow recently said the Browns treated him like a "piece of meat" when he was hospitalized for the condition, and he claimed they covered up the cause of his illness.

After Winslow spoke out, the organization suspended him for one game, then rescinded the suspension after a settlement with Winslow over the weekend. The Browns said in a statement Saturday that the team and Winslow had worked through their differences, and that the team looked forward to his return. Winslow joined the team again Monday.

Peyton Manning of the Indianapolis Colts was revealed to have a staph infection, the Indianapolis Star reported Friday. University of North Carolina-Asheville fans also recently learned that Kenny George, the 7-foot-7 center on the basketball team, had a staph infection complication that led to part of his foot being amputated.

It's unclear how these high-profile athletes acquired their infections, but locker rooms have been found to habor staph bacteria in previous outbreaks. The topic is generating buzz throughout the sports world as more players' staph cases are revealed. Hospitals have long been known to be hot spots for transmitting staph, but recently cases have cropped up in other community settings. Regardless of where these players got their infections, the close quarters of a locker room raise questions about overall risks.

About 30 percent of people carry staph in their noses without exhibiting symptoms, according to the Centers for Disease Control and Prevention.

Experts say Methicillin-resistant Staphylococcus aureus, or MRSA, a form of staph resistant to common antibiotics, has become a more prevalent problem in settings such as contact sports that involve skin-to-skin touching.

Most MRSA infections acquired in community settings present themselves as sores or boils and often appear red, swollen, painful or with drainage such as pus, the CDC says. Infections often occur in cuts and abrasions but also on body parts covered in hair, such as the back of the neck, armpit or groin.

Schools, prisons and other crowded environments are particularly known for transmitting MRSA, said. Elaine Larson, professor of epidemiology at Columbia University's Mailman School of Public Health.

MRSA may spread particularly easily among athletes because they have repeated skin-to-skin contact, share items and surfaces that touch skin and have a hard time staying clean, the CDC says. Athletes often get cuts and abrasions; MRSA can enter uncovered skin breaks and cause infection.

Dr. James Steinberg, medical director at Emory University's Crawford Long Hospital in Atlanta, Georgia, said that environment plays a role in the spread of MRSA but that it's less a factor than coming into contact with a person's skin.

"If you have somebody who has an infection -- he has a draining infection -- and he gets some of his pus on a bench, that staph's going to be there for hours or days before it dries out," he said. "But the higher concentration is going to be on that person's skin."

A second infection in the same person could result from re-exposure or from treatment that didn't get rid of the bacteria colonization, he said.

MRSA has been around in hospital settings since the 1970s, but community-associated MRSA was born in the late 1990s, and is now widespread in the community, said CDC spokesperson Nicole Coffin. A report from the CDC said that the deaths of four children from MRSA in North Dakota and Minnesota during the late 1990s "demonstrate the potential severity of community-acquired MRSA infections."

A study on the St. Louis Rams published in the New England Journal of Medicine in 2003 found that during the 2003 football season, there were eight MRSA infections among five of the 58 Rams players.

To protect against MRSA, the CDC recommends practicing good personal hygiene and taking care of your skin, which includes wearing protective clothing and covering cuts and abrasions with clean, dry bandages. Also, do not share items that come into contact with your skin, such as towels, razors and ointments. Put something between your skin and shared equipment -- for example, sit on a towel on a bench.

Larson said she is not directly familiar with Winslow's situation but understands the dilemma that a team would face if a player contracted a staph infection. There could be economic and psychosocial repercussions -- for example, another team might not want to play against that one, she said.

But in general, other team members should be made aware of the situation so they do not share towels or engage in other behaviors that might transmit the infection.

Still, there is a danger of overreaction, she said. In some instances when a child in a public school has died, the whole school panicked and fumigated the facility, she said.

"It's a good idea to avoid that level of fear, because it's costly and it scares people unnecessarily," she said.

On Thursday, the Brown's General Manager Phil Savage said the team did not alert players to Winslow's staph infection partly because of the health privacy laws and partly because the team was in "game mode" when Winslow had a confirmed diagnosis.

"To come out and talk about that just was going to be another distraction," Savage said on his regular weekly appearance on WTAM radio in Cleveland, Ohio. "That's our job, is to limit distractions as much as we can."

Winslow said in a statement released through his publicist, Denice White of EAG Sports Management, that he had been discouraged from making the issue public.

"This has nothing to do with football, and this has nothing to with my current contract situation," he said. "This is a health concern."

A spokesperson for the Browns did not return a request for comment. An NFL representative said the league has no statement on the issue.

MRSA and Flu Can Overlap into Pandemic Proportions

The importance of MRSA in a flu pandemic by Maryn McKenna
Excerpted from her blog.

Constant readers will know that, in another part of my life, I write a great deal about seasonal and pandemic influenza, a subject I've been following since writing the first story in the American media about avian influenza H5N1. And people concerned about MRSA realize that flu and MRSA have an important overlap. For decades, long before the emergence of MRSA, staph was one of the most important contributors to secondary bacterial pneumonia, which occurs after the flu virus has damaged the lung tissue and allows staph and other bacteria to take hold.

In the past few years, we've been reminded of this interaction because of the shocking rise in cases of necrotizing pneumonia caused by MRSA. Twice in the past two years, the CDC has asked state health departments to report any cases of flu/MRSA co-infection; in the 2006-07 flu season, 22 children died from MRSA necrotizing pneumonia secondary to flu.

Comes now one of the giants of staph research to warn of an unconsidered danger of MRSA: as a contributor to deaths in a flu pandemic. Dr. Theodore Eickhoff, who wrote some of the earliest papers on hospital-acquired staph infections, has written an assessment in Infectious Disease News of two new pieces of research into deaths during the 1918 flu pandemic. Both papers contend that it was bacterial pneumonia that was the major killer in that global storm of death, and not the novel flu virus itself.

Eickhoff looks forward from those findings to consider what havoc a new pandemic could wreak in this era of massive MRSA transmission. He contends that national planning for pandemics — a huge effort and expense for the US and other governments over the past few years — has paid insufficient attention to the possibility that bacterial infection will be as significant a danger as whatever new flu has emerged:

Authors of both of these reports point out that their findings have important implications for pandemic preparedness today. U.S. preparedness policy, and indeed that of almost all other countries, has been focused on preventing or modifying influenza virus infection itself. Thus, vaccine development and anti-viral drugs (eg, neuraminidase inhibitors) have been the major efforts, and a great deal of stockpiling has already taken place.

Clearly it is equally necessary to stockpile antibiotics effective against primarily community-acquired organisms causing post-influenza pneumonia today, including both MSSA and MRSA. Much more consideration needs to be given to the possible role of pneumococcal and possibly other bacterial vaccines as part of pandemic preparedness.

Flu Shot Might Have Prevented MRSA Pneumonia

College student dies of rare ailment; MRSA pneumonia case brings warning

A college student in Whatcom County died from a rare case of MRSA pneumonia -- prompting health officials to urge state residents to be vigilant about their health and to get a flu shot if they haven't.

Chris Feden, 20, a student at Western Washington University, died from what county health officials said was MRSA pneumonia, a rare staph infection that he may have contracted after getting the flu.

Separately, an 18-year old Pacific County resident died from respiratory failure, which wasn't caused by MRSA pneumonia, although it was believed to have been flu-related.

Respiratory illnesses, including the flu, typically peak in Washington in February and March and can be serious and even fatal. Cases of MRSA -- methicillin-resistant staph aureus -- are increasing in number nationwide, including in Washington, and can complicate influenza and other respiratory illnesses.

MRSA pneumonia, a relatively new infection that wasn't on national health officials' radar until about five years ago, is rare, but it may also be on the increase, health officials say.

MRSA infections have been common in health care settings for decades, and in recent years have spread into the community at large, particularly in relatively crowded facilities.

Although MRSA can be deadly, the infection itself is relatively common, and most people show no symptoms. The bacteria can be living in the nose and not cause problems.

But if an infected person catches the flu or other severe respiratory illness that becomes pneumonia, the lungs are weakened and people can infect themselves by inhaling the MRSA they already carry.

MRSA pneumonia first gained attention during the 2003-04 influenza season, when 15 cases linked to the flu were diagnosed across the country, according to the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report from April 2007. No formal surveillance was conducted, and few additional cases of MRSA pneumonia were reported to the CDC between the 2004 and 2006 flu seasons.

Between December 2006 and January 2007, there were 10 reported cases of severe MRSA pneumonia, including six deaths, in previously healthy children and adults in Louisiana and Georgia.

No statistics are kept for MRSA pneumonia in Washington, the state Health Department said.

"It's a combination of a community-acquired infection and flu season," said the state's health officer, Dr. Maxine Hayes. "It can cause catastrophic events, which is what happened to this young man," she said, referring to Feden. "Influenza is serious, and sometimes people think it's just a bad cold, but here we have a staph infection superimposed to that."

"Now we have MRSA and now we have more complications, and it's a killer."

Hospitals can test for MRSA through a nasal swab culture or a culture from a wound, which yields results in an hour or a few days, depending on which test is used.

Though MRSA is contagious through human contact, local public health authorities said the risk of MRSA infection to members of the Western Washington campus is very low.

"While this is a tragic loss of a young life, and our thoughts are with the family and friends of this young man, there is no evidence of an outbreak of severe MRSA in our community. This appears to be an unusual and random event," said Dr. Greg Stern, the health officer for Whatcom County.

The state Health Department is providing support to health officials in Whatcom and Pacific counties while they investigate the deaths. Health Secretary Mary Selecky said people should be aware that are in the middle of flu season, and while it has been an average one in Washington so far, getting a flu shot is still recommended, and it's not too late.

As for MRSA, simple steps such as covering coughs, washing hands and alerting a physician if there is a history of MRSA infections help reduce infection, she said.

"MRSA pneumonia is uncommon in this country, but we're still in flu season, and it can lead to pneumonia."

Feden's death, she said, "is an unfortunate reminder of the seriousness of the disease."


Methicillin-resistant staph aureus pneumonia is a relatively new and rare infection described as pneumonia with complications of MRSA, which is a common bacterium resistant to antibiotics.


How do you get it? A victim already has a MRSA infection, which may or may not make him sick. The victim then gets influenza or another severe respiratory illness that turns into pneumonia. The MRSA infection spreads to the weakened lungs, resulting in MRSA pneumonia.

How is it spread? MRSA is commonly spread by direct human contact. Although flu can spread from a sufferer, MRSA pneumonia is not an airborne disease and is not contagious.

How common is it? MRSA pneumonia is relatively new, and there are no statistics in Washington and no formal U.S. surveillance. Nationwide, there were 15 cases during the 2003-2004 flu season and 10 cases, including six deaths, between December 2006 and January 2007 in Louisiana and Georgia, according to the Centers for Disease Control and Prevention.

How deadly is it? MRSA pneumonia often affects young, otherwise healthy people and can be fatal. The patients who died did so within three to five days of the onset of respiratory symptoms. MRSA should be suspected in people with severe pneumonia, especially during the influenza season, and in those with a history of MRSA infection, according to the CDC.


For more information about MRSA, visit the state Health Department's Web site at or the Western Washington University MRSA information page at

P-I reporter Cherie Black can be reached at 206-448-8180 or
Read her To Your Health blog at

Jump Seen in Staph-Linked Flu Deaths in Kids

By LINDSEY TANNER , AP Medical Writer, Medicine & Health / Health

(AP) -- More children have died from flu because they also had staph infections, according to a new government report that urges parents to have their kids get the flu shot. The number of deaths wasn't high - 73 during the 2006-07 flu season - but there was more than a fivefold increase in hard-to-treat complications. And preliminary figures indicate deaths rose again during this past winter's flu season.

Public health officials say the numbers underscore the importance of a brand new recommendation that all children, from 6 months through 18 years, get routine flu shots. Before this year, shots were recommended for kids under 5 years.

More than half the children who died were between ages 5 and 17 and had been healthy until they got the flu.

Parents shouldn't panic, "but it's an important message to say even healthy children develop complications and die almost before anything much can be done for them," said Dr. Gregory Poland, a Mayo Clinic infectious disease specialist. He was not involved in the federal study, but has worked with a federal vaccine advisory committee and has consulted for vaccine makers.

Flu season is just beginning, and this year's vaccine should be widely available this month.

While few children die from the flu virus, it puts about 20,000 U.S. kids in the hospital each year.

Only 6 percent of the children studied who died had been fully vaccinated against the flu. Two doses are recommended each flu season for children ages 6 months to 8 years who have not been vaccinated previously; for older kids, just one dose a year is needed.

The study, appearing in the October edition of Pediatrics for release Monday, is based on an analysis of reported flu deaths from the 2004-05 through 2006-07 seasons. Flu deaths in children during those seasons totaled 47, 46 and 73, respectively.

The percentage of those who also had bacterial infections jumped from 6 percent to almost 36 percent. Most had staph infections, and 60 percent of those involved the dangerous MRSA bug, which is resistant to antibiotics.

More recent data suggest flu deaths among children have continued to rise, with 86 tallied for the 2007-08 season in a preliminary report last month, said Lyn Finelli, the study's lead author, who is a researcher for the Centers for Disease Control and Prevention.

Preliminary information also suggests there has been no drop in fatal flu-staph cases in children, and those could still be on the rise too, she said.

Staph germs commonly live in the nose or skin without causing illness; more than one-fourth of U.S. children and adults carry them.

These bugs can become deadly when they get into the bloodstream, sometimes through wounds. The flu is thought to make people more susceptible to bacterial infections like staph, Finelli said.

Details on how children in the study died were not available, but some developed bacterial pneumonia, seizures and shock.

Finelli said parents should take children to the doctor when they have flu symptoms and signs of other complications. These could include extreme fatigue, no thirst, or in older children complaints about feeling very ill.