Flu Shot Might Have Prevented MRSA Pneumonia

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

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."

WHAT IS MRSA PNEUMONIA?

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.

ABOUT MRSA PNEUMONIA

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.

MORE ONLINE

For more information about MRSA, visit the state Health Department's Web site at goto.seattlepi.com/r1087 or the Western Washington University MRSA information page at www.wwu.edu/mrsa.

P-I reporter Cherie Black can be reached at 206-448-8180 or cherieblack@seattlepi.com.
Read her To Your Health blog at blog.seattlepi.com/toyourhealth.