KILLER RASH BREAKS OUT

New York Post ^ | May 30, 2004 | Sam Smith

[Dont Mention the War]

KILLER RASH BREAKS OUT

By SAM SMITH

May 30, 2004 -- EXCLUSIVE

A vicious skin infection resistant to all but the most powerful antibiotics has jumped out of New York City hospitals and onto the streets.

The "superbug," as health officials refer to it, can cause anything from reddening of the skin, to abscesses, tissue loss, amputation or even death in severe cases, doctors said.

For decades confined to hospitals, where it preyed on patients and built up immunity to antibiotics, the bug - known officially as Methicillin Resistant Staphylococcus Aureus or MRSA - has also grown in strength.

"Usually with infections you need a break in the skin to pass it," said Dr. Howard Grossman, who has a private practice in Chelsea.

"Not with this. It gets through unbroken skin with casual contact."

The city Department of Health first detected the infections outside hospitals early last year, according to health officials.

[Born Conservative]

Opportunistic infection ping

[BurbankKarl]

is this the ash-rash? they have had this in LA County Jail for the past two years...

yech

[steve86]

it's showing up in the gay community.

It's showing up in all communities. Someone mentioned in another thread today that one or two resistant staph infections are always present even in little rural hospitals.

[Dont Mention the War]

(Emphases below mine.)

---

VOLUME 3, ISSUE 305 | January 29 - February 04, 2004

HEALTH

NY Doctors Report Staph Spread

Health providers unsure if infections indicate a crisis or limited incidences

By DUNCAN OSBORNE

New York City gay men are apparently in the grip of an outbreak of antibiotic resistant bacteria of the kind that affected dozens of gay men on the West Coast in late 2002 and early 2003.

Dr. William Shay, who is one of four internists in a Manhattan practice, estimated that he and his colleagues had seen roughly 50 cases of methicillin-resistant staphylococcus aureus (MRSA) skin infections since the summer of 2003. “You can have two or three a day and then none for a while and then several per week,” Shay said. Roughly half of the infections were “very minor” requiring treatment with antibiotics while others were more serious and required a more aggressive intervention. None of the clients with MRSA had to be hospitalized.

Other doctors who see large numbers of gay men in their practices reported seeing MRSA cases beginning last summer.

“I have seen a slow, steady number since last year,” said Dr. Howard Grossman. “There doesn’t seem to have ever been a huge outbreak.”

Grossman estimated that he was seeing one case “every couple of months” and some of the infections may have been acquired during travels outside New York City.

Dr. Frank Spinelli, a physician in private practice, told Gay City News he saw a cluster of cases in the summer of 2003, but only two recently. One of those two recent cases came in 2004.

Dr. Joseph G. Olivieri, medical director for primary care at the Ambulatory Surgery Center of Brooklyn, reported seeing two cases since last July. Both men required treatment with antibiotics and outpatient surgery.

“They were very serious,” Olivieri said. Dr. John Montana reported just one recent case.

Usually, MRSA infections occur in medical settings, but beginning in the 1990s MRSA started to appear outside of hospitals in so-called community outbreaks.

“It seems to be that the overall case numbers are going up,” said Dr. Barry Kreiswirth, director of the Tuberculosis Center at the Public Health Research Institute. “We don’t understand why.”

There have been MRSA outbreaks among school children, prisoners and athletes. Part of the reason for the increase may be that doctors, who may not want their practice associated with the bug, are more comfortable reporting cases.

“Even with that said I still think the overall numbers are going up and definitely in many, many different settings,” Kreiswirth said. “The number of these cases is definitely rising.”

Unlike the resistant bacteria found in hospitals, MRSA in community outbreaks is usually resistant to just one type of antibiotic.

“These particular strains that are causing these community acquired clusters are easy to treat,” Kreiswirth said.

Following the West Coast outbreak the city health department investigated the possibility of an MRSA outbreak in New York, but by March of 2003 it appeared that the city had seen no more than three cases among gay men.

Two of those three cases were reported by the Callen-Lorde Community Health Center in Chelsea. Dr. Dawn Harbatkin, the center’s medical director, did not respond to calls asking if the center had seen any additional MRSA cases since early 2003.

The MRSA problem among gay men is not limited to New York City and Los Angeles.

In February of 2003, the Centers for Disease Control and Prevention held a conference call to discuss MRSA with seven health clinics across the country that serve predominantly queer populations. The federal agency learned during that call that clinics in Houston and Boston were also seeing MRSA cases, according to Nicole Coffin, a CDC spokesperson.

Since then the CDC has become “aware of clusters of men who have sex with men” across the country who were contending with MRSA infections, according to Coffin.

Government health officials are hampered to an extent in their efforts to track MRSA because doctors are not required to report it like other infections such as syphilis or HIV.

MRSA usually appears on intact skin as a pimple, but it will quickly grow larger, more inflamed and more painful. The infection can occur anywhere on the body. While MRSA can be easily cured, it must be treated immediately. If left untreated, MRSA can cause serious health problems including death. People who think they may have an MRSA infection should contact their doctor, Callen-Lorde at (212)271-7200, or go to a hospital emergency room.

[Southack]

27th March 2001

According to my colleague who is a microbiologist and the infection control team at our hospital, survival of Methicillin-resistant Staphylococcus aureus (MRSA) depends upon the size of the population present - the larger the number of bacteria present the greater the potential for survival - and the availability of a suitable medium to support survival.

Given that there are a number of strains of MRSA it is only possible to give a general guide. It appears the organism may survive, in a domestic environment, for anything from 3-4 days to several months. Skin scales which have been shed and lodge in floor coverings may favour survival for a period of 6 months or more.

At this point I feel it is important to stress that if an individual's external body defences are intact the risk of MRSA actually being responsible for causing any infection must be very small. Added to this, even during MRSA outbreaks within hospitals the yield from the environment is apparently small. Cultures taken from a hospital environment have generally proved negative during outbreaks except in burns units (Crossley et al, 1979). When an outbreak of MRSA occurs, it is not common for healthcare staff to become infected. Rather they more commonly become colonised in the nose. The likelihood of staff colonisation is low and appears to be related to the amount of patient contact (Mackenzie and Edwards, 1997).

[ladyinred]

Oh really? Is it also being passed to others though? Sounds terrible! What next?

[Dont Mention the War]

It's showing up in all communities. Someone mentioned in another thread today that one or two resistant staph infections are always present even in little rural hospitals.

The article is not talking about the existence of MRSA. It is alleging the general spread of MRSA outside of hospitals. And that is untrue. It is starting to spread, but not amongst the general population.

[steve86]

It is starting to spread, but not amongst the general population

You are wrong. Read any dermatological or epidemiological publication.

Example:

In a case-control study, Dr. Coffin and coinvestigators identified 447 cases of community-acquired MRSA between 2001 and 2003. Of that group, 134 cases (30%) of infections were due to MRSA. There was no change over time in incidence of MRSA in invasive infections; however, MRSA incidence rose sharply in children with soft tissue S. aureus infections, from less than 20% in 2001 to nearly 50% in 2003, although the investigators qualified this finding by the risk of possible referral bias or other factors.

Are you saying these community-acquired cases in children are not the general population?

http://www.medscape.com/viewarticle/474245

[dandelion]

Raw Honey seems to work against MRSA, for some reason - I don't know why they aren't pursuing this as treatment...

http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12171686

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14633019&dopt=Abstract&itool=iconabstr

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=32305

http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2672.2003.02050.x/abs/

[AntiGuv]

I guess you missed this part:

There have been MRSA outbreaks among school children...

[steve86]

Honey is good for many types of skin infections. And the Russians (I believe) have done a good deal of work with garlic concoctions (including topical ointments) against MRSA.

[dandelion]

Maybe it's time to go to Whole Foods and get a big ol' tub of raw honey... and a braid of garlic, just in case!

[steve86]

I've already got them, dandy.

[Dont Mention the War]

You are both right. I screwed up. I've asked the admins to yank my more conspiratorial parts of the original post.

[AntiGuv]

OK, cool deal. No biggie! I think there are some legitimate questions about why MSRA outbreaks have popped up amongst gay men - and what, if anything, this might signify for the community at large - but that's still a quite peripheral concern to the greater problem of how they've begun slipping out of hospital settings.

[endthematrix]

Yeah, but PETA says that is bad...

Bee Products:
Produced by bees for their own use. Bees are selectively bred. Culled bees are killed. A cheap sugar is substituted for their stolen honey. Millions die as a result. Their legs are often torn off by pollen-collection trapdoors.

[Boundless]

> Raw Honey seems to work against MRSA, for some reason ...

I'd be inclined to try Australian Tea Tree Oil, the distilled oil of the Melaleuca alternifolia plant.

Be sure to use a medicinal (not aroma-therapy) grade, and look for a statement of compliance with either Australian Standard AS 2782-1997 or the International Standard ISO 4730.

[Boundless]

> I'd be inclined to try Australian Tea Tree Oil...

Well, well; look what I stumbled into.
http://www.coldstream-plantation.com.au/about.html

"Current in-vitro results suggest Australian Tea Tree Oil may be useful in the treatment of methicillin resistant Staphylococcus aureus (MRSA) carriage within hospitals."

This is not an endorsement for Coldstream, as I've never used anything of that brand.

[steve86]

I tried Australian Tea Tree Oil on a small open lesion but it stung badly. Maybe there are other formulations that don't have the bite. Could have been the concentration was too high.