Tough New Superbug Known To Athletes Spreading Openly Across US And Now Canada

Clones of the antibiotic-resistant MRSA superbug which has infected a number of professional football and baseball athletes as well as children in day care centres in the US is set to take Canada by force.

This warning was issued in a pubic health commentary published in the Canadian Medical Association Journal yesterday.

Officials from various health institutions in Canada, including the Department of Infectious Diseases, and the The Hospital for Sick Children, Toronto, say they do not wish to alarm the public, and that by following some simple hygiene procedures the epidemic can be minimised. However, while the public's attention is on the threat of a flu pandemic, a new MRSA mutant is quietly spreading outside of public awareness.

Until now MRSA, short for Methicillin-Resistant Staphylococcus Aureus, has normally been associated with hospitals. However, the new strain of bacteria, which has been termed CA-MRSA (Community Associated MRSA) is starting to emerge outside of the hospital environment, for instance in locker and changing rooms of sports facilities and in childcare centres.

The health officials call the new strain of MRSA "an old foe with new fangs", a pathogen that combines "virulence, resistance and an ability to disseminate at large". Usually MRSA preys on vulnerable people like the elderly and people recovering from serious operations in hospital, but this new strain is infecting healthy people as well.

Once it gets into the body MRSA, or "Staph A" as it is commonly referred to, usually erupts as a minor skin ailment like a boil or a pimple, impetigo (honey -coloured crusted lesions) inflammation and irritation of wherever there is soft tissue like around the fingernails (paronychia). If untreated the milder symptoms can become more deepseated and lead to pneumonia, blood infections, toxic shock, septic arthritis, bone infections, and other, in some cases fatal, conditions.

Healthy people carry the bacteria around with them all the time, in their nostrils and on the skin. So infection is through skin to skin contact or sneezing in warm damp or steamy areas with people close to each other such as public showers, changing rooms, whirlpools, and locker rooms.

Last year a number of professional athletes, wrestlers and football players were infected with MRSA. And since 2003 three US National Football League (NFL) teams have reported multiple infections of the superbug. The Washington Redskins had their whole training facility cleaned and disinfected. Another club replaced benches with individual stools in the locker rooms.

The US Center for Disease Control (CDC) and the NFL and other sporting associations have teamed up to issue straightforward hygiene guidelines to fight the spread of the bacteria.

These include reporting cuts and abrasions, cleaning them with soap and water and applying a dressing, and wash hands frequently. Also, shower well with soap after playing contact sports. Be sensible about even small open sores on the skin - don't get into whirlpools or plunge pools that are shared with lots of other people until the soreness has cleared up.

According to the Canadian Department of Infectious Diseases, those most at risk of contracting CA-MRSA include: athletes and contact sports players, children under 2, minority populations such as African-American or Native American, intravenous drug users, men who have sex with men, people serving in the armed services, prison inmates, pet owners, farmers and veterinarians.

Advice to childcarers is the same as that for schools. Teach children to be aware of where germs come from, not to pick up things from the floor and put in their mouths, to wash hands after using the toilet, playing with pets, after sneezing (particularly a really wet one!) or doing sports and being outside. Also, keeping surfaces and objects that come into contact with lots of hands free of germs - like wiping doorknobs and toilet flushing handles with disinfectant every day. These are all common sense basic personal and household hygiene - as our mothers always told us.

"Community-associated MRSA: Superbug at our doorstep."
Michael Hawkes, Michelle Barton, John Conly, Lindsay Nicolle, Clare Barry and Elizabeth L. Ford-Jones.
CMAJ. January 2, 2007; 176 (1). doi:10.1503/cmaj.061370.