Death Toll from MRSA Spotlights
U.S. Public Health Crisis
Oct. 20, 2007 (EIRNS)A new report in the Oct. 17 JAMA (Journal of the American Medical Association) on the U.S. extent of MRSAmethicillin-resistant Staphylococcus aureusstates that MRSA deaths in 2005 were an estimated 19,000, exceeding that of HIV/AIDS. At the present rate of infection, an estimated 90,000 Americans are sickened each year from the superbug, which pathologists first identified in the 1960s as a virulent strain of staph. The study was done by the Centers for Disease Control and Prevention (CDC).
The bacteria can be spread by skin to skin contact, or sharing an item with an infected person, particularly with an open cut or wound. It can be carried on the skin or in the noses of healthy people, and transmitted to others. Good anti-microbial sanitation can contain the microbe; and fast diagnosis and treatment can likewise save lives, but with the HMO-era decline in the hospital system, and takedown of the public health system in particular, these practices no longer obtain.
Outbreaks of MRSA are currently present in several areas, including suburban Washington, D.C. In Bedford, Virginia, one teen died last week. Several school systems in the D.C. suburbs in Maryland and Virginia have closed facilities in order to sanitize them. A pre-school age child died in New Hampshire; and an eleven-year-old in Mississippi. Schools in those areas are likewise shut for cleaning. Other states hit recently are New York, Connecticut, Indiana and West Virginia.
Some years ago, hospital-associated MRSA, or H-MRSA was the most common manifestation of the infection, connected to contamination in surgical and other medical treatment situations. But in recent years, community-associated MRSA (C-MRSA) has spread widely, referring to sports locker rooms, dormitories, prisons, and similar venues of transmission. A pilot project based in Pittsburgh, Pennsylvania facilities, including the Veterans Administration and Allegheny General Hopsital, showed that if infrastructure and means are present, the rate of H-MRSA can be reduced to near zero. But the progams have not been generalized.
Until recently, MRSA was not even an infection classifed as "reportable" to the Centers for Disease Control system. In the overstretched and underfunded state public health departments, there has been traditionally no mechanism for surveillance of such diseases. Hospitals may or may not bring attention to drug-resistant organisms spreading in their midst. Only yesterday, Virginia Gov. Tom Kaine (D) ordered his state to now keep track of MRSA.
The new CDC report in JAMA is the result of its focus on MRSA infection rates in nine states, under its program to survey invasive bacteria called, Active Bacterial Core Surveillance Network. Patterns in the states (California, Oregon, Minnesota, Colorado, Connecticut, Maryland, Georgia, Tennessee, and New York) were used to model trends and rates of infection for the rest of the U.S. Whether their modelling is accurate remains to be seen. The highest rates of MRSA infection, including both community and health-care acquired forms, were seen in Baltimore, where rates were over twice that of any other area, at almost 117 cases per 100,000 people. This data were thrown out of the statistical analyses as an "outlier"! But, as LPAC has written of the "death zone" phenomenon of Baltimore, this could be the crucial anomaly indicating future trends as health-care infrastructure crumbles.
Yet another superbug is being brought out of Iraq. Multidrug-resistant Acinetobacter baumannii, which has been found in hundreds of troops injured in the Iraq and Afganistan combat zones, is now to be found in several military and civilian hospitals in the U.S., including beleaguered Walter Reed Hospital.