Flesh Eating Virus Infection: Can You Catch It in Public Places? It’s really a frightening prospect that’s almost like something straight out of a sci-fi thriller.
Bacterial strains colonize the skin and membranes of your nose and remain benign but stealthy colonizers there until they come into contact with, maybe a surgical wound in a person who’s just had a transplant and who’s taking immunosuppressant to prevent the transplanted organ from being rejected.
Suddenly, they unleash a tissue-eating infection that spreads quickly, rotting the patient’s skin, heart cavities, and tissue of the lungs or spread to the bone marrow or the blood. The patient dies.
However movie-like that may sound, it’s sadly, a real ailment. Methicillin-resistant Staphylococcus aureus bacteria or MRSA are strains of a familiar bacteria that have mutated to become resistant to the most common antibiotics, including all penicillin antibiotics.
A simple ‘Staph’ bacteria can cause a range of illnesses from skin infections like pimples, boils and abscesses to serious diseases such as pneumonia, meningitis, toxic shock syndrome and septicemia. But
MRSA is much more frightful because it’s the bacteria now resistant to a range of common antibiotics.
And it’s this disease that’s been giving people in the United Kingdom a big scare these past few weeks.
At the start of February, British tabloids alarmed commuters when they warned that coughing and sneezing on crowded trains and buses could spread a deadly “flesh-eating superbug.”
The Metro, The Daily Mail, and other British tabloids claimed that a dangerous, highly infectious, and new form of community-acquired MRSA had emerged. The new strains of bacteria, the tabloids claimed, were “more virulent than the infamous hospital-acquired MRSA were “spreading across Britain.”
“Flesh-eating bug that you can catch on the bus or train is spreading in the UK,” screamed The Daily Mail’s headlines. The Metro said, “Flesh-eating bug USA300 spread by sneezes and coughs.”
As quick as the bacterial infection was supposed to be spreading, news spread like wildfire across the U.K.
The National Health Service, the U.K.’s national health provider, was quick to douse public panic, pointing out that the tabloid coverage was “alarmist” and “overblown”—and had taken a new study out of unwittingly or deliberately out of context. (See: Flesh Eating Virus in the UK.)
But what exactly is MRSA? Are their new and more dangerous strains? Should we worry? Can we do anything to protect ourselves?
Found worldwide but benign
MRSA strains of bacteria can be found almost anywhere in the world. That’s no cause for alarm because generally, people don’t get serious infections from MRSA when they’re healthy, their immune system is working well, and they have no cuts, abrasions, or breaks on their skin.
But even so, colonies of Staph bacteria live quietly in the mucous membranes and the skin in about one in every 100 persons—who then pass it on to others. MRSA bacteria can be passed from person to person by direct contact with infected skin, mucus, or droplets spread by coughs.
And yes, it can be picked up in crowded buses — indirect contact also can spread the bacteria. Touching things like towels, utensils, clothing, door handles, sinks or floors that have been in contact with an infected person can spread the bacteria to other uninfected individuals.
Careless antibiotics use
From being simple ‘Staph’ bacteria, they’ve mutated into MRSA because of the careless use of antibiotics.
“Each time a person takes an antibiotic, especially if they don’t finish the course, any bacteria with a mutation that gives them resistance to that drug, survives. Then the survivors go on to multiply, so spreading that resistant mutation throughout the bacterial population,” explains an interactive report on MRSA published by The Guardian.
About two years after the antibiotic methicillin was initially used to treat S. aureus and other infectious bacteria in 1961, doctors first took note of MRSA.
By then, the Staphylococcus bacteria had developed a resistance to methicillin by mutating a penicillin-binding protein coded for a mobile genetic element termed the methicillin-resistant gene (mecA). Over the next five decades , the gene continued to evolve, so that today, many MRSA strains are resistant to many different antibiotics like penicillin, oxacillin and amoxicillin (Amoxil, Dispermox, Trimox).
As The Guardian noted, hospitals can be breeding grounds for MRSA. As many as one in four patients colonized with MRSA in acute wards suffer a serious MRSA infection.
Health experts classify MRSA infections as community acquired (CA-MRSA) or hospital- or health-care-acquired (HA-MRSA).
Hospital HA-MRSA are often also resistant to tetracycline (Sumycin), erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), and clindamycin (Cleocin).
Worse, research in 2009 showed that many antibiotic-resistant genes and toxins are bundled and transferred together to other bacteria, which speed the development of toxic and resistant strains of MRSA.
Most CA-MRSA starts as skin infections. But HA-MRSA abound because there’s more open sites for the bacteria to attack in people who are already sick—the infection often starts in at the surgical site, or in IV lines, catheters and other location where medical devices are placed.
Outside the healthcare setting, MRSA doesn’t develop as much as the tabloids would want us to think.
Skin tissue in normal people usually protects against MRSA infection. But if there are cuts, abrasions, or other skin flaws such as psoriasis (a chronic inflammatory skin disease with dry patches, redness, and scaly skin), MRSA has a foothold from which to spread its vicious infection.
The antibiotic resistant Staph can then go on to infect the heart, causing endocarditis, or become the flesh-eating infection necrotizing fasciitis, or cause fatal blood or bone marrow poisoning (osteomyelitis or sepsis)—leading to death.
What are the signs of MRSA?
Skin diseases are often the first sign of an MRSA infection:
• cellulitis, an infection of the skin or the fat and tissues that lie immediately beneath the skin that usually starts as small red bumps in the skin
• boils, pus-filled infections of hair follicles
• abscesses, collections of pus in under the skin
• sties, infections of the eyelid gland
• carbuncles, infections larger than an abscess, usually with several openings to the skin
• impetigo, skin infection with pus-filled blisters
How is it diagnosed?
Culture and antibiotic sensitivity testing of S aureus bacteria isolated from an infected site can diagnose most MRSA infections.
In 2008, the U.S. Food and Drug Administration approved a rapid blood test (StaphSR assay) that can detect the presence of MRSA genetic material in a blood sample in about two hours. The test can determine if the genetic material is from MRSA or from less dangerous forms of Staph bacteria—but it’s not recommended as the only basis for the diagnosis of a MRSA infection.
Who are at risk?
Even otherwise healthy people—especially children, teenager and young adults don’t notice these small cuts and scrapes. And outbreaks of MRSA occurs in places where people are in close contact and are more prone to these small cuts and scrapes—athletes that share dorms and shower rooms, armed service personal, even children in daycares and nurseries.
Apart from these people, most prone are the people with depressed immune systems—infants, the elderly, people taking immunosuppressants for an autoimmune condition, or HIV-infected individuals. People who have chronic diseases like diabetes or cancer also have a higher risk for getting an MRSA infection.
People with pneumonia from MRSA can transmit MRSA by airborne droplets, and healthcare workers are repeatedly exposed to MRSA, can have a high rate of infection, and should take precautions.
How can I take precautions?
However frightening the idea of antibiotic-resistant bacteria that “eats” skin, and tissues of the lungs and heart, MRSA can be prevented by simple hygiene practices.
In the hospital setting, for health workers and visitors should avoid skin contact with infected people or items they have touched. They should use disposable masks, gowns and gloves when they enter the MRSA-infected patient’s room.
MRSA carriers should take care to be careful with their personal hygiene—cover their mouth when they cough or sneeze and wash hands after scratching itches.
In general, people like you and me can take care by treating and covering skin abrasions and minor lacerations immediately with an antiseptic cream and Band-Aid—especially in children and in people involved in group or sports activities. Hand washing with soap is a simple but effective measure.
Is it spreading in the U.K.? In the U.S?
In August 2011, U.K.’s Health Protection Agency announced that MRSA cases were at a record low, with fewer than 100 infections in a single month across that country’s NHS trusts.
That was ten years after the Labour government introduced mandatory surveillance of hospital infections, following an outcry in 2001 over the number of patients contracting MRSA and another feared bacteria, Clostridium difficile (C diff).
Figures from the health trusts across the U.K. showed that 25 acute trusts have been free of MRSA in 2010. In June 2011, MRSA bloodstream infections fell from to 97 from 134 in June 2010.
In the U.S., the number of MRSA cases tripled from 2002 to 2007, according to statistic from Kaiser Foundation, but have fallen since then.
In 2010, a Centers for Diseases Control and Prevention study published in the Journal of the American Medical Association showed that invasive or life-threatening MRSA infections in healthcare settings was declining. Invasive MRSA infections that began in hospitals declined 28 percent from 2005 to 2008, the study showed. The National Healthcare Safety Network (NHSN) also found rates of MRSA bloodstream infections occurring in patients in hospitals to have fallen nearly 50 percent from 1997 to 2007.
And yes, MRSA can be treated
Finally, contrary to widespread fears and misinformation, many MRSA infections can still be treated with certain specific antibiotics.
Hospital-acquired MRSA is treated with vancomycin, often in combination with linezolid (Zyvox)and other antibiotics given intravenously. Moderate and even severe infections need to be treated by intravenous antibiotics given in the hospital setting.
While some MRSA strains have developed a resistance to vancomycin, researchers in 2011 developed a chemical change in the antibiotic vancomycin that rendered vancomycin-resistant MRSA susceptible to the drug.
Outside the healthcare setting, CA-MRSA can often be treated on an outpatient basis with specific oral and even topical antibiotics.
Some CA-MRSA strains are susceptible to trimethoprim-sulfamethoxazole (Bactrim), doxycycline (Vibramycin), and clindamycin (Cleocin). Only serious CA-MRSA infections of the lung, for example, require appropriate antibiotics by IV.
GlaxoSmithKline is also currently working to develop an S. aureus vaccine, which, if successful, could play an important role in preventing widespread infection.
Flesh Eating Virus Infection: Can You Catch It in Public Places? posted 21 February 2012.