Gyms and Community Acquired Staphylococcus aureus (CA-MRSA)

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healyje

Trad climber
Portland, Oregon
Topic Author's Original Post - Nov 6, 2006 - 03:27am PT
Heads up [url="http://www.rockclimbing.com/topic/122174" target="new"]from RC.com (from a climber in Massachsetts[/url])...

I'm passing on some relevant news to all of us as climbers, (and a bit of a personal story.) The main point is this, if you are recieving spider bite looking infections, there is a very good chance that they are not spider bites at all, but rather misdiagnosed bacterial infections caused by Community Acquired Staphylococcus aureus (CA-MRSA). You should inform your doctor of this possibility, and insist to have a culture taken of any new infection. This is of concern to you all, because I believe, as do many people in the Center for Disease Control, that indoor climbing gyms are high risk environments for spreading, and becoming infected with CA-MRSA. This will take some explanation.

According to the Center for Disease Control, "Outbreaks of CA-MRSA have been associated with sports that require physical contact and result in frequent damage to skin (3,4) and with crowded settings (e.g., correctional facilities, military settings), where access to hygiene measures is limited (5,6)." This would be our local indoor climbing gyms.

My Story: I started recieving recurring "spider bite" infections early this spring, and they were repeatedly misdiagnosed by my doctor as such. Some were lanced and drained, and I was sent home with antibiotics. Complications from recurring use of these antibiotics lead to a more serious infection in both kidneys, a hospital stay for 6 days, and then a PICC line (permanant IV) that was used to give myself antibiotic for the remainder of the month. It wasn't until recieving another infection on my ear that a culture was finally taken of these recurring skin infections (with my insistance) and it was determined that I had CA-MRSA. Needless to say, this meant a serious break from climbing-- like three months. Believe it or not, climbing was the last thing on my mind.

Also of note, with this last infection, I was told if I waited another day before coming to the doctor, I would have to be admitted to the hospital, (again). The infection was significant (only slightly smaller than a golf ball). They sent me home with a high dose of antibiotic while I waited for culture results- it took me 6 days. I was sick during this time due to the infection with low grade fevers and lots of pain. When the culture results came back, they found I was completely resistant to the antibiotic they had given me, and that I had been fighting the ear infection off on my own. Luckily, I was ok, and I had successfully fought of the ear boil with no assistance.

CA-MRSA has been around since the 1980's, and recently grown exponentially in the community. It is highly infectious; spread my hand to hand contact, or in cases that may concern us, by shared use of equiptment without proper cleaning measures. We can all help the spread of CA-MRSA by becoming aware of what CA-MRSA is, and the symptoms to look for (spider bite looking infections), and by practicing simple steps of good hygene. This would simply mean washing your hands before and after climbing at the gym.

I climbed at the gym while infected not knowing that what I had was contagious. I believed I had spider bites. I suspect many other climbers may do the same thing-- and unknowingly put others at risk. I believe I contracted CA-MRSA from another climber, who possibly could have contracted this from a gym or elsewhere- we will never know certainly.

These infections are treatable, and most often do not lead to the serious complications I had. However, if not treated correctly, they can cause blood poisoning and death in certain cases. It's important to know if you have CA-MRSA so you can get proper treatment, and this can be determined by taking a culture of the infection.

I am sure I am leaving things out from this story, and if you have questions feel free to ask. I'll try to follow-up this post with relevant links to more reliable sources than myself.

FYI: I am much better now - a picture of health and back into climbing. I have gone through a decolonization process that appears to have been successful in getting rid of this bacteria.

Thanks for reading, and hope this will be of help to you all.

-m
steelmnkey

climber
Vision man...ya gotta have vision...
Nov 6, 2006 - 08:17am PT
Geeze, between this and all the gear (ropes, harnesses, cams, etc.) falling apart, we should all quit climbing right now!!!! Especially all yous people heading off to J-Tree on the weekends!!!
Batrock

Trad climber
Burbank
Nov 6, 2006 - 09:11am PT
The fire station I work at had an "outbreak" of MRSA this year. When it satrted the guys just thought there were spiders in the dorm that bit them during the night. I suspected MRSA because we frequently go to LA County Jail to transport prisoners to the county hospital. MRSA is a huge problem in the jail. When the bug bombs didnt help they finaly went to the doctor to get checked out. When all was said and done 9 out of the 33 guys at our station had MRSA. No we use a industrial streangth Lysol on everything we touch, toilet seats, gym equipment, trauma boxes, benches etc.... we have been MRSA free for about 8 months. Its nasty stuff and can be fatal. Thanks for the sharing your story.
healyje

Trad climber
Portland, Oregon
Topic Author's Reply - Nov 6, 2006 - 11:41am PT
Riley - Just a note that it wasn't me that got it, I just cross posted from some poor fellow on RC.com in MA that did...
atchafalaya

Trad climber
California
Nov 6, 2006 - 11:45am PT
thats it, I f$#@$$%% quit climbing...
healyje

Trad climber
Portland, Oregon
Topic Author's Reply - Nov 6, 2006 - 05:08pm PT
Riley,

Seemed a relavant topic as the real winter has arrived here in the NW with a vengence. Beacon needs at least one solid dry/sunny day to dry out and we won't be getting a lot of 2-3 day sunny stretches between now and Feb. 1st when it closes, so it's into the gym for the winter. I'd been wondering about this very issue since hearing how it has been sweeping some high school athletic programs in Texas and in the South. Seems like gyms should add some bleach or other disinfectant when they remove and clean holds.
Ouch!

climber
Nov 6, 2006 - 05:48pm PT
Where did all this stuff come from? When I was a kid, we were covered in mule and cow sh#t half the time. Never heard of E-Coli, Salmonella, or Staph. Just an occasional case of gas gangrene or bullet or axe wound.
healyje

Trad climber
Portland, Oregon
Topic Author's Reply - Nov 6, 2006 - 06:12pm PT
Well, now here is a good climbing topic for Lois to jump in on...
poser

Trad climber
emporium, pa
Nov 6, 2006 - 11:12pm PT
Hi guys
I am "Poser"'s father and am posting about something that needs to be in the forefront of anybody that is around other people closely, is unsanitary, tends to get scrapes and cuts, and thinks he is invincible. One of my son's best friends was a football player for Lycoming College in Williamsport, PA and roomed with Ricky Lanetti, also a football player for Lyco in 2004. Ricky had flu-like symptoms early in the week of an upcoming big game. By Thursday he really felt bad but went to practice and told his parents and friends it was nothing. Early Saturday morning his roomate Andy took Ricky to Williamsport General Hospital because he was "out of it and weak". Admitted at 7:30 AM, Ricky was dead by 7:30 PM. This happened in front of coaches and trainers who checked these kids over daily. The culprit, of course, is underestimating staph, or in this case, MRSA. Check it out at
rickylanetti.com/newsarticles/lethalcatch.htm.
My son wrestled at the University of Pennsylvania and the trainers feared staph like no other, realizing the possibility of MRSA. Like climbing, having "beta" is a good thing, like a rope, "catching" an unsuspecting warrior who otherwise might "solo" into the darkness of ignorence.
murcy

climber
Nov 7, 2006 - 12:59am PT
two n's:

http://rickylannetti.com/newsarticles/lethalcatch.htm

now you got me poking at all my scrapes.
meg_

Trad climber
Boston
Nov 7, 2006 - 09:07am PT
I am the original poster from RR.Com- In the original post I followed up my story with a good link describing in better detail what CA-MRSA actually is;

Here is a good link with a general overview of what CA-MRSA is, it's history, and to links to sources. Additional links from this page below offer general guidelines directed towards coaches and athletic facilities on how to prevent the spread of CA-MRSA in athletic communities.

FYI: CA-MRSA first publically emerged in athletic communities in football teams— now it is effecting competitive athletics on a much wider spectrum. Even the Boston Celtics have had outbreaks of CA-MRSA in their teams recently.

http://www.health.state.ny.us/diseases/communicable/staphylococcus_aur eus/methicillin_resistant/community_associated/fact_sheet.htm

FYI: CA-MRSA is different than Staph and other forms of HA-MRSA. Hospital Aquired MRSA has been around for a while, but this new nasty strain has been emergin in the community and effecting otherwise completely healthy people (atheletes).

Please follow up with any questions about this-- I know it took me weeks of research to wrap my head around it.
Irisharehere

Trad climber
Gunks
Nov 7, 2006 - 10:40am PT
Quite honestly, I'm not that worried about CA-MRSA, and I spent the last 9 years working on Staph aureus research for a Ph.D degree.

Treat any traumatic injury that breaks the skin in the same manner people have been doing for years. Wash with clean water, apply a little triple antibiotic cream, and cover with a clean bandage.

If it's a deep wound, dirty wound, doesn't appear to be healing, is highly inflamed or anything out of the ordinary, go see your doc ASAP, and tell him/her how you got the injury.

Notwithstanding the tragic deaths that have occurred from CA-MRSA, the vast majority of healthy individuals are capable of fighting off the bacteria themselves, without any noticable signs of infection. I'd be more worried about the car ride to the gym than catching CA-MRSA in the gym.

Irish
jnut

climber
Nov 7, 2006 - 10:58am PT
Yes, CA-MRSA does normally presents itself as a 'not that serious' skin infection. The problem is that the infection is too often diagnosed as spider bites, even in areas where spiders that can cause necrotic skin lesions are not endemic.
By being aware that it is more likely a bacteria infection than a spider bite in most cases, this won't become a problem. It is a reality that climbing gyms have a risk of spreading the bacteria primarily because of shared equipment. CA-MRSA are 'nasty' partly becasue they can live on a foreign surface (climbing hold) for 24+ hours.
Irisharehere

Trad climber
Gunks
Nov 7, 2006 - 11:29am PT
Actually, staph can live on foreign surfaces for far far longer than 24 hours....
meg_

Trad climber
Boston
Nov 7, 2006 - 09:35pm PT
irisharehere-

I'd love to pick your brain a bit considering your topic of study. My friend here in Boston is also getting her PhD studying Staph, and I was also surprised at how little she knew specifically about CA-MRSA, or even more specifically, USA300. The USA300 strain can cause infections in otherwise completely healthy individuals, unlike normal staph. It's about 1/3 the size of normal staph (SCCmec typeIV) and has PVL toxin, both factors that make it more virulent than typical staph.

It's interesting to hear many people who are more familiar with HA-MRSA don't consider MRSA a larger risk for the community. However, at a seminar on CA-MRSA that I attended last week at Novatis by a professor of Molecular Biology who specifically researches CA-MRSA, she predicted that CA-MRSA will pose a greater threat to community health than HIV in the next 5 years. That is a pretty profound prediciton, and it's interesting to hear so many different points of view on this subject.

As for the present situation, misdiagnosing these infections is a big problem- not only does it put you at risk for blood infections (like what happened to me), but you also can walk around holding babies and hang out with old people not knowing you have it, (also like me). This could be potentially deadly for them. That is a problem.

I'd predict from personal experience that about 50% of family physicians would misdiagnos these infections as spider bites- regardless of the fact that there are no biting spiders in New England.

Please share your thoughts- I'm interested in what you think about this--

Meg
meg_

Trad climber
Boston
Nov 7, 2006 - 09:37pm PT
Oh- Staph can live on climbing holds for up to 4 days.
Irisharehere

Trad climber
Gunks
Nov 7, 2006 - 10:29pm PT
Meg - thats an interestingly precise timespan - where does the data on that come from?

As to why all the lab geeks like me and your friend don't know about CA-MRSA, wwell, its because of the nature of a Ph.D. - you choose your own tiny niche, and dig deeper and deeper into it. A lot of the other stuff in the field, well, you just don't have time for it.

My own particular niche was the pathogenicity island that causes toxic shock syndrome (SaPI-1), and how it moves between strains.

Annnnnyhow, PVL is indeed a nasty toxin - can change you from healthy to dead in a fairly short timespan. The gene is carried by the Panton-Valentine leukocidin bacteriophage. There's so much we don't know about this, and CA-MRSA in general - why its emerging as a problem now, how much of a problem it will become, how it will change over time etc etc.

Strains of bacteria aren't static (except for the ones kept in my -80C freezer!). As they spread through the human population, they pick up other genes, via plasmids, phages, pathogenicity islands etc. But we don't understand the dynamics of all of this, why some strains come to predominate for a while, and then fade away. So for this reason, I think predictions that CA-MRSA will be a bigger problem than HIV are perhaps somewhat overstated. When toxic shock syndrome burst onto the scene in the late 70's, its was seen as the new plague. These days, we understand a lot more about the disease, and how to avoid it, and it frankly isn't much of a clinical problem anymore.

Sadly, I probably won't have a part to play in all of this anymore. Defended my thesis a month ago. Salaries for post-docs in biology are absolutely derisory, so I'm off to the buisness side, hopefully...........

Adios,

Irish
meg_

Trad climber
Boston
Nov 7, 2006 - 11:02pm PT
Sorry for giving seemingly precise info for something not precise, but this is one source for how long MRSA lives on different metals- on stainless steel can live for 72+ hours (according to this article).

I hypothesize that sweaty plastic would not provide worse conditions worse for MRSA than stainless steel, but I am not an expert on this— would you agree? I am very curious about this. On certain other metals, MRSA has a shorter life span, like copper. However, I've been told copper is unstable and this is why bacteria does not live long on these surfaces. does anyone know more about this? I would imagine sweaty plastic to have some pretty good living conditions for MRSA, but can't back that up with any real data... You probably know more than me.

http://www.engineeringtalk.com/news/cda/cda144.html
DHike

climber
Nov 7, 2006 - 11:38pm PT
A classic quote from a friend comes to mind:

"Climbing plastic? Isn't that like scraping the bong?"

Seems it may be more dangerous as well....
quietpartner

Trad climber
Moantannah
Nov 7, 2006 - 11:53pm PT
Awright, awright, I'm never climbing the crags again unless the sun has been blasting it with ultraviolet radiation for days, and no climber has touched it in weeks. ;^)
meg_

Trad climber
Boston
Nov 8, 2006 - 12:25am PT
I do wonder about the possibilities of contracting this in outdoor environments too. Cracks seem particulary fond of holding onto skin particles, and bacteria can live on rocks too— not just indoor mats. Given every leader has a follower, and both share, (and leave skin and other things on), those cruxy skin abrasive finger locks, well a risk factor does seem to be there. Especially with the traffic I've seen at the Gunks on weekends— how many people climb Bird's Nest on a sunny weekend day at the Gunks? It just takes one unknowing climber (who thinks they have a spider bite) to put some nasty stuff on that rock for all those that follow them.

Not to burst anyone's bubble here, but I do think it's worth while to get the word out about what this is and what to look for. We do a lot of things that can put us at risk for this, and should be on the look out for spider bite looking infections. If you get them- treat them appropriately for your own health, and for other people.

We shouldn't get paranoid about this- it is true that driving in Boston poses a greater health risk than these infections for sure— but it's a situation where getting information out could really help a whole lot.
meg_

Trad climber
Boston
Nov 8, 2006 - 12:43am PT
That is good news.

But to drive that point home in my sometimes thick skull- that includes even those gros off-widthy cracks that eliminate skin from the backs of your hands? I mean, some of the stuff we leave in these cracks seems like heaven for bacteria.

I know you answered this, but I would love to hear your answer one more time to be sure :)
ernst

Trad climber
west coast
Nov 8, 2006 - 01:11am PT
radical and irisharehere have it right. good to be aware, but no reason to be fearful.

ca-mrsa skin infections responds well to bactrim (septra) - the literature shows >90% susceptibility, and i have not personally seen any failures. any abscess needs to be incised and drained -oral and even iv antibiotics will not effectively penetrate a walled off pus pocket.

an interesting note not yet mentioned, for recurrent infection, the nostrils are common sites of colonization, so in addition to either intravenous or oral antibiotics, it is common to prescribe and anitbiotic ointment (bactroban) to use in the nostrils for up to ten days (for that matter, under the fingernails as well).

ancef is not effective against ca-mrsa.
augmentin is not effective against ca-mrsa.
(forgive the jargon - but for those interested, ca-mrsa is not susceptible to beta-lactam antibiotics - this includes all penicillins and cephalosporins).

wash your hands, wear a helmet, and a seatbelt. mom was right. cheers.
TradIsGood

Fun-loving climber
the Gunks end of the country
Nov 8, 2006 - 08:37am PT
...she predicted that CA-MRSA will pose a greater threat to community health than HIV in the next 5 years. That is a pretty profound prediciton,[sic] ...

Check definition of profound. Nothing profound here.

And what the hell do you (or she) mean by "threat to community health"? -that it will be more widespread and kill more people?

I'd predict from personal experience that about 50% of family physicians would misdiagnos [sic] these infections as spider bites- regardless of the fact that there are no biting spiders in New England.

Even if you went to 20 family physicians, your prediction would be based on a hopelessly small population. Statistically unsound. Not to mention that almost anything that hardly ever occurs and presents similarly to something common is more likely to be misdiagnosed than something that commonly occurs.

Years after they discovered deaths from Avian flu in Asia they discovered that infection by the strain was actually quite common in the human population there.
meg_

Trad climber
Boston
Nov 8, 2006 - 09:29am PT
Tradisgood-

My assumption that about half of doctors would misdiagnos this in my area is purely based on my personal experience and hte expereince of another person I know who has CA-MRSA. We were both misdiagnosed through about 6 infections prior to diagnosing ourselves via the internet. My doctor knew close to nothing about CA-MRSA, and was convinced I had spider bites. In reality, there are no biting spiders in New England, and the likely hood of me having recurring spider bites is VERY slim. The likelyhood of my infections being CA-MRSA were much greater, yet no cultures were taken of my infections until after 6 misdiagnosis and over $10,000 in medical expense.

CA-MRSA is now the leading cause of skin and soft tissue infections in emergency rooms across the country— that makes this condition relatively common. Even if it hasn't seen huge numbers in our climbing community, it is still something we should be aware of.

I agree with the notion that we should not be scared of this, but rather informed. I am scared of how people (including my primary care doctor) are not informed of this, and it has had a direct effect on me.

As for the views I was relaying from the seminar, I was bringing this to light to show that there are other well informed, qualified sources that do see CA-MRSA as a significant issue. There are many reasons that are hard to get into through this forum as to why she saw this a real threat- this had a lot to do with the rapid rate that bacteria evolves and mutates. In the 6 years since it's been in the community, there have been instances where USA300 has developed resistance in certain individuals to all antibiotics. There are aspects of this disease in particular, including it's very virulent properties, that make it of concern. I don't want to be misleading with giving information, and do agree it is best to be informed rather than scared. My intent would be to inform here.

I would just hope that now to all who reads this forum, they will now insist to have a culture done if they get a spider bite. Even though this is in general CDC guidelines, it's still not practiced by many family doctors.

TradIsGood

Fun-loving climber
the Gunks end of the country
Nov 8, 2006 - 10:03am PT
Trachelas tranquillus, Dysdera crocata.

Both live in New England.

Both reported to bite.

http://www.ento.psu.edu/extension/factsheets/Spider/spiders.htm

Dartmouth Hitchcock Medical center listed New England phone number for bites.

Finally, it would seem strange that a physician would rule out spider bites even if there were no local species unless he also ruled out travel. And the brown recluse apparently sometimes arrives with food.
jnut

climber
Nov 8, 2006 - 10:19am PT
However, the brown recluse is the only one that will cause necrosis, which is what CA-MRSA does. Wouldn't the appearance of the bite be the first thing a doc would consider when diagnosing?
meg_

Trad climber
Boston
Nov 8, 2006 - 11:03am PT
Tradisgood-

This may be a bit longwinded, but worth including. This is an email to me from an entemologist in Pittsburgh concerned with the recent increases in spider bites in New England.

Start copied message:
I am NOT AT ALL an expert on spiders, their behavior, their bites, or on the fauna of New England. However, the species implicated so often as the cause of necrotic "spider bites" that in fact are not, are species in the genus Loxosceles, in particular L. reclusa, the brown recluse. Unfortunately we know of virtually no records of this spider in New England despite many records of its bites. In Pittsburgh we are regularly contacted by medical doctors asking about the bites by this species, but in fact have NEVER found a recluse spider when examining evidence...and in fact we have no Pennsylvania/Pittsburgh recluse spiders in our collection at all! You can see why some of us have been wondering if the reported lesions are indeed spider bites, and because they may in fact be something worse and more serious, there is need to clarify the diagnoses.

So here are some guesses at answering your questions....

1. All spiders bite, at least potentially, and all spiders have toxic glands producing venom in the bites....the ones implicated for health reasons are the recluse spiders and the black widows. The widows are not that common, and the brown recluse is unknown from much of New England.

2. Widows hang out in tangle webs under rocks, boards, and in other relatively enclosed spaces...the recluse is a surface runner, much like a small wolf spider, and in the plains states often enter homes, running about on the carpets and floor. Both species bite only when confined or pressed against the body by accident...they don't just cruise up and bite things.

3. I believe serial or clustered bites from any spider would be rare, usually a single accidental bite forced by the person "crushing" the spider or otherwise confining or constraining it in some way.

4. Bites are usually where constraint happens, on legs or arms placed against the ground, or under clothing where spider got trapped and when constricted against clothing, induced to bite. They can be on the trunk if the bite was caused by rolling over, often while sleeping, on the hapless spider. I have never seen or heard of one on the face.

5. Basically necrosis from bacteria are wet ulcers....spider bites like the recluse are relatively dry (a probe is not easily passed into the center of even a large necrotic region). Damage increases slowly, the necrotic area increasing in size over days, not hours. Obviously the very real concern here is that aggressive bacterial infections might not be appropriately treated if misdiagnosed as spider bites, and the danger is not from the spiders but from the rather rapid and frightening symptoms of a bacterial attack.

In the last year or so there are many sources of information on this confusion, the diagnosis of bacterial attacks as spider bites, and these may be found on the web. Of course, the web is also full of urban legends about deadly spiders, so you have proceed with caution. My concern is that someone with knowledge should carefully review the IMAGES in diagnostic texts, physician's guides, and other media for assisting in diagnosis of spider bites, as I suspect you will find that some or several of these "spider bite" images that doctors are using for comparison to clinical observations are in fact NOT spider bites.

Google Loxosceles brown recluse diagnosis bites images ........or any combination of those...you will find a rich literature on the web on this matter....two for example are below....go carefully amidst the web data....trust only stories that are published in valid journals...have fun.

http://www.arachnology.org/Arachnology/Pages/Reclusa.html

http://www.medscape.com/viewarticle/518429_References

and many many more....


And remember...Megan, I'm not an expert on any of this...but you would think that here in Pittsburgh, where the incidence of recluse bites would seem to be rising steadily....that someday us old buggers would actually see on in the lab!!! They are very easy to identify accurately....only six eyes.....and so they are not likely to be overlooked or confused with other similar spiders.

Good luck and sorry we aren't authorities on this topic!!! But it is one that concerns me....! The bacteria are serious business, and any delay in appropriate treatment because the physician thinks the cause is a little spider, is time we just can't waste!

End message.
meg_

Trad climber
Boston
Nov 8, 2006 - 01:08pm PT
Thanks so much for responding in this way— it gives me a strong feeling of comfort to hear your responses and reactions.
meg_

Trad climber
Boston
Nov 8, 2006 - 01:18pm PT
FYI: Allergies should be carefully monitered with this. I for one took many antibiotics over this past summer that I had never been exposed to. I had a severe reaction to Levquin, which was given to me through an IV in the emergency room. My mother and I watched as it caused my veins to bulge, and a bright red rash spread up my arm and neck. Mom ran around like a chicken trying to get help, but by the time somone responded the entire dose had gone into my arm. They gave me benedryl in response, and my blood pressure hit an all time low (given it is already very low due to my high activity levels).

Another nasty side effect was that the allergy prohibited me from absorbing IV fluids over the next four days. With NO food intake, I gained 16+ lbs in four days- that's pure IV fluid retention. No one could quite explain my feelings of being "bloated" until an xray (for gastritis) showed huge amounts of water retention.

Food for thought to you med professionals--

allergies are no fun.


Bruce Morris

Social climber
Belmont, California
Nov 8, 2006 - 03:25pm PT
After reading this chain, I developed an iching rash around my neck and began to blame my climbing gym. Then, I realized I had just bought a new merino wool bicycle jersey and it was hot outdoors while I was riding. Now, it's cooled off and the rash has gone away. IOWs: Don't visit the dermatologist or call for a surgeon too soon. A lot of rashes are caused by sweat.
jnut

climber
Nov 8, 2006 - 04:00pm PT
Yeah no kidding, this is the last thing a climbing gym owner wants to read, right?!
Amazing those little bugs can cause such turmoil.
A lot of athletic teams are proactive about keeping rid of thes problems, but in a gym what do you do about the fact that the shared equipment (sweaty climbing holds) cannot in reality be disinfected every day? And every few weeks is not even good enough when dozens of different fingers with thin worn out skin are thrutching and sliding all over them every day, one after the other. I guess the only action they can take is to help the educational side of it all...


fear

Ice climber
hartford, ct
Nov 8, 2006 - 04:38pm PT
>>Oh- Staph can live on climbing holds for up to 4 days

Or 12 days with a little blood and booger....
meg_

Trad climber
Boston
Nov 8, 2006 - 10:55pm PT
I'm also interested in hearing more about how people think climbing gyms should approach this. Do you feel they should take some responsibility in educating people about it? Should we wait until more people become infected, and then address the issue? Do you think it is the community's responsibility to educate ourselves? What are your thoughts?

How would you want your local gym to respond to this?
meg_

Trad climber
Boston
Nov 9, 2006 - 08:55am PT
LEB-

CA-MRSA is different from HA-MRSA, which is what you were exposed to with your patients. Yes, the immune system plays a role, (of course), but this is effecting people who have no compromised immune systems. You too could easily get this is you were exposed to it, regardless of how healthy your immune system is.

Another way education plays an important role in this, (in addition to things we have already discussed in this forum), is that I could have never had this experience if I had been aware of what CA-MRSA is. In fact, I could have prevented myself from ever getting infected (possibly- that's another story). My Ca-MRSA was in fact contracted from another climber who didn't know what they had. If they knew, we could have treated it the right way and I never would have gotten it.

BUT, if I visited your local gym, was climbing there, and then this happened to me, would you want to know about it? With all of my life habits, it is likely the climber I contracted this from picked this up at the gym, although this cannot be proven. Would you want to know about this if someone contracted this at your local gym that you climb at? This brings up some interesting ethical questions.

FYI: There is a decolonization process that i went through for this, and since doing so have tested negative on all tests and have had no recurring infections. There are ways of treating this, although no methods are 100% effective. I am currently not considered a threat of spreading this, and may never get an infection ever again, (meaning this bacteria could not live on me anymore).


Irisharehere

Trad climber
Gunks
Nov 9, 2006 - 10:50am PT
Given how recently CA-MRSA has emerged, I don't know of any large-scale epidemiological studies on its prevalence among the community at large. It may be that it's more common than we think, but it passes unnoticed as our immune system takes care of it.

Frankly, without data that suggests its a widespread problem, I don't think its necessary to take anything more than the usual precautionary measures - i.e. avoid other peoples bodily fluids, be aware of the possibility of transmission in situations of close living conditions, and use plenty of soap andhot water!

Crying wolf too many times when it turns out to be a puppy will just lead to people switching off (who listens to the evacuation proceedures on the plane any more?)

Irish

P.S. - All of the above is not meant to belittle the painand suffering that Staph aureus infections can cause. They can be life-threatening. But for the healthy general population, it doesn't seem that it requires any special vigilance at the moment
meg_

Trad climber
Boston
Nov 9, 2006 - 11:42am PT
In 6 years, CA MRSA has surpassed other strains of bacteria and is now the leading cause of soft tissue infections in emergency rooms across the country. Whether you like it or not, this is a problem that currently effects everyone.

Here's an excert from this cite, http://www.dermatologytimes.com/dermatologytimes/article/articleDetail.jsp?id=375405&pageID=1

National report — Community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) has become a ubiquitous presence across the United States.

It was the most common identifiable cause of skin and soft tissue infections in a study conducted at 11 university-affiliated emergency rooms during August 2004. The study was conducted by the EMERGEncy ID NET Study Group, and the results appeared in the Aug. 17 issue of New England Journal of Medicine.

"The main message for physicians is to recognize just how common this has become," study leader Gregory J. Moran, M.D., tells Dermatology Times. "In most places in the U.S., this is the most common cause of skin infections."

The cities ranged in size from Albuquerque to New York. Kansas City had the highest proportion of MRSA infections (74 percent) and New York the lowest (15 percent). Dr. Moran says anecdotal reports suggest that the lower-incidence cities have caught up over the two years since the samples for this study were gathered.

End copied excerpt.
I'm not crying wolf here- nor do I want to people to be scared, but do think this is something we should all know about and take very seriously. Education is important with this one. Considering this has effected so many people in 6 years since its emergence in the community, it's reasonable to assume that this will effect you too if you come into contact with it. This doesn't mean it will kill you, but you will have to deal with infections caused by it. My story is one of a more severe reaction to the misdiagnoses of infections- it is not likely that the infections will cause most people as much harm as they did to myself.

Irish-
quoted from you, "But for the healthy general population, it doesn't seem that it requires any special vigilance at the moment."

I encourage you to read a bit more about this condition. It effects competely healthy people when they come into contact with it. I have always lead a very healthy lifestyle and have a very strong immune system. My labwork, according to doc's, is stellar. As a said before, I am a picture of health and take good care of it. I suspect if you learned more about CA-MRSA, your point of view would change.
can't say

Social climber
Pasadena CA
Nov 9, 2006 - 02:07pm PT
I guess I should chime in here and reiterate the "heads up" regarding innocent looking spider bites. I was unfortunate enough to have to deal with a staph infection last year and I have to say it scared the beejeezus outta me. I had never had something like that and the speed at which it grew blew my mind. This stuff is everywhere these days and it appears to be spreading into the general population.

A recent study of one hospital's single month treatment for bacterial skin infections found over half of them to be CA-MRSA.

Dirtbaggin just ain't what it used to be. Now you can die from not taking a shower I guess. But then again I'm not a dirtbag anymore.

A friend of mine had a long time friend of his die from the flesh eatting bacteria. He was surfing at a river-mouth in N. California and cut his leg with his board's fin. It was cold water, it had stopped bleeding under his wetsuit and he soon forgot about it. The next day it became infected and he kept it under observation. The next day it was way worse. He went to the hospital to have it checked out. They admitted him and had to amputate the leg. This didn't stop the spread of the infection and the next day he died.

Don't ignore gobbies or innocent looking spider bites.
meg_

Trad climber
Boston
Nov 10, 2006 - 01:49pm PT
Noone has expressed opinions about how they would like their gym facilities to respond to this one- say in an instance where there were breakouts at your gym. Would you want your gym to help educate other people who use this facility, or would you consider it the responsibilty of those infected to educate other gym users? Right now, this disease is unreportable, so there is no obligation for those who have this to publically report that they have been infected.

How would you want this type of situation to be approached at the gym facility you use? These are interesting ethical questions I am curious about. My stance on this is not yet decided, and I consider my opinion somewhat skewed due to personal experience. I would love to know opinions on this.
Ed Hartouni

Trad climber
Livermore, CA
Nov 12, 2006 - 04:29pm PT
From the late Stephen J. Gould... The Age of Bacteria...

the crown of creation?
Crista

climber
Las Vegas
Nov 12, 2006 - 05:06pm PT
2 friends... Staph came to both of them by settling in their hip joint. I'm not sure what kind of Staph it was, but since we are on the topic of warning people.

1st friend believes he got Staph from an open sore coming into contact with guano while crack climbing. Unfortunatly for him, they thought he had some sort of joint problem, shot his hip full of cortisone and sent him on his way... later (when he became severely ill) he was treated for Staph. Now he has a "frozen hip"

2nd friend believes she caught it while performing in a diving show in mission bay. Again it also settled in her hip, she refused the cortisone shot and instead got a second opinion because she felt ill. The only thing that clued in the docters was an onset of fever and (I think) pnenomia. She is lucky and regained almost full use of her hip, but was in the hospital for a month and on antibiotics for 6 months.

both of these individuals tested positive for ecoli also. I don't know if that helps give away what kind of Staph it was, but it makes me think twice about climbing routes with bird/bat/rodent poo.
meg_

Trad climber
Boston
Nov 12, 2006 - 09:03pm PT
I feel the need to clarify some things about CA-MRSA. It lives on the skin and in moist body cavities (like the nose or throat). You can become colonized with CA-MRSA by touching a shared surface where another infected person has left the bacteria, or by coming in direct contact with that person's skin. CA-MRSA does not need to enter an open wound. If the infected person has a breakout, the bacteria is especially present and it is more likely for that individual to spread the bacteria to other surfaces or people. If you pick this bacteria up on your hands, then pick or rub your nose, well then it can live inside there too. It doesn't necessarily cause infections right away, and with some people never will. It can just hang out on you for a while with no visable effect. However, at some points the bacteria is able to get into microscopic openings in your skin, and then colonize forming spider bite looking infections.

Short summary: CA-MRSA is spread by hand to hand contact, or through shared use of athletic equiptment. After you climb in the gym, it's a great idea for you to wash your hands thoroughly- this helps to get rid of any nasty bacteria that you might have picked up on your hands while using the gym. It's also just good hygene- Other than that, it's pretty much up to getting word out about what to look for with this one. It makes itself very clear with spider bite looking infections. If you, or someone you know is getting these, let them know it could be CA-MRSA and that they should get a culture done. For some people these infections may not be a big deal, but for others they can be very impactful. It's good to know about it in case it may happen to you or someone you know.
Fingertrouble

Mountain climber
Nov 13, 2006 - 04:28pm PT
Here's how it happened to me.

In late August I contracted a staph aureus infection of unknown origin (no "spider bite," no inflamed wound, no CA opportunity, etc). At first I thought I just had a mild sprain and a fever. After a few days the pain became so intense that I went to an urgent care facility, where I was diagnosed as having gout (a condition mainly of lower extremities). The treatment for gout creates 15 hours of debilitating and unrelenting diarrhea, before blood tests showed I didn't have gout. The urgent care MD missed whatever else the blood workup showed. That and my GP's absence consumed a few more days before I decided to see a hand specialist at the orthopedic hospital that previously had fused my lower spine and nailed my shoulder back together. The doc put on a compression bandage and gave me some NSAIDs. Three days later when he cut the bandage off he said, "My goodness that's red! I'm sending you to an infectious disease specialist, NOW."

The ID-MD put me on oral antibiotics (Levaquin, because it penetrates well) and ordered blood tests and cultures. Back in her office a couple of days later she got the preliminary blood culture results and immediately hospitalized me, four year old daughter in tow.

The infection was in my blood and left wrist. I spent a week in the hospital, had two wrist surgeries, then six weeks on in-home IV antibiotics (Rocephin, 2 gm) through a catheter (PICC line) from my elbow into my vena cava. Whoa! I coulda, like, died, man. Now I'm in intensive physical therapy, including electrical stimulation (getting the crap shocked out of my left arm) and much painful wrenching and pulling on recalcitrant tendons. Maybe another surgery in several months after things settle down. There's constant big time pain and I'm on a nerve pain killer cocktail that alters reality just a tad; adds entertainment to freeway driving with one hand. Maybe I'll eventually get most of the functionality back; maybe I'll be able to ski and climb again, but not any time soon. Right now I can't touch my thumb to my fingers or pick up a pencil with my left hand; typing, I could use my foot just as effectively. Sucks, but would suck much less if I had the correct treatment a week earlier.

But wait, there's more. While they were doing nerve tests on my arm they discovered an (old) unrelated problem in my cervical spine, a crushed disk. No symptoms so far, but it seems that if I hyperextend my neck I could become an instant paraplegic. That could happen in a skiing/climbing fall or a fall around the house, but hasn't so far. The fix is "simple; we just go in through the front, stick in a plate, and fuse your vertebrae. No problemo." But the spine guy seems reluctant to do this "just in case," especially since I've just had a staph infection of unknown origin.

Lessons? Don't assume your doc will spot a staph infection; if it swells and looks inflamed, be sure staph (or flesh-eating strep) is definitively ruled out. Don't waste time.

Also, in my many visits to clinicians of late, I've noticed that right along side the WASH! sign and soap dispenser is a squirt bottle of alcohol hand sanitizer. Used often. Wouldn't be a bad idea to carry your own little bottle and use it from time to time if you think you might be exposed to unfriendly microorganisms, wherever you are.

Craig Connally
Karen

Trad climber
Mammoth Lakes
Nov 13, 2006 - 05:10pm PT
In November of 2004 I had an outbreak of MRSA and the site of infection was initially mis-diagonosed as a spider bite by the urgent care. I followed up with my primary care physician who was clueless as well. This infection spread quickly and I ended up with several other areas becoming infected. My quack primary physician finally took a culture which showed the infection to be MRSA. However, by then, the areas of infection were inflamed and extremely painful. He wasn't helpful so I ended up at the ER where they lanced and packed the sites, all done without any anesthesia, I am sure my screams rather unsettled the rest of the ER !!!!
I went back to my primary and told him he needed to take some action, so he ordered IV Vancomycin to be adminsistered at my home. The home care nurse arrives and proceeds to "teach" me how to put in the am & pm drip, what a f*#king joke....
My veins would not hold the IV and the drip would end up infiltrating, so I would have to pull out the IV and call the nurse to return. Well, I only was given 2 paid visits through the HMO-f*#kers-when all along I feel I should have been hospitalized. During this ordeal I was on my own, in intense pain, fear over what the hell was happening to me and feelings of helplessness. I was never able to receive my full doses of vanco due to the issues with the IV.
All I can say is thank goodness for Vicodin, at least the quack MD gave me the full strength ones.
The initial sites of infection cleared but I continued to have outbreaks at other random sites on my body. I was given Cipro, it worked but the side effects were unpleasant. All in all, I battled this for six months and it took its toll on both my physical and mental health.
I must add, prior to contracting MRSA I was training at an indoor gym, one located up in Victorville. This gym was also a boxing gym, so a lot of sweaty and I imagine unsanitary conditions were present.
meg_

Trad climber
Boston
Nov 14, 2006 - 11:58am PT
Sorry to hear of your experience, Karen. It's a crazy experience to get this and not be able to rely on the medical professionals for education. When you're sick, and noone is clear as to what the problem is, it is an extremely frightening place to be in. I often find I am educating my doctors and even ID doctor about things with this.

There are people who know about this, and they all admit (as with other afflictions) that there is so many things that are still a mystery with CA-MRSA. There is also so much new information that comes out on it each day. I'm learning every week.

Shoot me mail if you ever want to chat about this or need to vent- I've learned so much in the past few months about this from medical, personal, microbiology, and emotional perspectives...

I am fairly certain we will hear more and more examples of CA-MRSA "popping" up in indoor climbing facilities, but time will tell on this one.

take care-
meg
looking sketchy there...

Social climber
Latitute 33
Nov 25, 2006 - 07:55pm PT
I was just released from the hospital on Wednesday and am on a lengthy course of antibiotics to fight a MSRA infection. What started with a bothersome, but very small cactus thorn (yes, I tried to dig it out) quickly became a very inflamed thigh.

I figured it would get better, but after several days, it was only getting worse, so I showed it to my wife (who rightly got pretty steamed that I hadn't mentioned it or done something about it sooner). It was off to several visits to the emergency room and IV antibiotics. On my third visit, they were not satisfied with how things were going and I was admitted.

A surgeon removed a nice bit of my flesh (down to the muscle -- now I can relate to Shakespear's Merchant of Venice) and have been fitted with a portable "Wound Vac" which is to be my constant companion for the next couple weeks (think Borg implant sort of thing that makes farting noises).

A nose culture found MSRA happily in residence. In addition to a current course of multiple oral antibiotics, I have to swab the inside of my nose with another antibiotic gel.

Perhaps I wiped my nose while trying to get the cactus thorn out?

As a person who does frequent the gym, this seems the most likely source of the bacteria (no other particular risk factors). Now, it seems that washing up after using all those holds is an excellent idea. The gym also has decided to really crack down on barefoot climbers (though already prohibited).

Because I have a strong immune system, waiting to get treatment didn't result in more serious consequences. I never had a fever. The ER and hospital treated for MSRA from the get go (apparently it is that common) and I received excellent care.

I'll probably miss only a few weeks of climbing and biking. It could have been a far different result. I was lucky.

meg_

Trad climber
Boston
Nov 28, 2006 - 12:06am PT
Thanks for sharing the story, and I'm sorry to hear what you've been through.

I am curious about a couple of things. Did you happen to get your culture results back? Did they tell you if you have CA-MRSA or HA-MRSA, or perhaps a necrotizing bacteria if they had to remove tissue? To let you know, CA-MRSA is sensitive to a broader range of antibiotics, but is also more virulent with healthy people. There are a couple of forms of CA-MRSA, and it does posess a toxin that can cause death of tissue.

The thing that is tricky with CA-MRSA is that it's REALLY hard to get rid of. In fact, not many people do "get rid" of it. Less than 1% of the population has this particular strain of bacteria on them, and I certainly don't wish it on anyone.

I don't want to bring somber news to you, but I urge you to learn a bit about the specific type of bacteria you harbor. For your wife too-- this stuff really sticks around, and can be put into remission, but rarely goes away completely. I know because I'm going through a second try of getting rid of my own invasive bacteria, but it's still hanging on. It appears to give me infections at least once every two months when I am not on antibiotics. I am also an otherwise completely healthy person. Everyone responds differently to it.

Its always good to play safe and be aware of what you have in order to take precautions to prevent infecting your loved ones and others- this has happened before. CA-MRSA is treatable, and containable with the right medications and precautions. CA-MRSA has a pretty distinguishable sensitivity pattern, and will also cause tell-tale boil-like infections. If your infection required IV antibiotics, it may have been HA-MRSA, which won't effect you when you are healthy. Anyway, all questions for your ID doctor, right? I certainly feel for you, and don't want to cause worry, but think it may be something to look into.

I hope you heal fast, and do get rid of this nasty stuff!

megan
meg_

Trad climber
Boston
Jan 12, 2007 - 09:46am PT
There has been a slew of recent articles written about gyms and Ca-Mrsa. When I was searching on this topic earlier in the Spring, it was hard to find news on this subject, now when you google the subject, there are pages of articles.

I will post a few;

http://news.nationalgeographic.com/news/2006/04/0425_060425_staph.html

http://www3.whdh.com/features/articles/specialreport/DBM1269/

http://www.nbc4.tv/station/4510495/detail.html

just google staph and gyms, and there will be many, many more. A recent statistic says 25 percent of Ca-MRsa cases lead to hospitalization. This is a serious issue!!

I still wonder how other climbers would want their gyms to respond to this issue? Mine hasn't taken any proactive stance what-so-ever. In fact, the owner of my gym seems to be under the impression that I must have been unhealthy to have contracted this in the first place. I feel he thinks I have been through trauma and am over-reacting.

I'm trying to be diplomatic, but I am finding the lack of pro-activeness in my gyms response to this extremely aggrevating. Am I the only one to feel this way? If you climbed at a gym where someone else was diagnosed with this, how would you want your gym to respond?
Irisharehere

Trad climber
Gunks
Jan 12, 2007 - 12:56pm PT
Can you think of any practical measures a gym might take?

You can't identify people colonised with CA-MRSA when they walk in the door.

You can't make people climb in latex gloves

You can't steam-clean the holds every time a person touches them.



All I can really think of is warning notices about CA-MRSA and its presentation.........
meg_

Trad climber
Boston
Jan 12, 2007 - 01:30pm PT
What about posters reminding people to wash their hands and covering their wonds/gobis? And reminders that if they look like spider-bites, to get your infections cultured.

It just worries me that I myself had several infections before being diagnosed. I hope everyone can learn from that and get cultures right away.

Each time I climbed with an infection (even though it was covered) I still put people at risk. I wish I had known better then, but didn't have any access to that info.

Do you feel that people who climb at the gym should be informed somehow that it is has been present in the facility? (Sort of like the note that gets sent home when someone gets lice at school). Right now, it is starting to be approached this way. Inmates who have contracted CA-MRSA in facilities where there have been breakouts are forming lawsuits against their prison for being aware of the situation, but not educating the inmates. This brings up interesting ethical questions.

thanks for all the thoughts- it helps me be a bit more relaxed about this all.

-m
meg_

Trad climber
Boston
Jan 26, 2007 - 07:06pm PT
For those of you following this thread, there will be an article in April's issue of Rock and Ice about CA-MRSA. The article gives a brief, yet informative, description of what CA-MRSA is, and discusses concerns about this disease in indoor gym environments. April's issue will be available starting March 1st.

Healthy and happy climbing to all!
-m

meg_

Trad climber
Boston
Jan 28, 2007 - 04:58pm PT
Education as prevention- a study on it's effectiveness in athletic
environments.

In fall of 2003, an outbreak of Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) occurred in Mecklenburg County involving athletes and non-athletes in the Charlotte-Mecklenburg School System.

In response to this outbreak the Mecklenburg County Health Department developed an educational video, brochure, and website with a fact sheet to educate athletes, parents, athletic personnel, and the public about proper hygiene procedures used to prevent and control this type of infection. Pre and post tests were administered along with the video to a sample of high school athletes to assess current hygiene knowledge, attitudes, and practices. Pre/Post testing showed:

* 86.4% increase in knowledge and attitude of effectiveness of hand washing,
* 6.4% in showering,
* 240.4% in cleaning shared equipment, and
* 145.4% in reporting suspicious sores to their school nurse or healthcare provider.

You can visit this link to read more about this study:
http://www.charmeck.org/Departments/Health+Department/Top+News/MRSAResponse.htm

Here is a link to an informational page on the site about CA-MRSA and also a link to the video mentioned in the athletic awareness campaign:
http://www.charmeck.org/Departments/Health+Department/Top+News/MRSA.htm

Maybe we should all try to pass this video around? Thanks,
Meg
paganmonkeyboy

Trad climber
the blighted lands of hatu
Jan 28, 2007 - 07:37pm PT
lots of good information
lots of food for thought
and one of the best lines ever

"Climbing plastic? Isn't that like scraping the bong?"

I'll never be able to do either again without thinking of MRSA ;-)
meg_

Trad climber
Boston
Feb 28, 2007 - 01:12pm PT
NATIONAL ATHLETIC TRAINERS’ ASSOCIATION (NATA) ISSUES OFFICIAL STATEMENT ON COMMUNITY-ACQUIRED MRSA INFECTIONS
Organization Addresses Potential Risks and Offers Prevention Tips

DALLAS , March 16 – In an effort to educate the public about the potential risks of community-acquired methicillin-resistant staphylococcus infection (CA-MRSA), the National Athletic Trainers’ Association (NATA) has issued an official statement recommending all health care personnel and physically active adults and children take appropriate precautions if suspicious skin infections appear, and immediately contact their physician.

NATA represents 30,000 members of the athletic training profession through public education and research. Certified athletic trainers (ATCs) are allied health care professionals who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses that occur to athletes and the physically active. They can be found in sports settings, performing arts, corporations, the military, schools, clinics and hospitals, physician offices, and other health care facilities.

According to the Centers for Disease Control and Prevention (CDC), Staphylococcus aureus , often referred to as “staph,” are bacteria carried on the skin or in the nose of 25 to 35 percent of healthy people. This is known as colonization. It occurs when the staph bacteria are present or in the body without causing illness. Infection occurs when the staph bacteria causes disease in the person.

In the past, most serious staph bacterial infections were treated with an antibiotic related to penicillin. In recent years, treatment of these infections has become more difficult because staph bacteria have become resistant to various antibiotics, including the commonly used penicillin related antibiotics. These resistant bacteria are called methicillin resistant staphylococcus or MRSA. According to the CDC, one percent of the population is colonized with MRSA.

MRSA infections usually develop in hospitalized patients. However, MRSA rates have increased recently in persons outside of health care facilities, affecting athletes and the physically active.

“Staph or MRSA infections develop from person-to-person contact, shared towels, soaps, improperly cleaned whirlpools and sports equipment,” says Ron Courson, ATC, PT, NREMT-I, CSCS, head athletic trainer at the University of Georgia in Athens, Ga. “Such infections usually appear first as pimples, pustules and boils. Some can be red, swollen, painful and/or have pus or other drainage. The pustules may be confused with insect bites in early states. The infections may also be associated with previous existing turf burns or abrasions. Without proper referral and care, more serious infections may cause pneumonia, bloodstream infections or surgical wound infections.” Courson believes maintaining good hygiene and avoiding contact with drainage from skin lesions are the best methods for preventing MRSA infections.

NATA’s official statement recommends the following precautions be taken:

Keep hands clean by washing thoroughly with soap and warm water or using an alcohol-based hand sanitizer routinely.
Encourage immediate showering following activity.
Avoid whirlpools or common tubs. Individuals with open wounds, scrapes or scratches can easily infect others in this environment.
Avoid sharing towels, razors, and daily athletic gear.
Properly wash athletic gear and towels after each use.
Maintain clean facilities and equipment.
Inform or refer to appropriate health care personnel for all active skin lesions and lesions that do not respond to initial therapy.
Administer or seek proper first aid.
Encourage health care personnel to seek bacterial cultures to establish a diagnosis.
Care and cover skin lesions appropriately before participation.
ATCs throughout the country are celebrating National Athletic Training Month in March promoting the message: "Rehabilitation: Accelerated Return to Activity."

To view the NATA official statement, visit http://www.nata.org/publicinformation/position.htm. For more CA-MRSA information, from the CDC, visit www.cdc.gov/ncidod/hip/aresist/ca_mrsa_public.htm or visit www.nata.org.

About the National Athletic Trainers’ Asssociation (NATA):

Certified athletic trainers (ATCs) are unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses that occur to athletes and the physically active. The National Athletic Trainers' Association (NATA) represents and supports 30,000 members of the athletic training profession through education and research. March is National Athletic Training Month. www.nata.org. NATA, 2952 Stemmons Freeway, Ste. 200, Dallas, TX 75247, 214.637.6282; 214.637.2206 (fax).
meg_

Trad climber
Boston
Apr 13, 2007 - 10:30am PT
Hello all-

It seemed like there were quite a few med folk following this topic, and I thought this news was significant to share. Basically, for those of us who are recieving MRSA infections (and for you med folk treating us), be aware that CA_MRSA can be very quickly lethal if it forms respiratory pneumonia. It has a rapid onset and is often fatal. I'm reacting to this in the following ways; I will treat any respiratory infection very carefully and monitor them, and also make all medical professionals who treat me aware of this condition. I will also be careful to not freak out about this all the time...:-) , but I do think as many people as possible should be aware of all of this to ensure that we get the fastest treatment possible if anything happens.

This is a recent announcement by the CDC:

CDC Reports Severe Influenza-Associated MRSA Pneumonia

The CDC reports 10 cases of severe influenza-associated
community-acquired pneumonia caused by methicillin-resistant
Staphylococcus aureus infection.

The cases, six of them fatal, occurred last December and January in
Louisiana and Georgia; the patients' median age was about 18.
According to a report in MMWR, the cases were especially notable
because of the rapid course of the disease. Death occurred within 4
days of respiratory-symptom onset for four of the six patients who
died, suggesting that the influenza and S. aureus infections occurred
concurrently in these cases.

Four of the patients had documented history of MRSA skin and
soft-tissue infection in themselves or a close contact before
developing pneumonia. The CDC said MRSA should be suspected in severe
pneumonia cases, particularly during flu season, and in patients with
cavitary infiltrates or a history of MRSA infection. In such
instances, treatment should include vancomycin or linezolid.

thanks,
Megan
pc

climber
East of Seattle
Apr 13, 2007 - 12:05pm PT
Yikes! Thanks Meg. Very good to be aware of.
Lambone

Ice climber
Ashland, Or
Apr 13, 2007 - 02:19pm PT
Gym climbers should keep a watch out for inconciderate climbers on the wall with open finger wounds, cuts, or gobis. Tell them to wash up, tape up, and/or stop climbing.

If you see blood on the holds or wall tell the gym staff and make sure they clean it...

wash your hands, A LOT!
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