Winchester sports team is checked for MRSA
Football player recovering amid staph-infection scare
The 85 members of the Winchester High School football team endured a different kind of exercise this week: A trainer checked them for the pimples, bumps, and boils that can be the harbinger of a dangerous bacterial infection.
One of their teammates had come down with an infection caused by a germ called methicillin-resistant staphylococcus aureus, and school administrators wanted to make sure none of the other players had caught it.
"Everybody was checked, and there was no one else who had it," said Tom Gwin, Winchester High's principal. "We have to take it very seriously."
It was evidence of a problem decades in the making that has seized the public's attention and prompted schools in Massachusetts and across the nation to inspect students and scrub walls and tables.
Once exclusively the scourge of frail hospital patients, staph infections capable of outwitting standard antibiotics have appeared in the broader community in the past eight years. The case of the Winchester student, who has recovered from his infection, resonated with disease trackers, who have seen outbreaks on high school, college, and professional teams.
And when a grade-schooler in Wrentham was diagnosed with the condition this week, that, too, rang familiar. Specialists recognize that younger children, never known to be especially vigilant about hygiene, can easily spread the germs to classmates.
"For the skin infections, the most common routes of transmission are skin-to-skin contact," said Dr. Arjun Srinivasan, a medical epidemiologist at the US Centers for Disease Control and Prevention in Atlanta. And athletic events as well as playtime at the neighborhood day-care center can be ideal petri dishes for the transmission of the germs.
At Delaney School in Wrentham, parents were very concerned, said Superintendent Jeffrey Marsden. "Given the fact this has been an issue on the news in the past month or so, it was definitely on people's minds."
A study appearing in the Journal of the American Medical Association this week reported that the germ, widely known by the acronym MRSA, was responsible for 94,000 serious infections and nearly 19,000 deaths in the United States in 2005. Those statistics were substantially higher than previously reported.
Patients with hobbled immune systems remain the most vulnerable and the most likely to suffer serious consequences from an infection. In otherwise healthy children and adults who develop skin infections from MRSA, "it's very, very rare that they develop into more serious types of infections," Srinivasan said. "The overwhelming majority [of cases] are treated by drainage of the abscess or with antibiotics."
Studies have estimated that 1 percent of Americans carry MRSA on their skin or in their noses. But it wasn't always that way.
There was a time when the only kind of staph in the community was the garden variety. It was everywhere, but it was easily thwarted by front-line antibiotics, including methicillin, a member of the penicillin family.
In 1999, disease investigators first identified a strain of staph circulating outside hospitals that did not respond when treated with methicillin. The alarm was immediate. And contrary to what specialists initially believed, the bacteria are not simply renegade germs that escaped from hospital wards.
Instead, they appear to be once-routine germs that acquired the ability to survive certain drugs. When antibiotics are used too widely or when patients do not take all their pills, only the germs most susceptible to drugs are eliminated, leaving the hardier, drug-resistant strains to flourish. Specialists also theorize that the standard staph might have acquired genetic material from unrelated germs, making them invulnerable to certain antibiotics.
"In the past five or six years, there's been an explosive spread of these organisms in the community, and they're causing the kind of infections you're seeing here," said Dr. Robert Moellering, an infectious disease specialist at Beth Israel Deaconess Medical Center.
In Massachusetts, the proportion of staph infections caused by drug-resistant strains has almost doubled since 1999, said Dr. Alfred DeMaria, the state's director of communicable disease control. There are so many cases that the state does not have the capacity to track them all, he said. Most, like the Wrentham student, recover without serious consequences.
"The dramatic cases, they're horrible to deal with, but they're just the tip of an iceberg that's a much bigger issue," DeMaria said.
The infections can happen when athletes share razors in the locker room, with the dangerous germs gaining entry through small cuts. They happen, too, when someone with an infected cut doesn't cover it and the germs linger on surfaces, such as gym equipment.
Both scenarios can start a chain of transmission.
"The one good thing that's coming out of these unfortunate cases is that it's going to give awareness about good hygiene," said Dr. Linda L. Lawrence, president of the American College of Emergency Physicians. "Use your own personal supplies, use your own razors, use your own cosmetics. If you get a cut, go wash it."
Stephen Smith can be reached at stsmith@globe.com. 