PrestoPundit

“Skid Row” Staph Speads in Los Angeles

Posted by PrestoPundit on 10/25/2006

The staph epidemic is moving from the streets of Los Angeles and into the LA safety and social service community. Quotable:

Detective Tricia Hauck finished a burglary investigation at Pete’s Café and returned to the Central Division station near Skid Row. Her left foot started to feel uncomfortably warm. She wondered if it had anything to do with an ankle fracture she suffered on vacation in Mexico a few months earlier. Within a half hour, the warm feeling turned into pain so excruciating that her leg went numb. Unable to walk, the 39-year-old burglary-investigations supervisor was carried to a patrol car and rushed by her partner to an emergency room.

An MRI detected fluid around her bone. Later that day, a surgeon cut into her foot and removed an abscess. The diagnosis: Skid Row staph, or, more technically, a strain of methicillin-resistant Staphylococcus aureus that is sickening dozens of police officers, firefighters, health-care workers and homeless people. These cases pose a new challenge to county health officials, who so far have refused appeals by Skid Row care providers to step up help to the city’s most down-and-out population. Cops are so accustomed to seeing people with oozing boils that they call them Skid Row cooties ..

In 2005, staph infections hit at least 20 Los Angeles city firefighters, many of whom work on Skid Row. A staph infection landed a deputy city attorney, who works out of the Central Division police station, in the hospital for two weeks. An LAPD helicopter pilot, who helped a homeless man across the street, almost had to have his leg amputated. Two doctors working at a wound-care clinic got infected. A chaplain and a night manager working at the Union Rescue Mission got it. So did the director of public affairs and two other employees at Midnight Mission. Besides Hauck, a deputy chief and a rookie officer at LAPD’s Central Division have been diagnosed with Skid Row staph ..

“We are trying to understand how people are getting [Skid Row staph] in jail,” says Dr. Loren Miller, associate professor of medicine at the David Geffen School of Medicine at UCLA ..

The first cases of staph infection proved puzzling to jail officials in 2001. The pinpoint-size infections were blamed on brown recluse spiders. Pesticides didn’t stop the complaints. In spring 2002, several spiders were captured and identified as nonbiting spiders. At the same time, the inmates’ lesions were tested and found to be staph infections.

The jail tried to eradicate staph by doubling the laundry exchange, cleaning cells more often, allowing daily showers and educating inmates through videos and posters. In 2005, an epidemiologist began tracking the bacteria. Inmates began using a highly potent bacterial soap but still were getting sick.

Regardless of the cleaning efforts, the number of infected inmates has continued to rise: 1,849 in 2003, 2,464 in 2004 and 3,214 in 2005. One way to show how prevalent Skid Row staph has become is this statistic: In 2002, 9 percent of inmates diagnosed with staph were believed to have contracted the infection in the community; now, it is up to one-third ..

“There are a lot of sick people in the jail and people who are at risk of being infected. One-third of our inmates are on pill call,” says jail epidemiologist Dr. Nina Harawa.

RELATED: How Europe is dealing with the Staph crisis. Quotable:

If you are an American admitted to a hospital in Amsterdam, Toronto, or Copenhagen these days, you’ll be considered a biohazard. Doctors and nurses will likely put you into quarantine while they determine whether you’re carrying methicillin-resistant Staphylococcus aureus, a deadly organism that is increasingly common stateside, especially in our hospitals. And if you test positive for methicillin-resistant staph, or MRSA, these European and Canadian hospital workers will don protective gloves, masks, and gowns each time they approach you, and then strip off the gear and scrub down vigorously when they leave your room. The process is known as “search and destroy”—a combat mission that hospitals abroad are undertaking to prevent the spread of germs that resist antibiotics. Our own health authorities, meanwhile, have been strangely reluctant to join the assault.

In the United States, MRSA kills an estimated 13,000 people every year, which means that a hospital patient is 10 times as likely to die of MRSA as an inmate is to be murdered in prison. The latest survey by the Centers for Disease Control and Prevention found that 64 percent of the Staphylococcus-aureus strains in American hospitals were MRSA—that is, resistant to the powerful antibiotic methicillin and other antibiotics—which makes them difficult to treat. MRSA has also spread to the general public, afflicting football teams and schools in the last three years. I know a healthy 5-year-old who got a staph infection recently after she skinned her knee on the playground. She ended up requiring two full months of antibiotic treatment, while her mother scoured the house with bleach on doctor’s orders. And she may not be rid of the bug yet.

Given the dimensions of the threat, you’d think that the CDC would be making a priority of fighting it. After all, federal health agencies have spent billions to fight anthrax (which caused five deaths in 2001), smallpox (last U.S. death: 1949), and pandemic flu (yet to appear in the United States). And there is reason to think that search and destroy works, since health-care authorities abroad have kept rates of antibiotic-resistant bugs in their countries much lower than ours. In Dutch hospitals, the rate of MRSA is less than 1 percent. Canada’s rate is 10 percent. And more than 100 studies have shown the effectiveness of search and destroy ..

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