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healyje
Trad climber
Portland, Oregon
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Topic Author's Original Post - Nov 6, 2006 - 03:27am PT
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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
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steelmnkey
climber
Vision man...ya gotta have vision...
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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!!!
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Batrock
Trad climber
Burbank
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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.
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healyje
Trad climber
Portland, Oregon
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Topic Author's Reply - Nov 6, 2006 - 11:41am PT
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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...
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atchafalaya
Trad climber
California
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thats it, I f$#@$$%% quit climbing...
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healyje
Trad climber
Portland, Oregon
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Topic Author's Reply - Nov 6, 2006 - 05:08pm PT
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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.
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Ouch!
climber
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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.
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healyje
Trad climber
Portland, Oregon
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Topic Author's Reply - Nov 6, 2006 - 06:12pm PT
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Well, now here is a good climbing topic for Lois to jump in on...
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poser
Trad climber
emporium, pa
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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.
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meg_
Trad climber
Boston
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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.
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Irisharehere
Trad climber
Gunks
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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
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jnut
climber
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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.
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Irisharehere
Trad climber
Gunks
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Actually, staph can live on foreign surfaces for far far longer than 24 hours....
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meg_
Trad climber
Boston
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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
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meg_
Trad climber
Boston
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Oh- Staph can live on climbing holds for up to 4 days.
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Irisharehere
Trad climber
Gunks
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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
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meg_
Trad climber
Boston
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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
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DHike
climber
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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....
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quietpartner
Trad climber
Moantannah
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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. ;^)
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