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Commercial Fisheries News
Volume 37 Number 3
November 2010
MRSA infection outbreaks can happen anywhere
In early October, news reports began circulating that a persistent skin infection had showed up among lobstermen on Vinalhaven Island, ME. The diagnosis for the red, boil-like skin eruptions was “methicillin-resistant Staphylococcus aureus,” often abbreviated MRSA, which is pronounced “mersa.”
S. aureus is a bacterium. We usually hear of S. aureus infections as originating in hospitals. However, there is a strain known as “community-acquired MRSA,” also known as CA-MRSA.
In describing the condition, people often say the infection or boil looks like a spider bite. The condition is resistant to certain penicillin- or cephalosporin-related antibiotics.
So, who is at risk? CA-MRSA often shows up in communities or groups of people who live or work in close proximity. Some typical groups are athletic teams, prisoners, and home health aides who work closely with patients. CA-MRSA also can cluster in homes or where there are crowded living conditions.
Other at-risk populations include those with compromised immune systems, severe asthma, diabetes, or those who use intravenous drugs. However, compromised immune system or not, MRSA is potentially very serious and must be promptly and properly treated.
The risk for MRSA infection increases in the presence of broken skin, meaning open cuts and/or abrasions. While the bacteria can contaminate and live on fromites – inanimate objects such as towels, gloves, boots, doorknobs, and shower curtains – it does not survive in significant numbers in salt water.
Yet, clearly lobstermen and fishermen are at risk. Their hands often have broken skin, and broken skin may be present on the legs or feet when, for example, rubber boots cause chafing.
Risk reduction
There are a number of steps lobstermen and fishermen can take to reduce the risk of MRSA infection.
The first is to wash hands frequently and keep skin clean and as scrape- and nick-free as possible. When soap and water are not available, alcohol hand cleaners are an excellent alternative. Purchase the kind that contains aloe or other softeners to help prevent over-drying of the skin.
Another is to keep trousers, shirts, socks, underwear, towels, and sheets as clean as possible. If you can, wash all laundry in hot water, at least when an infection is present.
And, it is best not to share clothing, towels, face cloths, razors, rubber gloves, boots, or any other personal item with anyone else.
A medic with the Navy once told me that an investigation of a MRSA infection among a group of Marines discovered that the reservoir for the S. aureus bacteria was their flak jackets.
One possible culprit for harboring the bacterium among lobstermen could be rubber gloves and rubber boots. S. aureus likes warm, moist environments, so it potentially could colonize inside gloves and boots not routinely cleaned with hot soapy water.
Several of us in the occupational health profession have come up with a prevention idea to reduce the potential for rubber gloves and boots to harbor bacteria, but I need to try it out before putting it out there for suggested use.
Treatment
Because CA-MRSA spreads so easily and can become so serious, anyone who suspects they may have an infection should not self-treat or pop the boils. Instead, cover the area and consult a health care provider as soon as possible.
The health care provider may incise (cut) the boil to drain it and/or prescribe one of the antibiotics that does work against MRSA. As always, it is extremely important for anyone who is prescribed antibiotics to take the pills as prescribed and finish all of them in order to reduce the risk of the S. aureus becoming resistant to that antibiotic as well.
And, by the way, having had the infection does not mean a person is immune from having it again in the future, as Vinalhaven residents have experienced firsthand. So, the especially careful hygiene regime must become routine. There is no telling where a reservoir of S. aureus might colonize or lurk.
Ann Backus, MS, is the Director of Outreach in the Department of Environmental Health, Harvard School of Public Health in Boston, MA. She can be reached at (617) 432-3327 or e-mail <abackus@hohp.harvard.edu>.
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