Four crew athletes treated for CA-MRSA bacterial infection

Author: Tamara Hilmes

In the past two weeks, four members of the Middlebury crew team have been diagnosed with and treated for community-associated MRSA (CA-MRSA), a strain of antibiotic-resistant staph bacteria. The College has taken measures to prevent further spread of the bacteria, which include disinfecting equipment and informing student athletes as to how they can avoid contracting the infection.

The spread of CA-MRSA, however, is not limited merely to athletes. CA-MRSA is spread through skin-to-skin contact between otherwise healthy people outside of healthcare facilities - unlike the bacterial infection methicillin-resistant Staphylococcus aureus (MRSA), which typically occurs in hospitals and healthcare centers, such as nursing homes - according to the Centers for Disease Control and Prevention Web site.

The first case of the most recent handful of MRSA incidents was diagnosed on April 20. About two weeks ago, Dave Peduto '11, a member of the Middlebury crew team, noticed a pimple on the side of his wrist. The next day, Peduto attended a regatta with his team and remembered noticing, in the middle of showing off his blisters, that the pimple had increased in size.

The next day, Peduto went to Parton Health Center, where they suspected that it might be related to the bacterial infection, and was referred to the ER in Porter Hospital. In the ER, the pimple was lanced and a culture was taken. An IV of antibiotics, two additional visits to the Health Center and a shot of novocaine later, Peduto had been diagnosed with CA-MRSA.

In the ER, Peduto met with a surgeon who told him that the bacteria was essentially living off of the dead skin in the area where the supposed "pimple" had been - the area, by this point, was completely black and purple and had grown, according to Peduto. The surgeon recommended operating.

"I did not really want to have surgery," said Peduto. "The doctor explained that he would have to go in kind of deep, and that he might knick a nerve that would reduce the feeling in my hand and fingers. At the same time, though, I didn't really have an alternative. I was pretty shaken up by that."

Peduto spent four days in the hospital on antibiotics, during which the infected area was removed. What started as a pimple, said Peduto, is now a gaping hole. Peduto continues to go to the Health Center twice a day, where the nurses clean and pack the area with wet gauze.

Before he contracted the bacterial infection himself, Peduto had never really thought much of the risks of CA-MRSA.

"That's the craziest thing about it," said Peduto. "You see the posters in the gym - like, there's that poster right next to the door of the men's locker room with the guy with the scar on his knee talking about MRSA, and the ones by the water fountains in the fitness center - but you don't really think about it affecting you."

After Peduto had been diagnosed, three additional members of the crew team found themselves being treated for the infection, despite the immediate measures that were taken to disinfect all equipment that might have come into contact with the bacteria.

"As soon as the diagnosis of CA-MRSA was confirmed, all rowing equipment was disinfected using commercial-grade disinfectant solution or a 10% bleach solution," explained interim Crew coach Noel Wanner in an e-mail. "This process was repeated a second time the following week." The team has also begun to disinfect oar handles and seat tracks once a week, "as these are the areas which come into closest contact with the athletes, and where abrasions are likely to occur," according to Wanner.

Peduto worked with his coach to find other means of preventing further spread of the bacteria, which included assigning oars to specific members of the team for the remainder of the season. In the future, each athlete will be assigned one oar to use for the entire season, and when changes in the lineups require athletes to switch oars, said Wanner, the oar handles will be disinfected prior to the change. The increased use of disinfectant wipes, along with alcohol-based sanitizing gel, has also been encouraged.

"Three other guys got it after me," said Peduto, "that's the scary thing. I can't row, which is killing me, but we're just trying not to let it spread any more than it already has."

Director of the Health Center Dr. Mark Peluso also met with the team to discuss ways of preventing the spread of CA-MRSA, emphasizing the importance of maintaining good personal hygiene habits. Members of the team were told to shower often, wash their practice clothes after every use and to change their sheets more frequently.

According to Peluso, dealing with the threat of CA-MRSA is nothing new.

"The medical literature began reporting CA-MRSA infections among sports teams in 2004, and several of our peer institutions experienced clusters of cases starting soon thereafter," he wrote in an e-mail. "We began instituting several prevention measures that were thought to be helpful in terms of preventing outbreaks. After an environmental assessment was performed to identify areas where CA-MRSA might spread, several measures were instituted, starting in 2005-2006."

"A great deal of the credit in keeping Middlebury's infection rate low should be given to the Facilities, Sports Medicine, Equipment Room, and Athletics staff. These groups have taken CA-MRSA seriously, and made simple adjustments in their operations to prevent potential spread of the bacteria, often without needing to be asked. It's unrecognized in many cases, but many of the people that work at Middlebury College have shown great dedication to the students in this effort."

Despite the recent handful of infected students, the Health Center did not issue a campus-wide e-mail as it has in the past-such as when an e-mail was sent out regarding mumps in the fall - denoting the risk of the bacteria. Peluso explains that this was not necessary, as CA-MRSA is not as highly contagious as the mumps, and the symptoms are more easily recognizable.

"The Health Center has not issued a campus-wide email regarding a cluster of cases on one sports team because it is an isolated cluster - not an outbreak," said Peluso. "The skin and soft-tissue landscape is changing, which is something that students and the entire American population are going to have to learn to live with. However, it should not cause excessive concern if proper prevention measures and care are followed."

"Most people don't know what it is," said Peduto. "When they ask, I've just been explaining it as a really bad skin infection. People have been great, in general, and really supportive. Probably the most politically-incorrect reaction I received was 'EWW!' But if what I've gone through can help raise a general awareness about it - if we can take that away from this - well, I think that's a good thing."