Skin Infection Article

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Locker-room menace

Rash of serious skin infections puts athletes at risk

Friday, June 23, 2006


Athletes have more than the usual sprains and strains to worry about. A new health hazard with potentially fatal consequences has emerged: skin infections that fail to respond to medication.

"We were not seeing these five to 10 years ago," said Dr. Don LeMay, an Ohio State University sports-medicine specialist. "Skin infections among athletes are not new, but skin infections resistant to normal treatments are new. "They can progress to the point where people lose limbs or die." Cases historically have occurred among hospital patients with weakened immune systems, LeMay said.

But public-health officials have noticed an increasing number in healthy sports participants of all ages. During the past four years, health departments have documented outbreaks among fencing, football and wrestling teams nationwide.

The most serious ailment, known as MRSA (methicillinresistant Staphylococcus aureus), is caused by a common bacteria resistant to methicillin and other antibiotics.

The infections have been linked to the 2003 death of a football player at Lycoming College in Williamsport, Pa., and the April death of a University of Tulsa football player.

And this season the infections temporarily sidelined two star wrestlers at Worthington Christian High School, sophomores Colin Heasley and Daniel Foley. Each needed intravenous administration of stronger and more-costly antibiotics.

Heasley went on to finish fifth in the state, but Foley failed to qualify for the district tournament. "He never could recover," said his father, Kevin Foley, the wrestling coach. "I didn't know his condition could be this bad. I was too ignorant to be worried."

Sports participants are susceptible because they often sustain cuts and scrapes that serve as portals for germs from contaminated teammates, opponents or equipment.

The risk is greatest in contact sports that require a lot of gear, including football, hockey and lacrosse. The skin-to-skin contact makes wrestling another highrisk sport.

"Our wrestlers have skin infections all the time," said LeMay, an OSU team physician. The National Federation of State High School Associations, the National Collegiate Athletic Association and the National Athletic Trainers' Association have issued alerts about the dangers of this flesh-eating superbug, which can trigger pneumonia and blood poisoning.

In response to an MRSA infection in a wrestler this year, Gahanna Lincoln High School plans to organize a meeting about the issue in the fall for parents and athletes, and publish fliers about prevention.

"We want to know about every infection among all of our athletes," said teacher and team trainer Paul Miller. "This is something serious. I hate to scare our kids and parents, but how else do we get their attention? "

The infections initially resemble harmless spider bites and pimples that can discourage many people from seeking immediate treatment, LeMay said.

Youth-hockey referee Gary Graven spent four days in the hospital last summer after he allowed what looked like boils to fester for several months.

His fingers eventually swelled to the size of sausages and a red streak ran up his arm.

"My doctor told me I might have lost my arm if I waited another 24 hours," he said.

Graven blamed the infection on bacteria from dirty shin guards.

The experience encouraged him to invest $100,000 in a washing machine to start Clean Gear of Columbus, a sports equipment cleaning business ("People don't realize how dangerous these infections can be," he said. "Parents don't even think about them."

Most of the staph infections among OSU athletes respond to routine antibiotic therapy, LeMay said.

An increasing number of strains, however, require more aggressive treatment. The problem promises to become more severe as bacteria mutate to resist different antibiotics.

Drug companies have not been motivated to develop new compounds because they can be rendered ineffective in as little as four to six months. "Our choices are becoming fewer and fewer," said Mike Crowder, a Miami University biochemist.

The Centers for Disease Control has issued prevention guidelines that essentially amount to good hygiene.

But some parents find it nearly impossible to keep clean the clothing and gear of children who play or practice four to five times a week.

Dave Abernethy's 15-year-old stepdaughter, Alyssa Smith, is at the ice rink up to five times a week during hockey season between September and March. "We've tried the washing machine and the dishwasher," said Abernethy, a youth-hockey referee. "But her equipment still gets pretty gross. It's a breeding ground for bacteria. Sometimes I think we should just burn it and buy new."

Marigene Dolven has two sons -- Grant, 13, and Graham, 12 -- who play hockey and constantly fight rashes.

"My kids are just a mess," she said.

Mrs. Dolven regularly treats them with antibiotic cream and periodically cleans their gear in an industrial-size machine at a laundromat.

"My sons have a passion for playing, so I let them play," she said. "But I am all over their skin.

"These infections can be devastating, and people should pay attention to them."