All Those Bugs at the Gym, Oh My!

By: Jenny Walters

A recent article on Cnn.com entitled Germ warfare moves to the gym by Linda Saether dealt with the ever increases germs that are present at gyms around the U.S.

According to Dr. Brian Adams, director of University of Cincinnati Sports Dermatology Clinic, “Gyms are great for fitness, but like fun in the sun, you just have to be careful.”[1]

The main microorganisms present at gyms include bacteria, fungi, and viruses. Germs are able to travel to and from many gym –goers’ due to the number of people who share equipment, exercise mats, lockers, and showers. In addition, the activities that gym-goers’ take part in also put them at risk.

Dr. Adams stated: “The first several layers of skin are like a castle wall protecting the athlete from outside marauders. Abrasions from mats and weigh equipment, blisters from constant rubbing while running or using weight equipment both help to break down the castle wall and allow microorganisms to enter the skin.”

Sweating is also another way that germs can enter the body at a gym. According to Dr. Adams: “Sweating super-hydrates the skin and makes the athletes more likely to develop blisters. Sweating by itself may alter the castle and allow penetration of the bugs.”

Bugs that can cause problems include fungi, which can cause athlete’s foot, to viruses that can cause herpes or potentially deadly infections known as MRSA, or methicillin-resistant staphylococcus aureus.

A first line of defense for the gym-goer is disinfectant. Before an individual uses any piece of equipment, he/she needs to wipe down the equipment with disinfectant wipes. The disinfectant wipes will kill any germs that were present on the gym equipment.

One gym-goer has her germ-fighting weapons all contained in her “ultrabreathable, pink, Nike backpack.” Her backpack contains a clean water bottle, plastic bags, workout gear, a clean towel, flip-flops for the shower, a fresh bag of wipes and “everyone’s weapon of choice, the don’t-leave-home-without-it pocket hand sanitizer.”

Due to news of MRSA spreading in gyms, germ fighting has been taken “up a notch.” Gyms today are offering hand sanitizers located throughout the gym and many other germ fighting products.

This article brings light to the age of being vigilant about germs. For me, a nurse a mother, I have the word vigilant about germs embedded into my brain. My husband thinks I go a little overboard, but I would rather be safe than worry about the germs my daughter has been exposed to throughout the day. However, as my pediatrician says, germs are everywhere and it’s good to be exposed to some now and than.

[1] Saether L. Germ warfare moves to the gym. July 2008. Available at: http://www.cnn.com/2008/HEALTH/07/10/hfh.fighting.germs/index.html. Accessed on July 18, 2008.

UCSF Scrambles to Undo Damage

As I wrote about earlier this week, UCSF researchers released a study linking a new drug-resistant strain of staph known as MRSA USA300 to the gay community, prompting worldwide headlines that read such 1980s flashback headlines as "FLESH-EATING BUG SPREADS AMONG GAYS" and "EPIDEMIC FEARED--GAYS MAY SPREAD DEADLY STAPH INFECTION TO GENERAL POPULATION". Aside from fueling general fears, the report (and headlines) gave ammunition to anti-gay groups like the Concerned Women of America, who used this latest research as a rallying point for their point of view that homosexuality is sexually deviant behaviour, and these infections are proof of it. And while conventional wisdom says everything becomes a fad 20 years after it was originally around, this is one particular period of the 80s I think we could all do without.

Anyhow, the UCSF researchers actually appeared to realize the damage done, and are waging a media war of their own to undo the inaccurate media reports, misconceptions of what their study said, and undermine groups who are trying to twist their study for other agendas. On Friday, the university and its researchers issued an apology, saying

their release had “contained some information that could be interpreted as misleading.”

“We deplore negative targeting of specific populations in association with MRSA infections or other public health concerns,” it concluded. Dr. Henry Chambers, one of the report’s authors and a professor of medicine at the university, said he was surprised by how the report had been spun.

“I think we were looking at this from a scientific point of view and not projecting any political impact,” he said. “We were focusing on the data. You want to make sure it’s as right as possible and written up in a form that reviewers would understand what you’re trying to say, and do it in a clear manner so it’s not subject to misinterpretation. Which is what happened later, it appears.”

What is interesting about this is the acknowledgment by Dr. Chambers that they did not think outside their own discipline when writing their report or releasing the study. While that limited view and hyper-focus was a common and accepted part of a pre-internet academic community, which relied on published journals to transmit information - guaranteeing that at least the media would have to wait to attempt to stir up sensationalist claims. These days of electronic media, however, lead to a situation of electronic publication of paper results, which is how the UCSF MRSA USA300 report was made public. With that comes instant reporting, instant response, and the emphasis moves away from accuracy and towards sensationalism, an effort to attract the viewer eye. How do you compete with that?

The answer, it seems, is simple. You play the same game. Instead of ignoring the potentials of the internet for rapid information dissemination, for instant response, you do what Dr. William H. Parker, clinical professor of obstetrics and gynecology at the University of California, Los Angeles School of Medicine did. You fight fire with fire, create your own email messages with accurate information you encourage people to forward on, and make sure when you release your research results to the public, you consider both your academic peers and the lay people who will see the research. This might mean writing a "dumbed down" or accessible version of your report for release to general media outlets - but isn't that preferable to having your research misinterpreted and misreported?
-Kelly

Casual Contact MRSA

BBC News is reporting something that some have undoubtedly already heard about: that there is a new MRSA strain, USA300, which varies significantly from the MRSA strains we've seen in the past: it's acquired in the community, from skin to skin contact, and not hospital settings.

Up until now, hospitals have been the tried and true mode of infection with any of the multiple drug resistant bugs in our environment, and for decent reason: hospitals, for all their efforts at sterility, house the sickest of the sick, and prove to be breeding grounds for antibiotic resistance.

What's noticeable about USA300 is two things. First is the fact that it's transmitted in the community, by skin to skin contact. While this is generally sexual contact, any sort of prolonged contact with another's skin is enough for transmission, and there is already evidence that this high contact no sex transmission has taken place.

The second interesting thing is that reporting of MRSA USA300 has reminded me of the initial reporting of HIV/AIDS back in the 1980s, albeit on a larger scale. And it might just be my memory of the San Fran/Bay Area reporting filtered through multiple books, novels, and movies, but the tone of the articles - "new outbreak in San Francisco gay community", "gay men affected by new skin to skin disease", etc - is eerily familiar. And I can't decide how I feel about this. On the one hand, it's only responsible to make sure it's clear everyone knows whether or not they're in a vulnerable population group. But on the other hand, it seems like it's walking dangerously close to stigmatization, again. This is alleviated by the acknowledgment of casual, non-sexual skin to skin transmission, but that seems overshadowed by the general tone of the articles I've been reading.

Perhaps most of all, it's disappointing. I would have hoped that these 20-odd years later, people would have learned how to write about an emergent infectious disease without creating, intentionally or otherwise, a stigmatized population group to go with it.
-Kelly

I'm editing this some six hours after the initial post, because I wanted to put up a picture of the kinds of headlines I'm referring to, as well as a link to the Google News collection of these stories - all of which have a disturbingly similar theme in their headlines. Click on the image above to see them all.

Pollan on Pollen-Patties and Porcine MRSA

Michael Pollan critiques the lip service paid to the word "sustainability" and shines a light on two larger crises that have roots in our food production system: "Our Decrepit Food Factories". (NYT)

He suggests that the rise of "community-acquired MRSA" (infections not from hospital exposure) stems from our excessive use of antibiotics in raising livestock, especially pigs. With 70% of the antibiotics used in America being fed to our livestock, it is certainly feasible that we are cultivating tomorrow's disease even as we grow today's dinner (UCS). What is so ironic is that comparisons between CAFOs (Confined Animal Feeding Operations) with humanely grown livestock end up with comparable cost-gain ratios, with the former spending less money on animal welfare and more on survival tactics like antibiotics, while the latter pays more up-front for smaller-scale operations but has considerably lower costs when fewer animals become ill from poor conditions. Not only should this serve as a call for a paradigm shift in how we expect our food to be produced, but it also shows a severe failure on the part of the FDA and other public health entities in letting this issue fall into their corporate-induced blind spot.

Pollan also explores the current decimation of our honeybees due to Colony-Collapse disorder, and points out the extreme stress that commercial monocultures like almond growing places on the bees. The stress reduces the effectiveness of their immune systems, and unchecked mingling of large numbers of hives from across the country at almond groves increases the chance of being exposed to viruses like Israeli Acute Paralysis Virus (implicated for causing CCD). In China, there are no more honeybees, and the only thing keeping their agricultural system running is a caste of nearly slave-class people whose job it is to hand-pollinate flowers of fruit trees. Fortunately for China (and for us, since much of our produce, including apples, is imported from there), they don't worry about niggling issues like worker rights and workers' compensation.

The running theme throughout stories like these are that the commodification of organisms and the hubris of complete disregard for the integrity of natural systems of checks and balances could be the source of our downfall. The irony is that each step we take to try to reassert our mastery of Nature is driving us further into this mire of public health threats and looming collapse of the agricultural economy.

Pollan concludes with this:

We’re asking a lot of our bees. We’re asking a lot of our pigs too. That seems to be a hallmark of industrial agriculture: to maximize production and keep food as cheap as possible, it pushes natural systems and organisms to their limit, asking them to function as efficiently as machines. When the inevitable problems crop up — when bees or pigs remind us they are not machines — the system can be ingenious in finding “solutions,” whether in the form of antibiotics to keep pigs healthy or foreign bees to help pollinate the almonds. But this year’s solutions have a way of becoming next year’s problems. That is to say, they aren’t “sustainable.”

From this perspective, the story of Colony Collapse Disorder and the story of drug-resistant staph are the same story. Both are parables about the precariousness of monocultures. Whenever we try to rearrange natural systems along the lines of a machine or a factory, whether by raising too many pigs in one place or too many almond trees, whatever we may gain in industrial efficiency, we sacrifice in biological resilience. The question is not whether systems this brittle will break down, but when and how, and whether when they do, we’ll be prepared to treat the whole idea of sustainability as something more than a nice word.

(Additionally, Pollan has a new book soon to be released: In Defense of Food: An Eater's Manifesto.)