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10-26-2008, 01:30 AM
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October 25, 2008
Experts Say Staph Is Common Problem for Athletes
By KATIE THOMAS (http://topics.nytimes.com/top/reference/timestopics/people/t/katie_thomas/index.html?inline=nyt-per)
The news in football this week often seemed ripped from the pages of a journal on infectious disease.
First there was Kellen Winslow, who received a one-game suspension after accusing the Browns of concealing his staph infection. Then there was the news that Peyton Manning (http://topics.nytimes.com/top/reference/timestopics/people/m/peyton_manning/index.html?inline=nyt-per) had developed a similar condition in his left knee earlier this year. Finally, there was Tom Brady (http://topics.nytimes.com/top/reference/timestopics/people/b/tom_brady/index.html?inline=nyt-per), whose rehabilitation from knee surgery has reportedly been delayed because of an unidentified infection, also in his left knee.
Despite the outbreak of headlines, several experts in sports medicine and epidemiology said the news only served to highlight how prevalent infections — especially staph infections — are among professional athletes and in the community at large.
“It seems like most of these are single-case episodes,” said Jeff Hageman, an epidemiologist for the Centers for Disease Control and Prevention (http://topics.nytimes.com/top/reference/timestopics/organizations/c/centers_for_disease_control_and_prevention/index.html?inline=nyt-org). “What we know is that staph is one of the most common causes of skin infection in the community,” he said, accounting for between 12 million to 14 million doctor visits a year.
Like athletes in other contact sports, football players are prone to staph infections because of their sport’s skin-on-skin contact, the frequency of cuts and the warm, moist conditions in locker rooms, which encourage the growth of bacteria. Because they are regulars in surgery wards, athletes are susceptible to infections there, too.
Garden-variety versions of the staphylococcus bacteria are easily treated and have lurked in locker rooms for years, but the problem has received heightened attention in recent years because of the emergence of a strain known as MRSA (http://health.nytimes.com/health/guides/disease/mrsa-infection/overview.html?inline=nyt-classifier), or methicillin-resistant Staphylococcus aureus, which is resistant to some types of antibiotics (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/antibiotics/index.html?inline=nyt-classifier). Serious cases of MRSA have derailed the careers of a handful of N.F.L. (http://topics.nytimes.com/top/reference/timestopics/organizations/n/national_football_league/index.html?inline=nyt-org) players, including Brandon Noble, a former defensive tackle for the Washington Redskins (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/washingtonredskins/index.html?inline=nyt-org), and Jeff Novak, a guard for the Jacksonville Jaguars (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/jacksonvillejaguars/index.html?inline=nyt-org) who later sued the team doctor for malpractice.
“These things are here, they’re very serious,” said Noble, who had two bouts of MRSA in 2005 and is now the defensive line coach at West Chester University in Pennsylvania. With high-profile players in the news, he said, “maybe it’ll wake some people up and get the ball rolling.”
Winslow has not said whether his staph infection — his second in three years — was MRSA, but Manning’s infection was not, according to a statement the Colts (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/indianapoliscolts/index.html?inline=nyt-org) released Friday. Brady, who contracted his infection after surgery, has not categorized it.
Greg Aiello, a spokesman for the National Football League, said the teams’ trainers and doctors met annually to discuss infections and other health concerns. “It’s an issue across the country,” he said. “It’s not an N.F.L. or a football player issue.”
A 2005 survey by the N.F.L. Team Physicians Society found that of the 30 teams that responded, 13 said a player had contracted a MRSA infection in recent years, for a total of 60 infections across the league. Andrew Tucker, the president of the society and the team doctor for the Ravens (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/baltimoreravens/index.html?inline=nyt-org), said teams had access to information about staph infections through an internal injury reporting database, but the N.F.L. declined to release the data.
Football teams increased their efforts to battle staph after 2003, when a MRSA outbreak among the Rams (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/stlouisrams/index.html?inline=nyt-org) resulted in eight infections. The Rams invited the C.D.C. to investigate their facility, and a 2005 study revealed some nose-wrinkling results — towels were being shared by as many as three players on the field, trainers did not always wash their hands when treating wounds, and players did not take showers before entering whirlpools. Football players were also taking antimicrobial drugs at 10 times the rate of the general public.
Jim Anderson, the Rams’ head trainer, said he was surprised when MRSA even turned up on ultrasound (http://health.nytimes.com/health/guides/test/ultrasound/overview.html?inline=nyt-classifier) equipment and in the cold pools. Since then, the Rams have been more diligent about disinfecting surfaces in the locker rooms and other facilities. Like other teams, they speak to players before each season about sanitary practices, imparting common-sense advice like washing one’s hands, treating open cuts, and not sharing drinks.
“The biggest thing was making them aware of it,” Anderson said. Since then, although a handful of Rams players have developed staph, none have been MRSA.
After Winslow criticized the Browns for concealing his illness from teammates — a claim the team denies and that led to his suspension, which he is appealing — several news media reports noted that the Browns have had six cases of staph infections since 2005. Bill Bonsiewicz, a Browns (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/clevelandbrowns/index.html?inline=nyt-org) spokesman, said in an e-mail message that Browns players have contracted seven cases of staph since 1999, including two MRSA cases separated by a few years. “Both players were aggressively treated and each returned to the field within a few weeks,” Bonsiewicz said. He declined to name the players, citing privacy reasons.
Tucker and Hageman said the frequency of staph infections among Browns players — spread over so many years — did not appear to be out of the ordinary. “You’re talking about one or two per year,” Tucker said. “That’s not a lot.”
Noble said that although teams were making an effort to prevent MRSA, eradicating the bacteria was nearly impossible. Locker rooms, after all, are filthy places. “There’s mud, there’s blood, there’s sweat, there’s spit,” he said. “It’s just a bunch of big, gross guys in a room together.”
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October 25, 2008
Experts Say Staph Is Common Problem for Athletes
By KATIE THOMAS (http://topics.nytimes.com/top/reference/timestopics/people/t/katie_thomas/index.html?inline=nyt-per)
The news in football this week often seemed ripped from the pages of a journal on infectious disease.
First there was Kellen Winslow, who received a one-game suspension after accusing the Browns of concealing his staph infection. Then there was the news that Peyton Manning (http://topics.nytimes.com/top/reference/timestopics/people/m/peyton_manning/index.html?inline=nyt-per) had developed a similar condition in his left knee earlier this year. Finally, there was Tom Brady (http://topics.nytimes.com/top/reference/timestopics/people/b/tom_brady/index.html?inline=nyt-per), whose rehabilitation from knee surgery has reportedly been delayed because of an unidentified infection, also in his left knee.
Despite the outbreak of headlines, several experts in sports medicine and epidemiology said the news only served to highlight how prevalent infections — especially staph infections — are among professional athletes and in the community at large.
“It seems like most of these are single-case episodes,” said Jeff Hageman, an epidemiologist for the Centers for Disease Control and Prevention (http://topics.nytimes.com/top/reference/timestopics/organizations/c/centers_for_disease_control_and_prevention/index.html?inline=nyt-org). “What we know is that staph is one of the most common causes of skin infection in the community,” he said, accounting for between 12 million to 14 million doctor visits a year.
Like athletes in other contact sports, football players are prone to staph infections because of their sport’s skin-on-skin contact, the frequency of cuts and the warm, moist conditions in locker rooms, which encourage the growth of bacteria. Because they are regulars in surgery wards, athletes are susceptible to infections there, too.
Garden-variety versions of the staphylococcus bacteria are easily treated and have lurked in locker rooms for years, but the problem has received heightened attention in recent years because of the emergence of a strain known as MRSA (http://health.nytimes.com/health/guides/disease/mrsa-infection/overview.html?inline=nyt-classifier), or methicillin-resistant Staphylococcus aureus, which is resistant to some types of antibiotics (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/antibiotics/index.html?inline=nyt-classifier). Serious cases of MRSA have derailed the careers of a handful of N.F.L. (http://topics.nytimes.com/top/reference/timestopics/organizations/n/national_football_league/index.html?inline=nyt-org) players, including Brandon Noble, a former defensive tackle for the Washington Redskins (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/washingtonredskins/index.html?inline=nyt-org), and Jeff Novak, a guard for the Jacksonville Jaguars (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/jacksonvillejaguars/index.html?inline=nyt-org) who later sued the team doctor for malpractice.
“These things are here, they’re very serious,” said Noble, who had two bouts of MRSA in 2005 and is now the defensive line coach at West Chester University in Pennsylvania. With high-profile players in the news, he said, “maybe it’ll wake some people up and get the ball rolling.”
Winslow has not said whether his staph infection — his second in three years — was MRSA, but Manning’s infection was not, according to a statement the Colts (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/indianapoliscolts/index.html?inline=nyt-org) released Friday. Brady, who contracted his infection after surgery, has not categorized it.
Greg Aiello, a spokesman for the National Football League, said the teams’ trainers and doctors met annually to discuss infections and other health concerns. “It’s an issue across the country,” he said. “It’s not an N.F.L. or a football player issue.”
A 2005 survey by the N.F.L. Team Physicians Society found that of the 30 teams that responded, 13 said a player had contracted a MRSA infection in recent years, for a total of 60 infections across the league. Andrew Tucker, the president of the society and the team doctor for the Ravens (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/baltimoreravens/index.html?inline=nyt-org), said teams had access to information about staph infections through an internal injury reporting database, but the N.F.L. declined to release the data.
Football teams increased their efforts to battle staph after 2003, when a MRSA outbreak among the Rams (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/stlouisrams/index.html?inline=nyt-org) resulted in eight infections. The Rams invited the C.D.C. to investigate their facility, and a 2005 study revealed some nose-wrinkling results — towels were being shared by as many as three players on the field, trainers did not always wash their hands when treating wounds, and players did not take showers before entering whirlpools. Football players were also taking antimicrobial drugs at 10 times the rate of the general public.
Jim Anderson, the Rams’ head trainer, said he was surprised when MRSA even turned up on ultrasound (http://health.nytimes.com/health/guides/test/ultrasound/overview.html?inline=nyt-classifier) equipment and in the cold pools. Since then, the Rams have been more diligent about disinfecting surfaces in the locker rooms and other facilities. Like other teams, they speak to players before each season about sanitary practices, imparting common-sense advice like washing one’s hands, treating open cuts, and not sharing drinks.
“The biggest thing was making them aware of it,” Anderson said. Since then, although a handful of Rams players have developed staph, none have been MRSA.
After Winslow criticized the Browns for concealing his illness from teammates — a claim the team denies and that led to his suspension, which he is appealing — several news media reports noted that the Browns have had six cases of staph infections since 2005. Bill Bonsiewicz, a Browns (http://topics.nytimes.com/top/news/sports/profootball/nationalfootballleague/clevelandbrowns/index.html?inline=nyt-org) spokesman, said in an e-mail message that Browns players have contracted seven cases of staph since 1999, including two MRSA cases separated by a few years. “Both players were aggressively treated and each returned to the field within a few weeks,” Bonsiewicz said. He declined to name the players, citing privacy reasons.
Tucker and Hageman said the frequency of staph infections among Browns players — spread over so many years — did not appear to be out of the ordinary. “You’re talking about one or two per year,” Tucker said. “That’s not a lot.”
Noble said that although teams were making an effort to prevent MRSA, eradicating the bacteria was nearly impossible. Locker rooms, after all, are filthy places. “There’s mud, there’s blood, there’s sweat, there’s spit,” he said. “It’s just a bunch of big, gross guys in a room together.”