Sunday, July 6, 2008
Could Meth Users Be Spreading Staph Infections?
A study by the Centers for Disease Control and Prevention (CDC) indicates that nearly 19,000 people died in the U.S. in 2005 after being infected with an antibiotic-resistant staph infection, formally known as Methicillin-resistant Staphylococcus aureus (MRSA). As noted in an AP story the New York Times ran in October of 2007, this would mean that, each year, more Americans die of staph infections than of HIV-AIDS, Parkinsons, emphysema or homicide.
Rural communities, particularly communities in the rural South, are thought to be the hardest hit by these staph outbreaks - although infections have gone largely unreported.
The CDC and the Georgia Department of Public Health studied three rural Georgia emergency rooms and three urgent care facilities over two months in 2005. Of the 119 patients who visited these facilities to seek treatment for a skin infection, a full 68% had an MRSA infection. Ten percent of those patients infected with an MRSA admitted to using methamphetamine.
This study suggests that rural Georgia has among the highest rates of MRSA infection in the nation. It also shows that crystal meth-users are five times more likely to develop an MRSA than the general population, a figure that has been confirmed by other studies.
Drug users are not the only people at risk. Anyone who comes in physical contact with an MRSA-infected person can contract the disease, and those living in households with an MRSA-infected person are particularly vulnerable. Unlike other infections related to drug use, meth-users who have MRSA do not spread the disease via injections. Rather, it is contracted via contact with MRSA-infected skin. Meth-users suffer from a feeling of "crawling skin," and are thus prone to excessive scratching. Once an MRSA sore is opened via scratching, the disease is spread through physical contact.
Therefore, the children of crystal meth-users, a vulnerable population with limited access to health care, are at particular risk for contracting the disease. Once MRSA is contracted, they can spread it to other children via physical contact at school. This may, in part, explain the introduction of MRSA into Georgia schools. Despite extensive research, I could not find a health organization, nor a news organization, that has yet investigated this possibility.
With Atlanta serving at the U.S. distribution base for an influx of Mexican methamphetamine, Georgia maintains a high rate of crystal meth use. The deaths of two children due to MRSA recently garnered a front page spot on the Atlanta Journal Constitution. I am surprised that, given the 2005 CDC study, the AJC didn't explore the possible link between methamphetamine users and these children's MRSA exposure.
I am by no means suggesting that the grieving parents of the children that died due to MRSA infections are meth-users. But perhaps it would be useful, in finding the source of these infections, to investigate whether the children could have come in contact with a meth-user or the child of a meth-user. If we can isolate and treat the person introducing the disease into the population, perhaps we can stop its spread.
Of course, these children could have easily come in contact with someone who was infected with MRSA during a hospital stay, as hospital infections account for approximately 85% of MRSA deaths. Contact with a meth user is certainly not the necessary cause.
It is largely my personal experience with MRSA that leads me to believe that the link between meth use and staph infection in the general population warrants further investigation. During the methamphetamine epidemic in my hometown of Elba, Alabama (pop. 4,000), staph infections became rampant. It began with the meth-users. In fact, we locals came to see a staph sore as the surest tell-tale sign that someone was using. However, infections also began to crop up in non-users as well, and in children - although at a lower rate than they did in meth-users. Thankfully, none of these infections was serious, and thus did not warrant reporting to health agencies.
But when I began to see news reports of staph infections here in Atlanta, I wondered why no one was talking about what everyone back in Elba had known: meth use brings with it staph infection, and staph infection can be spread to anyone, whether they use the drug or not. Perhaps I am making more of this connection than there is, based on my own anecdotal evidence. Still, with the number of serious MRSA infections rising steadily, particularly in places like the rural South, it would be reassuring to hear some discussion on the topic.