The Killer in the Locker Room
There's a deadly new superbug that targets fit young men, and even the NFL is worried. They're taking precautions. So should you
By: Christopher McDougall
If it weren't so real, so tragic, and such a Critical wake-up call, it could be a sick joke: Ricky Lannetti, 21 years old and tough as a truck tire, was killed by a pimple on his butt.
He'd noticed the little welt last fall, when he was dressing for football practice at Lycoming College in Williamsport, Pennsylvania. It was right under the back strap of his jock and getting a little raw, but he sure as hell wasn't going to ask the trainers to look at a pimple, not while other guys were waiting to have real injuries wrapped and taped.
Besides, apart from that, he felt great. As a senior and a starting wide receiver for Lycoming, Lannetti was having the best season of his life: He set a school record with 16 catches in a game, then the following week broke the record for catches in a season. The next Saturday, he snagged five balls as the Warriors won in overtime to advance in the playoffs. The next Saturday, he was dead.
The MRSA "Superbug"
What was found in Lannetti's blood was a "superbug," an especially aggressive type of bacterial infection called MRSA. Until recently, few family doctors had ever seen methicillin-resistant Staphylococcus aureus, and even fewer people had died of it. But over the past year, it has spread so quickly--and mutated into such frighteningly powerful strains--that even paramedics now know it by its phonetic nickname: "Mersa."
"Two years ago, it was completely unheard of," says Greg Moran, M.D., an infectious-disease specialist at the UCLA school of medicine. His E.R. has seen an "amazing" increase in MRSA cases. "Of the people who come in with skin infections, 64 percent have MRSA," he says. "It's remarkable how fast it's become one of the most common things we see."
Recent estimates by the Centers for Disease Control and Prevention (CDC) place the num00. "The majority of the infected seem to be men," says Dr. Moran, "although no one knows why. It's such a new thing, there's not a whole lot of published information out there." So little is known about this sudden surge in MRSA cases that Dr. Moran is leading a nationwide study of skin infections seen in emergency rooms. Until then, he says, "we're learning on the fly."
Spreading Infections
Just 10 years ago, chronically ill patients in hospital settings accounted for most MRSA infections. Kidney-dialysis patients, burn victims, and HIV-AIDS sufferers were among the high-risk groups, because their immune systems were weak and they took such heavy doses of strong antibiotics that their bodies became veritable petri dishes for the growth of superbugs. And even if they weren't growing their own germs, these patients often had bedsores that allowed bacteria to worm their way in.
But now, MRSA is turning up most among the people who'd least expect to get it: young, healthy men who are often in very good shape. Last year, several members of the Miami Dolphins, including star linebacker Junior Seau and kickoff-return ace Charlie Rogers, were infected with MRSA. Seau and Rogers had to be hospitalized, as did Tampa Bay Buccaneer Kenyatta Walker and the Cleveland Browns' Ben Taylor, who needed an emergency operation to beat the infection.
It's not just pro athletes who've been hit: Five members of a fencing team in Colorado were also stricken, as were two high-school wrestlers in Indiana, 10 college football players in Pennsylvania, and two more in California. Although no quantitative studies have broken down the MRSA outbreak by gender, the CDC has found that the majority of new infections are among young men who share some kind of skin-to-skin contact, such as through sports. Outbreaks have also been reported among military recruits (235 cases were diagnosed at one basic-training site in the South), gay men, police cadets, and prisoners. All those men recovered, but many needed hospitalization and heavy antibiotics.
"You don't even need direct contact to become infected," points out Barry Kreiswirth, Ph.D., the director of the Public Health Research Institute Tuberculosis Center. "Staph has been spread in locker rooms by towel snapping. If he's got turf burn on his leg and you've got the bacteria on the towel, he can become infected."
And the more MRSA spreads, the more aggressive it seems to become. Not long ago, a person infected with staph would show up in a doctor's office with nothing worse than an abscess.
But by 1999, MRSA had killed four otherwise healthy children in North Dakota and Minnesota. By December 2003, it was strong enough to kill Ricky Lannetti.
The Zit that Did it
"He called Tuesday and said he was throwing up, but it wasn't that bad," recalls Ricky's mother, Theresa Lannetti, who looks like a grown-up cheerleader with her gentle smile and gymnast-lithe appearance. First thing the next morning, Ricky dragged himself to the school clinic. "Just a stomach bug," the nurse said, and sent Ricky back to his dorm. On Thursday, Theresa called the football trainer to check on her son, which led to a visit to a local doctor for blood work. But Theresa didn't wait for the results: When she heard Ricky was still feverish on Friday, she drove 5 hours through a blizzard to reach him. The Lannettis are as tough as they come--after raising three kids on a secretary's salary, Theresa joined the Philadelphia Police Academy at age 39--so she knew if her son was hurting this badly, it wasn't a touch of the flu.
When she arrived at Ricky's dorm, she was shocked. Ricky was deathly pale, and so weak his roommate had to carry him downstairs. He had a raging thirst and kept gulping Gatorade, even though he hadn't urinated in days.
By the time they got to Williamsport Hospital, Ricky was vomiting blood. Every specialist in the hospital crowded into his room, but they were all mystified: They were looking at a muscular young man with zero medical history whose body was acting like that of an ailing geriatric. The doctors tried one antibiotic, then another, and another, until Ricky had five in his system, but he was still burning with fever and passing blood through his catheter. The hospital called for a medevac chopper to fly him to an infectious-disease unit in Philadelphia, but just that fast, it was too late: Within hours, Ricky's vital functions were shutting down. His kidneys went, then his liver, and when surgeons tried to keep his heart beating with a catheter, they lost him.
"I couldn't believe this was happening," says Theresa. She'd just seen Ricky slamming his 5'9", 170-pound body all over the field a few days before, and now he was lying dead on a gurney and no one could explain how it had happened. A few days later, however, the coroner discovered two things: Ricky had MRSA in his blood and a tiny red welt on his buttocks. "He told me the infection must have spread from that little pimple," Theresa says.
"We're seeing more people who've been infected with abscesses on their buttocks, and the truth is, we don't know why," says Kreiswirth. It might be because a larger, fleshier area is more vulnerable to soft-tissue sores, or because the buttocks tend to be more damp with sweat and less exposed to air, but that's just speculation. "Until we understand more about how this staph operates," says Kreiswirth, "we won't know why it seems to favor certain parts of the body . . . or why one person will get a boil, and another will die."
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