Superbug at Canada's doorstep

A superbug that is popping up in locker rooms and day cares in the U.S. is poised to "emerge in force" in Canada, doctors warn.

Community-associated methicillin-resistant Staphylococcus aureus, or CA-MRSA, was previously confined to hospitals but epidemics are occurring in the U.S. andit's making inroads in Canada, according to a commentary published Tuesday in the Canadian Medical Association Journal.

The bacteria cause large boil-like infections, and can cause hemorrhagic pneumonia or flesh-eating disease in rare cases.

The organism is an "old foe with new fangs: a pathogen combining virulence, resistance and an ability to disseminate at large," Dr. John Conly, an infectious disease specialist and professor of medicine at the University of Calgary and his colleagues wrote.

New Canadian guidelines for health-care workers are meant to prevent and manage the problem, the study's authors said.

In the U.S., clusters of infections have been reported among professional baseball and football players, and toddlers in day care.

So far in Canada, outbreaks have occurred in B.C., Alberta, Saskatchewan, Manitoba and Ontario, with infections reported in Toronto, Montreal and Quebec City.

Two fatalities in Canada have also been linked to the germ: a healthy 30-year-old Calgary man and a three-month-old infant in Toronto in 2005. The deaths resulted from necrotizing pneumonia, or lung abscesses, the commentators said.

"We don't understand a whole lot," said Shirley Paton, an infectious disease expert at the Public Health Agency of Canada, where studies aim to help answer the questions, "Why now, why here, why outside the hospital?"

Prevention tips

To prevent cases, the authors suggest emphasizing hygiene at day-care centres and schools, such as:

• Washing hands or using alcohol gels.
• Keeping kids at home if a draining wound cannot be consistently covered.
• Practising respiratory etiquette like covering coughs.

Athletes, particularly those participating in contact sports, are also at risk, and should also practise hygiene such as showering after every practice or game, cleaning common bathing areas frequently, and regularly cleaning equipment.

Doctors and veterinarians should also keep in mind that pets may act as a reservoir for infections.

Traditional risk groups include intravenous drug users, the homeless, First Nations, the military, people infected with HIV and prison inmates.

Two years ago, Christine Besson and her father founded the Montreal-based Association to Defend Victims of Nosocomial [originating in hospital] Infections after he was infected with MRSA.

"The minute we saw that it was starting in the States,we knew at one point it was going to gothrough the border," she said. "Bacteria are more dangerous than terrorists," becausepeople carry themwithout knowing it.

Infectious disease experts do not want to sensationalize cases of CA-MRSA,but stressthe simple preventive steps mayhelp. So far, CA-MRSA is resistant to some antibiotics but not as many as strains in hospitals.