| Sifting facts from panic on MRSA |
| Written by Bruno Tedeschi |
| Sunday, 04 November 2007 10:35 |
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On Oct. 15, a 17-year-old student at a Virginia high school died from the antibiotic-resistant staph infection known as MRSA. The next day, the Centers for Disease Control and Prevention released a report that found 19,000 people in 2005 died, mostly in hospitals, from the infection, more than the AIDS virus that year. With those two events, the "deadly superbug," as it was being called, suddenly had the national media spotlight, a position once held by other such dreaded infectious diseases as SARS, avian flu, anthrax and the ebola virus. Within days, reports of the superbug infecting students in New Jersey schools began showing up in newspapers. On Oct. 20, a front-page story in The Star-Ledger reported three high school students — two in Vernon and one in Point Pleasant Borough — were being treated for a community-acquired staph infection. The next Tuesday, the paper received a copy of a letter from the superintendent of the South Orange-Maplewood school district alerting parents that a student at Columbia High School was being treated for MRSA. An 812-word article ran the next day on the cover of the Essex County section and inside other zoned county sections. After the story ran, rumors and tips started pouring in about MRSA. A case from Glen Ridge. A security guard at Roberto Clemente School in Newark. A player on the Irvington High School football team. Star-Ledger news bureaus in other counties also were reporting incidences in schools. There was an outbreak, it seemed, of news stories about MRSA in school settings. The phenomenon wasn't confined to New Jersey. A Google search of MRSA and school returned hundreds of articles written by newspapers across the country in recent weeks. While coverage of MRSA fatalities is easy to justify on journalistic grounds, it's much harder to defend the continued onslaught of news stories on individual cases of MRSA where there is neither death nor serious illness. Some critics say the coverage is misleading and instills panic where none is warranted. New Jersey State Epidemiologist Eddy Bresnitz said he thought the MRSA story would have followed the expected news cycle and faded away a week after the CDC report and the death of the Virginia student. "But, in fact, that's not what happened," said Bresnitz. "We've been trying to understand why this has persisted." On Oct. 25, the New York City Health Department reported that a 12-year-old Brooklyn middle school student died from MRSA, diminishing any chance that the superbug would drop out of the news anytime soon. "We've been seeing continued reports from isolated cases that keep making the news," said Bresnitz. "I don't see how it's news anymore." MRSA certainly isn't news in a "new" sense. It's been around since at least the 1960s, but it has mainly been confined to health care settings, like hospitals and nursing homes. For the most part the hospital-acquired strains are different from the ones appearing in community settings, such as schools and prisons, where infections are spread through skin-to-skin contact. Hospital-acquired strains are resistant to a wide variety of antibiotics, while community-acquired MRSA skin infections, such as a boil, can often be treated by a doctor without the use of any drugs. A simple lancing of the boil and drainage is all that is needed. "The great majority of people receiving treatment go home and don't need to be admitted to the hospital," said Laurence DesRochers, president of the New Jersey chapter of the American College of Emergency Physicians. "It's just a localized infection." But with two high-profile deaths, the superbug has been hard for editors to ignore, especially since many parents first learn of MRSA when it is discovered in their child's school. Maryn McKenna, a former reporter for the Atlanta Journal-Constitution who covered the CDC in Atlanta and is writing a book due out in 2009 on MRSA, said the burst of media interest in drug-resistant staph is similar to the way AIDS came to the attention of news outlets in the late 1980s and early 1990s. "The country went from thinking AIDS was only a disease for certain groups to a sense of `Oh my God, it's a danger to all of us,'" McKenna said. "MRSA was not part of people's consciousness. If they thought about it, it was only in the hospital context. Then all of a sudden they're hearing about all these cases of this awful disease in the community. They realize that it's no longer isolated to sick patients in hospitals, and it occurs to them that they or their children are at risk." But how much at risk? Just like scientists, journalists are empiricists. They want to know how many cases of MRSA have been reported and whether the number has increased or decreased from the previous year. They want to know baselines and trends. With community-acquired MRSA, however, that kind of data isn't available. The state Department of Health and Senior Services does not require reporting of individual cases of the infection, only outbreaks of two or more cases in an institution. That may change. U.S. Sen. Charles Schumer (D-N.Y.) last week called for a national reporting system for MRSA. In the meantime, though, all we are left with is anecdotes. And they keep piling up. Ivan Oransky, a senior editor at The Scientist and a professor of medical writing at New York University, said providing readers with context is important. But it's equally important to tell readers when you don't have the context. "Our role is to give as much information as possible, but also to explain where the holes are," said Oransky, who is also a physician. "One of the ways to dampen the anxiety is to explain what it is actually happening. The fact that someone found MRSA at a school doesn't mean we're waiting for the other shoe to drop, that someone is going to die from MRSA." One thing The Star-Ledger has been doing is providing a MRSA information box with every story, describing the symptoms, how MRSA can be treated and, perhaps most important, how it can be prevented. The New Jersey Department of Education took a first step toward providing some context. On Oct. 22, the department asked school districts to report confirmed cases of MRSA. But Bresnitz, the state epidemiologist, doesn't find much value in collecting the information. "We're not asking for individual cases to be reported, nor do we want reports that the Department of Education collects unless they think there's an outbreak in a school," Bresnitz said. "Public health agencies collect data because we think it's going to have some public health implication. We don't collect data to provide context to the media." NOTES: Bruno Tedeschi is city editor of The Star-Ledger. |








