McCleary MRSA Prevention

This is the report done by Greg Lagerquist of WGME Portland, ME about MRSA in Maine.  Greg did a thoughtful and intelligent report about Maine’s MRSA problem and the work that MSNA, Rep. Adam Goode, the Health and Human Services Committee and I have been doing to solve it.  Please feel free to comment.

http://www.wgme.com/newsroom/top_stories/videos/wgme_vid_1131.shtml

UPDATE…Apparently, this link to my WGME interview doesn’t work anymore.

Today, I will volunteer at the flu shot clinic for children here in Bangor Maine.  There has been some difficulty getting the vaccine in Maine, but last week a supply arrived.  It was decided to do a big central clinic at our Civic Center to serve all of our community schools and many from outlying communities.  This clinic will be huge.  I did this same thing in 1976 when Swine flu was a threat.  I volunteered at a two clinics then.  The flu didn’t spread as quickly or as far and wide in 1976 as it has this year.

I know the necessity of preventing as much of H1N1 and regular flu as we can. Both can be deadly, particularly if someone becomes coinfected with a bacterial pneumonia, such as MRSA.   The vaccinations are very important in the prevention process and I will help in that process.   But I do have swine flu envy.  Let me explain.

The phenominal response from the CDC for the swine flu outbreak is admirable.  Many millions of dollars have been spent on prevention, education, vaccinations, testing, documentation, research, prepartation for flu disaster, etc.  It has been in the works for years. 

Where is the same attention for MRSA?  MRSA is killing approximately 20,000 victims each year and has been for  years.  Hospital acquired  infections kill over 100,000 patients yearly as well.  It has become “accepted” as part of doing business in hospitals.  Talk of a vaccination exists, but it will be years before one is ready.  These infections are happening every day, all year long in virtually all of our nations hospitals.

A small fraction of the expense to prevent flu could stop or greatly reduce MRSA.  If the CDC would recognize the process of  Active Detection and Isolation, the widely used prevention process for all outbreaks and epidemics, we could succeed.  ADI is THE proven preventative process for MRSA.  It has been proven in all of our VA hospitals, and many other hospitals nation and world wide.  Yet, CDC snubs ADI for MRSA prevention.  Their approach to MRSA prevention is to throw it in with all other MDROs and stop all infections.  This is an admirable goal but it is not attainable. In taking this approach, the needed steps to prevent MRSA have been watered down in the CDC recommendations.  MRSA is the most significant and wide spread Multi Drug Resistant organism.  It is also growing by leaps and bounds in the community.  About 30% of the general public is colonized with Staph and many of them are colonized with the more deadly and dangerous MRSA..a Staph infection that is resistant to many mainstream antibiotics.  The death rate for MRSA infections is alarming. Many tens of thousands more become disabled and lose their quality of life because of the infections.

The CDC needs to stop  politicizing  MRSA prevention and get down to the work of preventing it.  Until there is a vaccination to prevent MRSA, the process of ADI, along with military like enforcement of handwashing and education  is what will drop our MRSA rates.  It is time to end the epidemic of MRSA in our hospitals and our communities.

Amazingly, approximately 60 nurses, many other health care workers, and volunteers gave almost 8000 doses of Flu and H1N1 flu immunization to school age children at our Civic Center flu clinic in Bangor, Maine yesterday.  Over and over I am amazed at the flexibility and generosity of nurses.  Many of the ones there giving shots were volunteering their own time.  They were professional, caring and they treated each child gently and with dignity and respect.  Every nurse there knew the importance of keeping our children well and that is why they came.  Some of them were on the clock, but most volunteered.  This is an example of how nurses ( and in this case many other volunteers)  will come forward for the health of their patients and communities,  and give it all they have.  I am proud to be called a nurse and to know so many wonderful colleagues.

Dr Manoj Jain, infectious disease expert, spoke today on CNN about patients becoming coninfected with H1 N1 and MRSA.   We know that MRSA is very serious.   And this combination of both is doubly dangerous.  Many of the deaths so far from Swine flu are because of coninfections, many with MRSA.  This doctor went so far as to advise all medical providers to consider that a patient with Swine flu and  high white blood cell counts must be considered to be possibly coninfected and appropriate antibiotics  ( he named Vancomycin) be used right away .

So, if MRSA is a cause of increased complications and/or death in flu patients, why isn’t this word out there for patients.  We all  need to know that flu is not always just a mild disease and self limiting.  We need to know  that if we have flu with difficulty breathing and a persistant high fever that we need to be checked for coinfection.  We need to know that flu alone can kill but coinfections are even more likely to cause grave outcomes.

Why dosn’t CDC educate all of us about this?   I would love to see Dr Jain speak out everywhere and spread the word about this threat.  He spoke bravely today on CNN about how medical providers need to consider coinfecitons with all patients who present with flu and high white blood cell counts.  Is this information wide spread amongst our doctors and other healtcare providers?  If not,  it should be.  We as healthcare consumers and patients and all of our healthcare providers need to know that flu with MRSA (or other bacterial co infections)  can kill.  We all must be aware of the symptoms  and the necessity of early intervention.  The consequences are grave if the diagnosis is too late.

World MRSA Day

On October 1, my husband Mike and I attended the innaugural World MRSA Day at Loyola University in Chicago.  I was invited there by my friend and mentor Jeanine Thomas.  She is the pioneer of MRSA Activism and Advocacy  in the US.  She works tirelessly on the State , the Federal and worldwide  levels on MRSA Prevention and activism. 

We witnessed a first time event of this sort.  Experts in MRSA prevention, MRSA victims, lawmakers, and the Illinois Hospital Association leaders attended and participated in this event.  Jeanine knew how sad an event of this sort could be so she also interjected music.  We were entertained by a  bagpiper, a blues singer and a tabernacle choir singer and pianist.  They were all uplifting. 

The doctors who spoke were encouraging and progressive.  Dr William Jarvis is undoubtedly the most recognized MRSA prevention expert in the US.  His presentation was honest and alarming at the same time.  His passion regarding MRSA prevention  is evident.  He is an honest expert who is not afraid to tell the truth about the scope of the problem.  He knows what needs to be done to conquer the problem.  This was a refreshing change from some of the doctors I have met and worked with in Maine.  A statement he made about the CDC’s most recent number of deaths because of MRSA stood out.  The 19,000 deaths that CDC claims to be fact a few years ago only includes “invasive” MRSA.  I learned something.  It does not include surgical site MRSA .   So adding those to 19,000 would dramatically increase that number. 

The most moving speaker of the day was Ken.  Ken’s 2 month old daughter Madeline died just a few years ago with MRSA.  While a photo of his sweet baby girl was projected onto a large screen above his shoulder, Ken told of his experience.  It has been a few years since this happened, but he is still obviously emotionally raw over this horrible time in his life.  She had been an underweight preemie twin.  Her brother is fine, but Madeline became ill with MRSA after discharge, and died shortly after.  Ken told us that there is a happy part of his story.  He and his wife were blessed with a baby girl this year.  They expressed their concerns about MRSA to her doctors.  She was tested and she was colonized with MRSA.  This early screening for their new baby gave doctors the red flag they needed to decolonized the new baby and she has tested MRSA free the last three times.   Screening possibly saved this tiny new baby’s  life!

Jeanine has gathered a group of impressive supporters for MRSA prevention with Active Detection and Isolation.  I spoke with a leader in the Illinois Hospital Association, an Illinois representative and others.  She is an amazing force and her event demonstrated that.

It still amazes me how contentious the subject of MRSA prevention  is.  All of us advocates and activists want is a simple cheap screening and the appropriate steps for those who test positive.   Screening saves lives.  The number of medical screenings done every day every year for any number of purposes is astounding, and yet hospitals in Maine balk at  this inexpensiv screening for an infection that can and does kill and maim patients.  They insist that they have the solution in handwashing and other steps.  They do not.  They have watched the rate of MRSA infections rise for many years, alarmingly so for 15 years.  They have not stopped or stalled the infections yet.  But, ADI, the proven approach ,is available and they snub it.

So, because of  I know there is a way to stop MRSA,  I will continue this quest.  My Irish is up.  My father is gone because of pathetic infection control .  I will work on this until our supporters and I am satisfied that Maine hospitals are doing all that they can to stop MRSA infections.