Outbreak of Staph Hits USC Team

Before their first game of the season last month, seven USC football players became infected -- and four of them hospitalized -- with a painful staph skin infection not treatable with most common antibiotics, the school and public health officials said Friday.

While the outbreak on the team is believed to be over, it demonstrated what a serious problem drug-resistant Staphylococcus aureus has become in competitive sports, according to officials at the Los Angeles County Department of Health Services.

Last month, the Centers for Disease Control and Prevention published a journal article about a rise in the number of athletes who have suffered the pus-filled skin boils and other lesions from such staph infections. That report mentioned two college football players from Los Angeles County who were hospitalized last year in a separate outbreak, and officials Friday acknowledged that both were from USC.

Dr. Laurene Mascola, the county’s director of acute communicable disease control, praised USC’s recent response, which included sanitizing locker room facilities and equipment, as well as encouraging good hygiene among players.

USC also took nasal swabs from all members of the football team to check for the presence of staph bacteria. About a quarter of the team members had nasal colonies of staph, Mascola said, but the presence of the bacteria does not mean that people will develop infections. In fact, up to 30% of the general public have staph colonies in their noses intermittently but never get the skin boils and wounds.

USC sports information director Tim Tessalone said the school did a “great job in prevention.” No new cases have been reported since Sept. 1.

These infections are “not unique to USC,” Tessalone said.

The school did not test athletes on its other teams or make a general announcement regarding the infections because health authorities did not advise them to do so, he said.

USC also did not inform Auburn or Brigham Young, its first two opponents, because players with infections had either recovered or did not suit up for the games, he said.

The Los Angeles County public health director, Dr. Jonathan Fielding, said Friday that he believes USC handled the outbreak properly.

“There was no increased threat to the public or to other sports teams,” Fielding said. His department has been informed of some individual cases of staph infections recently among local college athletes, but the USC situation is the only cluster reported.

Schools nationwide have experienced similar problems.

The University of Illinois said its fullback Carey Davis will not play in today’s game with UCLA because of a staph infection in his knee.

Last year, six football players at the University of Texas were infected with drug-resistant staph. And in 2000, 10 players were infected, including seven hospitalized, at Thiel College in Greenville, Pa.

“It does seem like we have heard about more of these” outbreaks on sports teams, said Alicia Cronquist, an epidemiologist with the Colorado Department of Public Health and Environment. She investigated an outbreak among members of a fencing club in Colorado earlier this year while working for the CDC.

Drug-resistant staph infections are not confined to athletic venues. They have been a growing problem in jails and among children and the gay community.

In the first seven months of this year, the Los Angeles County Department of Health Services reported 989 cases among local jail inmates, and 69 children hospitalized with the condition.

“Our experience is mirroring that of other states,” Fielding said.

He added that athletes are particularly vulnerable because they are more prone to cuts and bruises, are more likely to have skin-to-skin contact, and tend to share equipment and towels, all of which may facilitate the bacteria’s spread.

“Any situation where you may have significant skin abrasions and where you have potential breaks in normal hygiene practice -- sharing equipment, sharing towels -- it is possible to spread infection,” he said.

USC’s outbreak this year began during training camp in early August. The four hospitalized players included sophomore fullback Brandon Hancock, who confirmed his treatment. USC did not release the identities of the other three but said all have since recovered.

Hancock had a scrape on his right knee when he suffered an ankle injury in the preseason. He was hospitalized Aug. 18 after his knee became swollen. After his release several days later, Hancock said, doctors had to make an incision, remove infected tissue and treat his wound directly with antibiotics.

Staph is a common skin organism -- many people carry it without ill effect -- and it typically causes infection when it enters a skin opening. Experts do not believe it is spread through the air.

The cases identified at USC, known as methicillin-resistant staph, don’t respond to the most frequently used antibiotics, such as penicillin and erythromycin. The drugs that work against it are Bactrim, rifampin, clindamycin, the expensive antibiotic Zyvox, and intravenous vancomycin for the worst cases.

The skin infections usually are mild and can be treated successfully with antibiotics and proper skin care, including regularly changing bandages. In some cases, however, the bacteria can lead to life-threatening blood or bone infections that require extensive hospitalization.

Health experts advise athletes to take several steps to minimize their risk of staph skin infections. They include covering all wounds adequately, showering with soap after all practices and competitions, not sharing towels and personal items with other players, and reporting skin lesions to coaches.

“Anybody who’s involved in competitive sports teams, be it a player, a coach, a parent, should be aware of the potential for this type of infection and should take measures to prevent it,” said Cronquist, of the Colorado health department.