MRSA infections persist on Vinalhaven

Posted Oct. 03, 2010, at 7:04 p.m.

VINALHAVEN, Maine — Methicillin-resistant Staphylococcus aureus, or MRSA, continues to circulate in this island community. About 35 people have developed skin and soft-tissue infections since July 2009, according to state epidemiologist Dr. Stephen Sears.

Transmission has been primarily among individuals in the lobster fishing community, Sears said in a recent interview. Some people have been infected more than once.

“There is a tremendous amount of hand and wrist trauma in lobstering — puncture wounds, scrapes and cuts,” he said. Even a minor open wound increases the risk of developing MRSA, especially given the close working conditions and the customary sharing of equipment, gloves and other tools of the lobstering trade, he said.

Some close friends and family members of lobstermen also have been infected, Sears said, including young children and teens.

MRSA is gaining notoriety as an invasive, opportunistic infection that can cause life-threatening infections in joints and internal organs such as the lungs and urinary tract. It can affect relatively healthy individuals, but for those with weakened immune systems, the organism can be especially deadly. It is a growing problem in in-stitutional settings such as nursing homes and hospitals.

So far, the cases of MRSA on Vinalhaven have been limited to skin infections, only a few of which have been severe enough to require intravenous antibiotics, said Dr. Rich Entel of the Island Medical Center. He compared the island outbreak to similar outbreaks among the members of sports teams, where close physical contact and minor skin injuries set the stage for the transmission of the organism.

But it has proved difficult to beat the MRSA outbreak in the lobstering community. Entel said that’s in part due to the difficulty of persuading infected individuals to isolate themselves until the infection clears, to communicate with others about their infection, and to take recommended steps to rid themselves of the bacterium.

About 30 islanders attended a recent MRSA forum at the town offices. The event allowed information to flow both ways — medical experts presented information and answered questions about MRSA, and the fishing community described the working conditions that have contributed to its spread.

With the lobster season wrapping up for the year, fishermen are understandably reluctant to take themselves out of circulation because of a mild MRSA infection, Entel said. Neither have health experts been entirely successful in getting infected individuals to comply with a time-consuming decontamination protocol that includes thorough, twice-daily showers using an antibacterial scrub and the application of an antibacterial ointment to the nostrils. Even a simple recommendation to keep a skin wound covered with a dry bandage becomes challenging, he said, in the context of a lobsterman’s wet work environment.

Entel said the outbreak likely will subside with the coming of colder weather and the end of the lobstering season on Vinalhaven. He said the Island Medical Center and the Maine CDC aim to eradicate MRSA from Vinalhaven. Prompt testing and treatment of suspicious lesions have become the standard, he said, and an ongoing educational campaign keeps the issue on the public radar.

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