Box Turtle Bulletin

Is MRSA The New Gay Plague?

Not according to the medical literature

Jim Burroway

A new study came out last week from researchers at the University of California, San Francisco, which found a high rate of drug-resistant staph infection among “men who have sex with men” in San Francisco and Boston. This staph infection, known as methicillin-resistant Staphylococcus aureus (MSRA), is a bacteria that is resistant to certain antibiotics. There are essentially two classes of MSRA: healthcare-associated MSRA which has plagued hospitals and other medical facilities, and community-associated MSRA (CA-MSRA) which is found outside of health care settings. This latest study from UCSF examines an outbreak of a particular form (USA300) of CA-MSRA in the Castro district of San Francisco and among gay men in Boston.

With this latest study, MRSA quickly became the newest “gay plague” and lead author Binh Diep rang alarm bells around the world with remarks like this one to Reuters:

Once this reaches the general population, it will be truly unstoppable.

That comment was like manna from heaven to anti-gay demagogues. But he didn’t stop there. Dr. Diep hyped the importance of his study to the San Francisco Chronicle, saying:

We probably had it here first, and now it is spreading elsewhere… This is a national problem, and San Francisco is at the epicenter.

Dr. Diep also said in his press release:

The potential widespread dissemination of multi-resistant form of USA300 into the general population is alarming.

But there’s a problem with all of this. None of it is true.

According to the medical literature — which Diep ought to be well acquainted with — the USA300 variant of MRSA is already widespread in the general population. And gay men, who are in the general population, had little to do with it. If the medical literature is any indication, it’s the “general population” that’s responsible for spreading MRSA into the gay community.

Over the past decade, community-associated MRSA (mostly USA300) has been reported in Atlanta, Albany, Baltimore, Birmingham, Boston, Chicago, Detroit, El Paso, Houston, Las Cruces (NM), Los Angeles, Memphis, Minneapolis, New York, Oakland, and Sacramento, as well as in the states of Florida, Hawaii, Kentucky, Indiana, Minnesota, North Dakota, Tennessee and Washington. (This list is not complete, by the way). CA-MRSA has infected inmates in jails and prisons and children in day care, as well as American Indians on reservations, rural residents of Southwestern Alaska, and Pacific Islanders of Hawaii.

Internationally, dangerous forms of MRSA have been reported in Australia, Canada, Denmark, France, Germany, Ireland, Japan, the Netherlands (where one study showed how it can be transmitted in families), New Zealand, Norway, Portugal, South Korea, Spain, Sweden, Switzerland, Taiwan, United Kingdom, Uruguay and Western Samoa. Again, this is not a complete list by any means.

All of these outbreaks were among the “general population” and not one was blamed on gay men.

The Athletic Menace?

But a review of the literature shows that one could make a case for blaming athletes. In 1998, the Archives of Internal Medicine reported on an outbreak which struck nearly a quarter of the members of a high school wrestling team in southern Vermont, who then passed the infection on to others in the surrounding community. But unlike Dr. Diep, the good doctors who wrote that report didn’t provide any dark warnings that if the epidemic spread from those disease-laden wrestlers to the general population, it would be “unstoppable.”

Maybe they should have. Since then we’ve seen outbreak clusters among high school wrestlers in Indiana, fencing club members in Colorado, college football players in Los Angeles and Pennsylvania, high school football players in Illinois and Texas, and Rugby players in Britain. In 2004, one in ten football players at a college in the Northeast were infected. “Cosmetic body shaving and turf burns” were cited as contributing factors. In 2006, the Journal of Athletic Training reported on a 2003 outbreak affecting nearly 16% of the USC Trojans football team.

MSRA has also struck professional football, landing Miami Dolphins Junior Seau and Charlie Rogers in the hospital in 2003 and sidelining Washington Redskins’ Brandon Noble in 2006. Dr. Holly J. Benjamin, writing for the Clinical Journal of Sports Medicine, has described MSRA as “the latest sports epidemic.” The problem has gotten to be so widespread that the CDC has published prevention measures written especially for athletes.

Did you get that? It’s a sports plague, not a gay plague. That comes as a surprising twist on the old jocks-versus-sissies conflict that many of us remember all too well from high school.

Smearing the Queer, Redux

But instead of panicking over the athletic menace, the media all over the world is fixated over the latest gay plague. The Toronto Star falsely asserted that this latest study “discover[ed] a new strain” of a super-bug “hitting gay men” Headlines in Britain screamed, “Flesh-eating bug strikes San Francisco’s gay community,” while Australians panicked over the more widespread, “Flesh-eating bug spreads among gays.”

What is it about gay men that sets everyone into fits of terror?

When the journal Clinical Infectious Diseases reported last February on the heterosexual transmission of MRSA in New York, nobody worried about a super-bug hitting straight men and women.

When the CDC reported in 2004 of an outbreak among 1.1% of naval recruits in the Southeastern U.S. and Clinical Infectious Diseases reported a 3% prevalence among US army trainees at Brooke Army Medical Center, there were no warnings of a super-bug infecting the military. And when Military Medicine reported an outbreak on a naval ship at sea or when the Journal of Clinical Microbiology reported that 11% of naval trainees in San Diego had MRSA during the summer of 2002, there was no seaman scare.

When the New England Journal of Medicine reported in 2005 that 9% of the St. Louis Rams football team had MRSA during the 2003 football season, there was no hue and cry over a flesh-eating jock staph.

When Epidemiology and Infections reported last April on a September 2004 outbreak which infected 14% of a communal religious community in upstate New York, there were no demands to halt the promotion of religion as an acceptable lifestyle.

But when the Annals of Internal Medicine reported that the prevalence of MRSA in the Castro’s 94114 zip code reached a tiny smidgen of 0.17%, all hell broke loose. And guess what? Buried deep within that dry academic report — the report that few reporters ever bothered to read — was this: the margin of error was a whopping +/- 0.13% [CI: 95%]. Also buried was a warning that these findings are not generalizable to gay men everywhere, and that nothing in the study points to specific sexual behaviors as risk factors. In fact, MRSA is easily transmitted by ordinary skin-to-skin contact, as well as contact with contaminated surfaces. But all of that was overlooked in the mad rush to smear the queers with yet another filthy, deadly disease.

Shades of AIDS

So what gives? Where did the media get the idea that a brand new, giant super-bug was eating San Francisco?

Well, much of the blame can be laid squarely at Dr. Diep’s own publicity stunt. It was his sensationalist comments in his press release — written precisely to grab journalists’ attention — that started the panic in the first place. And that panic was fueled even further by his alarmist statements to reporters from Reuters and the San Francisco Chronicle. The Bay Area Reporter described the repercussions of Diep’s incendiary comments this way:

The possible consequences of this news and the irresponsible way it was presented is people could become victims of physical harm because the public is now misinformed that only gay people carry staph. … The potential for anti-gay backlash is real, and has dire consequences for us individually and collectively.

Why did lead researcher Binh An Diep, Ph.D., seem to single gays out in his comments? In the news release Diep said that they are concerned “about a potential spread of this strain into the general population?” Gays are part of the general population. Drug resistant staph is already in the general population. There’s nothing new here. That sort of statement just feeds into the homophobia that is prevalent in this country and perpetuates all the stereotypes this community has been fighting since the advent of AIDS more than 25 years ago.

Like the AIDS crisis 25 years ago, Diep’s statements provided fresh fodder for anti-gay demagogues like Peter LaBarbera and Matt Barber, who quickly dusted off the same diseased-homosexuals scripts that has gone unchanged since 1981. LaBarbera had a veritable field day in his press release:

Is this not an eerie reminder of the initial stories 25 years ago about AIDS — then called GRID (Gay-Related Immunodeficiency Disease)? It is unfathomable that after that plague, disease specialists and the media are now surprised at the correlation of new infections with homosexual behavior.

Wake up, medical and political establishment: homosexual behavior is unhealthy — no matter how many secular sermons you preach against “homophobia.” Due to liberal political correctness, which treats aberrant — even deadly — behaviors as a “civil right,” we as a society don’t seem to have learned much from the AIDS pandemic.

And Concerned Woman Matt Barber found it difficult to improve upon Dr. Diep’s statements. After repeating Diep’s fears of MRSA being “unstoppable” if it reaches the “general population,” Barber exclaimed:

The human body is quite callous in how it handles mistreatment and the perversion of its natural functions. When two men mimic the act of heterosexual intercourse with one another, they create an environment, a biological counterfeit, wherein disease can thrive. Unnatural behaviors beget natural consequences.

And Joseph Farrah of World Net Daily also liked Diep’s Reuters “unstoppable” comment:

You’ve heard of AIDS – Acquired Immune Deficiency Syndrome. Is America’s immune system under attack?

The latest news out of San Francisco is not good.

A drug-resistant strain of potentially deadly bacteria has moved beyond the borders of U.S. hospitals and is being transmitted among homosexual men during sex.

Does this sound familiar? Shades of the 1980s?

LaBarbera, Barber and Farrah all share one thing in common. Everything they said about the emergence of MRSA in the gay community is flat out wrong, and more than 750 articles in the professional literature on community-acquired MRSA (78 on USA300) stands as overwhelming evidence of that. They also have something else in common. None of the actual facts will ever sway them from politicizing MRSA and using it as a weapon against the LGBT community. Don’t expect any retractions from these demonizers anytime soon.

But Farras is right about one thing. It is shades of the 1980’s all over again. Anti-gay demagogues were eager to politicize AIDS when they found that it was a useful weapon against the LGBT community. Today we see a new generation of demagogues politicizing MRSA in much the same way. And all it took was for one irresponsible, publicity-seeking researcher in San Francisco to hype an outbreak in the Castro, and suddenly we find a simultaneous outbreak of anti-gay hysterics everywhere else.

A Few Lessons

The good news is that better judgment is prevailing at the CDC. They are now trying to counter the anti-gay hysteria and undo some of the damage from Diep’s sensationalist comments. Two days after the news hit the papers, the CDC released a statement saying:

The strains of MRSA described in the recent Annals of Internal Medicine have mostly been identified in certain groups of men who have sex with men (MSM), but have also been found in some persons who are not MSM. It is important to note that the groups of MSM in which these isolates have been described are not representative of all MSM, so conclusions can not be drawn about the prevalence of these strains among all MSM. …

…

MRSA is typically transmitted through skin-to-skin contact, which occurs during a variety of activities, including sex. There is no evidence at this time to suggest that it MRSA is a sexually-transmitted infection in the classical sense. [Emphasis mine]

MRSA is dangerous if left untreated, and while it is resistant to some forms of antibiotics, it’s not resistant to all forms. In some cases, the wound might have to be lanced and drained. Only very rarely is surgery required.

And the best news is that MRSA is easily preventable. Cover any cuts, scrapes or sores, and wash your hands and shower regularly — ordinary soap and water does the trick. And don’t share personal items — toothbrushes, razer blades, sheets and towels and so forth. Preventing its spread is just that easy.

It’s time we all took a deep breath, calmed down, and learned a few lessons from all this. MRSA is not new, and gays aren’t spreading a new and deadly disease into the “general population.” It’s already been there for decades. If anything, all the evidence indicates that the “general population” has spread MRSA into the Castro and other places.

So the first lesson is this: When the media — and especially anti-gay fanatics like Peter LaBarbera and Matt Barber — scream about a new gay plague threatening the “general population,” your first instinct should be to get the facts for yourself. AIDS was passed around for 30-50 years as a heterosexual disease in Africa long before five gay men died in Los Angeles in 1981. And MRSA has been a problem in the general population long before Dr. Diep “discovered” it and hyped the latest festering gay man’s curse.

Which brings us to the second lesson: White-coated “professionals” sometimes carry with them all the baggage of prejudice and biases as anyone else. And “professionals” aren’t always pure in their motives when they speak to the press. Some are just as hungry for publicity as anyone else, and some are just as prone to making unconscionable comments. We’ve come to expect contemptible and scurrilous statements from the likes of LaBarbera, Barber and World Net Daily. They have no qualms about exploiting the suffering of others to score cheap political points, and grossly misrepresenting medical science is their stock and trade. We have no idea whether Dr. Diep shares any of their bigotry or whether he just let his ambition or simple carelessness getting the better of him.

Update: The University of San Francisco has posted an apology on their web site:

Statement from UCSF Dept of Public Affairs regarding study on emergence of methicillin-resistant Staphylococcus aureus clone USA300 in men who have sex with men

We regret that our recent news report (1-14-08) about an important population-based study on MRSA USA300 with public health implications contained some information that could be interpreted as misleading. We deplore negative targeting of specific populations in association with MRSA infections or other public health concerns, and we will be working to ensure that accurate information about the research is disseminated to the health community and the general public.

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