don't panic

[gross2004]

from today's paper.....

Health Protection Scotland (HPS) issued the recommendation following an inquest into the death of Royal Marine Richard Campbell-Smith, who died from a virulent mutation of the MRSA bug infected with the toxin Panton Valentine Leukocidin (PVL).

It is thought Mr Campbell-Smith, 18, was infected after he suffered scratches to his legs while on a training run. Once inside his body, the bug multiplied, killing off his white blood cells. Within four days, he was dead.

Experts last night warned that PVL MRSA was now out in the community and warned that it could be on the rise. In the United States, there have been an increasing number of reports of sportsmen and women being infected,

[Rich]

Whats the recommendation Gross? I'm sure its rare but Orienteers will be more at risk of this kind of thing than most others and is kind of worrying.

[distracted]

heard about this on the radio - don't think there's much you can do about it. From the BBC website:

A spokeswoman for the Health Protection Agency said: "We are aware of strains of Staphylococcus Aureus with Panton Valentine Leukocidin (PVL), but it is extremely rare in the UK.

"There is a surveillance scheme for this, but when we have Staphylococcus Aureus samples in our laboratory we test a proportion of them for PVL.

"We have issued advice for clinicians so that if they suspect patients may have this infection, they can send us the patient's sample for us to test in the laboratory."

Staphylococcus aureus is a bacterium which lives harmlessly in about one third of normal healthy people.

Some of the strains carry the toxin Panton-Valentine Leukocidin (PVL), which attacks white blood cells, leaving the sufferer unable to fight infection.

and there's also this:

http://news.bbc.co.uk/1/hi/health/4574713.stm

[ifititches]

below copied from a medical e group. Re-enforces good advice on looking after wounds. Also, don't be cavalier about leg protection. As Ryeland pointed out on a previous thread, infection of simple scratch can rapidly turn nasty, ususally with bacteria much more common than this one (this particular one has been causing much more problem in USA than here)

SUPERBUG DEATH SPARKS WARNING
Health experts have warned the public to wash cuts and grazes and cover them with antiseptic and plasters in order to reduce the chances of spreading potentially dangerous bacteria.

The warning came after an inquest heard that a fit and healthy 18-year-old Royal Marine trainee died because a wound on his leg became infected with a rare bug.

Doctors believe Richard Campbell-Smith was killed by a deadly bacterium called Panton Valentine Leukocidin, or PVL.

PVL is named after the two scientists Panton and Valentine, who discovered it in the 1930s. The term leukocidin means "white cell killer". PVL is a toxin caused by a genetic variation in the common bacteria staphylococcus aureus.

Around a third of the population carries staph aureus harmlessly in their noses or on their skin. Around 1% of staph aureus carries the gene for PVL.

Christine McCartney, a senior microbiologist at the Health Protection Agency in London, said yesterday that it was probable that Mr Campbell-Smith was infected by bacteria he carried on his own skin, which most of the time would be harmless.

"The skin acts as a barrier," she said. "We understand he was pierced by a gorse bush. That is likely to have been the mechanism. He was just incredibly unfortunate."

Although many people have staph aureus in their groin, armpits and sweaty parts of their bodies as well as their noses, they are likely to carry a number of different strains. It was an unlucky chance that PVL came into contact with the wound, she said.

A medical expert at the inquest in Exeter said she was concerned about PVL because she had come across two cases in nine weeks. The coroner, Dr Elizabeth Earland, said she would recommend that information about PVL should be sent to all doctors.

The Health Protection Agency said the toxic bacterium, which kills 75% of those it infects, has not gone away since it was discovered in the 1930s, but it does not know of any other fatalities.

Dr McCartney said she understood the public concern, but stressed the rarity of PVL. She urged people to take the same sort of precautions that are now promoted in hospitals because of the so-called superbug, another form of staph aureus that is resistant to the antibiotic usually used to treat infections, methicyllin.

"People need to be looking after their wounds and covering them and ensuring they have good hand hygiene," she said. "Covering cuts and abrasions is the most effective way of preventing the spread."

[Guest]

In the Telegraph today journalist Richard Alleyne writes:
There is no known cure once PVL (Panton-Valentine Leukocidin), which is immune to antibiotics, has established itself but doctors said yesterday that the immediate application of anticeptic cream or TCP would have prevented it entering his body and saved his life.

A doctor from the Association of Clinical Microbiologists is quoted as saying:'If he had cleaned it up properly early on and put a bit of anticeptic cream on it he would have been OK. But of course as he was a Royal Marine - he's not going to worry about a wee scratch'

There's a lot more of the same - advice is to clean wounds thoroughly and protect from nasties getting in. Interstingly on First Aid courses cleaning and covering the wound is the advice not using anticeptic cream.
HP

[Kitch]

here we have a bacteria - Stapholococcus Aureus. It is quite common and harmless

Some strains of SA have a mutation which means they produce a very nasty toxin called Panton Valentine Leukocidin (PVL) (named leukocidin because it kills white blood cells (white blood cells are called Leukocytes, to kill one would be Luekocide - just in the same way that killing a human - a Homo Sapien is called Homicide)).

So - this PVL SA has been recognised since 1930.
is rare
if you are unlucky enough to get a dose there is a 75% chance it will kill you.
so you have a 75% chance of dying from a very very very very very very rare infection.
When did you last hear of someone dying of PVL SA in the last 75 years ?

NOW, some PVL SA has been found to have mutated again to be multi-resistent to antibiotics (MRSA = Multi resistent Staphlococcus Aureus).
SO you this means that if you get it you can't treat it with antibiotics - therefore the chance of dying from an infection rises to virtually 100%

BUT if a PVL SA infection is very very very very very very rare.

then I suspect that PVL MRSA is very very very very very very very very very very very very rare indeed.

so whilst PVL MRSA will alsmost certainly kill you there is a far lower chance that you will catch it than the chance that you would have caught plain old PVL SA which would most probably have killed you anyway - and which you had never heard of because it hardly ever kills anyone.

therefore
Don't Panick

and make sure you have a towel with you (preferably a clean one).

[Mrs H.]

All the same - and I'm not one to panic - but I reckon it might be worth getting a big container of those antiseptice wipes and giving your legs a quick once over if they're scratched!

[Becks]

There's a lot more of the same - advice is to clean wounds thoroughly and protect from nasties getting in. Interstingly on First Aid courses cleaning and covering the wound is the advice not using anticeptic cream.
HP

I'm pretty sure the only reaosn they tell you not to use antiseptic cream as a first aider is that it might give someone a (very rare) allergic reaction and have you in more trouble than it's worth for doing the First Aid in the First place. As long as you're not one of these people, go for the antiseptic cream! You can bathe in Savlon too if you've been somewhere like Llyn Elsi where the area of legs taken up be scratches is double that of normal skin!

But as Kitch says - it is very rare, and although this woman has seen two cases very recently, this could all just be due to coincidence. It's always a good idea to clean yourself up though, whatever there is lurking out there.

[Kitch]

Kate is a nurse
and does alot of stuff on wounds.
research has found that it is just as effective to use water to clean a wound as any kind of antiseptic or disinfectant - tap water is just as good as clinically sterile water. (also water doesn't sting anything like as much as those wipes).

Antiseptic creams don't achieve much - nurses don't use tham when dressing wounds.

clean a wound with water and keep it clean by covering it with a dressing

[Guest]

How quick does this infection take place.

What if you scratch yourself on the way to the first control. Take 2 hours to complete the course. Queue at download, take a look at results, discuss course with friends. So, 3 hours after you 'injured' yourself wash down with bottle of cold water. Then drive home 2 hours, have shower/bath then treat wounds.
Is it too late by then?

[RJ]

A quick look through some recent results...

M21L in the DSQs
U Nlucky 4SUM missed no.18 PVL MRSA!

[chrisecurtis]

Last time I did a first aid refresher they said there was some evidence that antiseptic creams killed some "not bad" bacteria which allowed nastier ones to grow quicker in the wound. Anaerobic bacteria like tetanus was mentioned.

It is worth washing out a wound that is still open, even if it is an hour or two later. The bugs are in the wound but it will heal quicker if you get the grit and soil out anyway!

[ryeland of doom]

Its not just rare headline grabbing superbugs.

I am now in my third week off work, thanks to a thorn in the foot. OK I have had some bad luck with non working antibiotics and allergies, but its taking a lot of shifting.

I believe the culprit was a thorn in the sole. There were no big bramble scratches this time.

[srollins]

You are a load of worry-pots. If you want to avoid early death:
1) don't smoke
2) eat healthily
3) exerise
4) look both ways before crossing road

Risk:
chances of getting 3 balls in national lottery: 1 in 11
dying on road over 50 years of driving: 1 in 85
dying of any cause in next year: 1 in 100
annual risk of death from smoking 10 cigarettes per day : 1 in 200
getting four balls in national lottery: 1 in 206
needing emergency treatment in the next year after being injured by a can, bottle or jar : 1 in 1000
getting five balls in national lottery : 1 in 11098
death playing soccer : 1 in 50 000
death by murder : 1 in 100,000
being hit in home by crashing aeroplane : 1 in 250 000
death by rail accident : 1 in 500 000
getting six balls in national lottery : 1 in 2 796 763
being struck by lightning : 1 in 10 000 000
AND
likely statistic for this new MRSA-endotoxin-secreting bug:
death due to VPL MRSA : 1 in 30 000 000 per year (2 cases in UK in last year)

Simple washing sounds like sound advice!

[srollins]

Death by visible panty line?? OOps (see previous posting)[/quote]