Issue link: https://www.massageandbodyworkdigital.com/i/68165
PATHOLOGY PERSPECTIVES The constant, unceasing, sleep-ruining stress of worrying about a potential infectious threat may be more dangerous than the infection itself. the lungs, urinary system, skin, and bloodstream. When MRSA broke out of the hospital settings in the 1980s, it became associated with boil-like skin infections that run a significant risk of turning septic—that is, of leading to life-threatening blood poisoning. MRSA is, of course, of special interest to massage therapists, because it can be spread through indirect and nonsexual contact; and, because it is resistant to most first-line antibiotics, it can be difficult to fully eradicate an infection. VRSA MRSA is usually sensitive to an antibiotic called vancomysin, but concern has been growing about the evolution of vancomysin- resistant bacteria. This pathogen has arrived. Called VRSA (vancomysin- resistant Staphylococcus aureus), it is still mostly found within hospitals, where it is responsible for endocarditis, blood poisoning, wound infections, peritonitis, and catheter contamination. VRSA is usually responsive to other antibiotics, but it can be a long and dangerous process to figure out which ones to try. FLU SEASONAL FLU Of the three flu types that regularly make the headlines, the one that probably poses the greatest threat to the public health is the one that gets the least press: regular, garden-variety, type A seasonal flu. This group of viruses infects up to 15–20 percent of the general population (up to 60 million people) each year, and is responsible for the deaths of some 36,000 in the United States annually. Groups most at risk are the elderly, very young, and those with other complications including: immune suppression, asthma, cardiovascular disease, and diabetes. AVIAN FLU Regular seasonal flu has relatively high communicability and relatively low mortality—that is, it's easy to catch, but it isn't usually deadly. By contrast, the most virulent form of H5N1 avian flu ("bird flu") has a high mortality rate (in some settings 30–60 percent of the people who get sick die from this infection), but a very low communicability rate. It is a virus carried by wild water fowl (ducks, swans, geese) and spread to domestic poultry. People who handle dead birds may catch the virus, but so far it doesn't spread easily from one human to another: this has only been recorded in a couple of instances, and it hasn't yet broken out of immediate family groups. The epidemiologists who track avian flu are concerned that the virus may eventually go through an antigenic shift, in which genetic material from this virus combines with material from seasonal flu to carry the high communicability of one and the high mortality rate of the other. Interestingly, pigs are a reservoir where both human flu and bird flu can coexist, so this is being watched closely. SWINE FLU Until May 2009, swine flu (or H1N1 flu) was rarely seen in the United States. H1N1 flu is actually difficult to catch from animals, but it is highly communicable from human to human. This is seen in the fact that after one case was identified in Mexico in March 2009, within six months it had been labeled a pandemic. It also has a high morbidity rate—that is, people feel sicker for longer with H1N1 flu than with seasonal flu. Early evidence suggested that the H1N1 flu might be extremely dangerous, but its mortality rate is actually as low or lower than that of regular seasonal flu. There are some important differences though, most notably that H1N1 flu tends to affect children and young adults more severely than seasonal 96 massage & bodywork january/february 2010