Massage & Bodywork

January/February 2010

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pathology perspectives BY RUTH WERNER THE FLU & YOUR PRACTICE Superbugs: How Scared Should We Be? It is the thick of cold and flu season and most of you probably know we're in the midst of a pandemic of a novel swine flu virus, H1N1. This will be the first winter since the virus emerged last spring, and epidemiologists are waiting on tenterhooks to see what will happen. Swine flu has been grabbing a lot of attention in the press, but several other pathogens have also either arisen recently or become notably stronger. This has happened enough that alarming headlines are now commonplace. Up to the early part of the 20th century, the leading cause of death in this country and around the world was infectious disease. Our grandparents and great-grandparents grew up with the constant threat of typhoid, diphtheria, scarlet fever, cholera, polio, and tuberculosis. Between the mid-1940s and the late 1970s, our health-care culture developed a conqueror's attitude toward these and other pathogens. With advanced water treatment facilities, the development of antibiotics, and the availability of vaccines for several of the most threatening childhood diseases, the menace of death by infection seemed a thing of the past. Then, in the late 1970s, we got schooled: the worldwide appearance of human immunodeficiency virus (HIV) quickly humbled any assumptions about the human triumph over infectious diseases. AIDS was quickly followed by hepatitis B and C, and the consequences of bacteria with the power to become antibiotic-resistant began to make themselves known. Today, we don't exactly tremble in the face of microbial invasion, but we certainly have begun to treat this possible threat with more respect. This edition of Pathology Perspectives is dedicated to the discussion of a select group of pathogens that have some specific characteristics: they cause infections that are increasingly common, they're difficult to treat, they pose public health threats, or they have aspects of all three. I will provide a brief overview of some of today's headline grabbers, the "superbugs," with suggestions for finding more information in the selected sources section that follows. The purpose here is not to alarm or cause nightmares; it is to inform and educate so that readers may be better equipped to protect themselves and their clients, and to share accurate information with others. This gives us tools to avoid infection and cross- contamination—either by knowing when to cancel appointments, or by taking appropriate hygiene precautions in our work settings. MRSA The superbug most often referred to in today's headlines is MRSA: methicillin-resistant Staphylococcus aureus. This pathogen has been widely discussed, even in these pages (see "Mercy, Mercy MRSA!" Massage & Bodywork, July/August 2008, page 112). MRSA was first observed in hospital settings in the early 1950s—less than 10 years after the widespread implementation of the penicillin family of antibiotics. It occurs in several subtypes that can cause infections of connect with your colleagues on 95

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