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Tim Dees
Editor-in-Chief
Officer.com

Please do not confuse this column title with “silent but deadly,” the credo of a former patrol car partner that had a chronic and disgusting gastrointestinal disorder.

No, this deals with a threat to law enforcement officers that has been around for a long time, but is increasingly more deadly and more prevalent. And, like so many other threats (AIDS, AK-47, MS-13, etc.) it has its own acronym: MRSA.

MRSA (pronounced MER-sa) is methicillin-resistant Staphylococcus aureus, otherwise known as “staph.” Staph is nothing new. If you have ever had a wound of any size get infected to the point that you needed antibiotics to cure it, you’ve probably had a staph infection. Staph is highly contagious and potentially deadly, but up until relatively recently it was easily treated. But as the spelled-out version of MRSA suggests, the conventional cures are no longer working.

MRSA has been a problem in hospitals for several years. Hospitals are virtual storehouses for infectious agents, and the bugs can escape the most careful attempts at disinfection. Combine the presence of staph with patients with surgical wounds and compromised immune systems, and you can find yourself being sicker in the hospital than when you arrived there.

Homeless people, IV drug users, and other citizen clients of public safety services are also common staph carriers. They have poor hygiene, generally a standard of health that is inferior to more mainstream folks, and they share drug “works,” cooking and eating utensils, clothing, blankets, and so on. The bacteria are easily transferred to the cops, firefighters, and paramedics that serve them. But how did an infection that used to be so easy to eradicate become so virulent?

What part of “take all the pills” did you not get?

IN 1928, Alexander Fleming observed that staph cultures would not grow in the presence of a mold, called Penicillium. Unfortunately, the significance of this discovery wasn’t appreciated until the early 1940s, when Howard Florey and Ernst Chain managed to get Penicillium into a powder form. This development drastically reduced the number of war fatalities in World War II. Wound treatment between the world wars hadn’t changed much, and death from wound infection was as or more deadly than from the initial trauma. Penicillin, and other antibiotics that came into use after the war, changed many diseases from merely treatable to curable.

Antibiotics were reasonably inexpensive, and people became used to the idea that they didn’t have to endure common transient diseases, such as colds, flu, and sore throats. They went to their docs and asked for some of the magic pills, and the docs found it easier to hand them out than to explain that their problem was probably caused by a virus that would not be affected in the least by the antibiotics. When the antibiotics were an appropriate treatment, the instructions were to take all the pills as directed, even if the patient started to feel better. But people didn’t do that. They took the pills until their symptoms disappeared, then they either flushed them down the toilet or, worse, put them into the medicine cabinet to be used when they or another family member became ill.

The bugs would have made Charles Darwin proud. The weakest among them perished when the course of antibiotics began, and eventually their numbers were reduced so that there weren’t enough to produce any meaningful symptoms. But there were usually a few left around, and those were the hardier members of the clan. Had all of the pills been consumed, they, too, would have gone to Microbe Heaven, but they were allowed to survive and beget more like themselves. These spread and co-mingled with others that had survived the natural selection process. After this cycle was repeated a few million times, there emerged MRSA, and other bugs like it - bacteria that would encounter the traditional antibiotics, dump a generous portion into their coffee, and flip you the bird while they drank it.

The Scourge of Skid Row

A well-written article in last week’s LA Weekly (warning: if you have a weak stomach, don’t scroll down to see the graphic pictures of infections) detailed the enormousness of the problem in their city. LAPD officers and firefighters have come down with MRSA infections after casual contact with homeless people in the course of their daily duties. Sometimes, it hasn’t even been necessary for direct contact to have occurred. One officer believes that they picked up the infection from a table in an interview room where a carrier had been held briefly.

MRSA can manifest itself as a nasty skin infection, but it can also take hold internally, infecting throats, abdominal cavities, and joints. The abscesses swell and produce impressive quantities of purulence, which is infectious itself. Treatment usually starts with a course of antibiotics, upping the ante until there is no choice left except for Vancomycin, the drug of last resort. Vancomycin is expensive, it comes with a raft of potential side effects, and it doesn’t always work. At that point, surgical options, including amputation, are the only treatments left. Victims can wind up crippled or otherwise permanently disabled.

A cop who gets shot or stabbed in the line of duty generally has no difficulty getting their injuries treated at the expense of their employer, or their insurance carrier. Bacterial infections are another matter. The infection may not manifest itself or be recognized until days or weeks after exposure. How does the officer show a positive link between their injury and their official duties? An employer or an insurance carrier looking to reduce their liability can deny the claim, and try to force the officer to prove that the infection was contracted on the job. Good luck with that.

Not An Isolated Problem

When I started my career in law enforcement, we knew there were nasty bugs out there, but we didn’t worry about them too much. Latex gloves, bleach solutions, and hand sanitizers were not included in the combat loadout. Then, along came AIDS, and we were terrified of it. Some officers wouldn’t come near a homosexual male, as that was the stereotype of the AIDS carrier. No one was willing to believe that the virus was nearly impossible to transfer through casual contact. Then hepatitis in its various forms became a bit more well-known than it was before, maybe because research indicated that one in four clients of the correctional system were hepatitis carriers, and you could get that one from less-than intimate contact. Drug-resistant tuberculosis was and is around, also. You’ll probably get to look into the eyes of the miscreant that tries to shoot, stab, or bludgeon you to the next life. With this stuff, you won’t ever see it coming.

Public safety folks have to be around the carriers of these bugs to do their jobs. It’s not a risk that you want to take, but if you refuse to deal with it, maybe you should listen more closely the next time that ad for truck driving school comes on the radio. The part that tends to frustrate me is where cops spend significant money and go to considerable effort to outfit themselves with laser sights, upgraded body armor, Kevlar gloves, ballistic sunglasses, and other gear that will probably never be needed, but ignore far simpler and cheaper measures to protect themselves from a threat they will probably encounter every day. The most effective of these measures: wash your hands. Wash your hands every time you have the opportunity to do so. Wash your hands both before and after you go to the bathroom (think about it - of all the places to get a nasty infection, would you pick that anatomical area?). Wash your hands every time you come into a building with a rest room. Wash your hands after you have changed clothes, either into the uniform or out of it. When you get home, take a shower and if you wear your uniform home, keep it in an area away from your family (changing in the garage might be a good option). Carry a bottle of hand sanitizer for the times that you can’t wash immediately, and use it every time you come into contact with a person or surface other than yourself. Carry a bottle of 10% bleach solution, and wipe down the interior of your car before and after a patrol tour. You don’t even need the relatively costly brand-name stuff - the store brand will work just as well, and a 10% solution of laundry bleach and water will kill just about anything.

On the medical side, there’s probably not much we can do. That has to be handled by the public health folks. And the problem will probably get worse before it gets better. But protect yourself, and don’t allow laziness and complacency to make you a victim.