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Healthy living: bad bugs

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First came boils. Then, viral meningitis. And on Wednesday, public health officials identified a new case of tuberculosis in Alpharetta.

What's next on the metro disease front? The plague?

Medical experts say no, Atlanta is not the new center of disease outbreaks, even if news of three infectious diseases in recent weeks may have some people watching for locusts.

While a new strain of antibiotic-resistant staph infections is on the rise, Georgia Tech quarterback Reggie Ball was temporarily sidelined with viral meningitis, and a patient was found to have TB last week in north Fulton County, the recent infectious diseases are nothing that should make metro residents live inside a bubble, doctors and other medical experts said.

The diseases should remind us, however, that infections, particularly tuberculosis, are always with us and that it pays to have strong public health policies in place, doctors said.

"Acute events are much more destructive if long-term planning hasn't been done," said Dr. Marc Lipsitch, associate professor of epidemiology at the Harvard School of Public Health. "So it's in our interest to be concerned about controlling infections like TB even outside our own borders."

And, oh yes, it really does help to wash your hands.

Nationwide, doctors continue to closely monitor the far most threatening of the three, tuberculosis, even though cases of TB are at their lowest.

"Here in the U.S., we have a mixture of good news and bad news," said Dr. Kenneth Castro, director of the Division of Tuberculosis Elimination at the Atlanta-based Centers for Disease Control and Prevention. "We're at an all-time low, but they continue to occur."

Tuberculosis is one of the leading infectious killers of young adults worldwide; it was once the leading cause of death in the United States. The disease killed almost 15,000 people in the United States in 2003, the most recent year for which figures are available, but killed more than 2 million worldwide.

Public health officials and other doctors have some concern that as more people travel to the United States from other countries in which TB flourishes, TB could increase again in the United States.

Harvard's Lipsitch said that one new case would not indicate an uptick in risk for metro Atlantans, though. Fulton County had 112 cases of tuberculosis last year, according to the Fulton County Health and Wellness Department, and does not appear to be ahead of that pace for 2005. 'Not the hospital staph'

What is more puzzling to many Georgia doctors and public health officials is the spread of a new staph bacterium that many are calling "the towel clone."

At least three Georgia children have died this year from it, and hundreds more cases have been diagnosed. Doctors met in Atlanta Thursday to discuss how to stop its spread.

The germ appears to be spreading most often on shared towels and in recreational facilities rather than health care facilities. A previous strain of antibiotic-resistant staph typically was spread in hospitals.

The new strain of antibiotic-resistant Staphylococcus aureus, more commonly called staph, has its own genetic makeup.

"The community-onset bug is different. It's not the hospital staph we've seen in the past; it's a genetically different bug," said Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University Medical Center. "And it has a great capacity to spread and a great capacity to cause skin infection."

Like the staph strain that typically has spread within hospitals, this new staph is resistant to the antibiotic methicillin. But unlike its bacterial kin, the new staph appears to be more aggressive, taking advantage of small breaks in the skin that might not even be open wounds.

"It's beyond that," Schaffner said. "We're seeing people in the community come in and say, no, I didn't cut myself, and yet they have a staph infection." No reason to panic

The new staph typically starts with a small boil, or a pustule, on the skin. Often, it is on a person's more private parts of their body, making them somewhat reluctant to share the information or to seek treatment.

"The private area is a very common place for these to be, and who are you going to tell?" said Dr. Susan Ray, associate professor of medicine at Emory University School of Medicine. "It doesn't seem like a big deal, but you should go and check it out."

It is also important that patients be prescribed the right antibiotic, Ray said.

And while Reggie Ball's viral meningitis made big news last week, people do not need to be worried about a viral meningitis outbreak, doctors said. Viral meningitis differs from the far more threatenging bacterial meningitis, which can kill. A vaccine now exists for bacterial meningitis because of the serious threat it poses.

Viral meningitis is as predictable as a change of seasons, said Vanderbilt's Schaffner.

"It's a late summer phenomenon," Schaffner said of Ball's case. "It walked right out of the textbook."

While doctors across the country are seeing more cases of staph and a steady number of cases of TB and viral meningitis, the doctors said there is no reason to panic; germs are always with us.

"It is amazing how germy we are," Ray said. "If you could see what germs do as we stand around and talk, you'd see this cloud of bacteria around us. We're all like a bunch of little Pig Pens." Health question? Find the answer in our online health encyclopedia on

Copyright 2005 The Atlanta Journal-Constitution

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