These days, the University of Southern California's football players might seem more like fussy disciples of the TV detective Monk than scrappy athletes. They use paper towels on the practice field and at games, and they shower before setting foot in the training room. Their laundry is washed at a constant 140-degree temperature, which is monitored. Portable cold-therapy tubs are drained and cleaned after each use, and the team brings its own soap to away games.
That's because while racking up wins in the 2003 and 2004 seasons, the players and trainers also were facing down a different type of adversary - a potential killer known as MRSA, methicillin-resistant staphylococcus aureus.
S. aureus is a common strain of bacterium, often found on the skin and in nasal passages, that can cause infection if it enters the body through a cut or scrape. Although it easily can be treated with antibiotics, methicillin-resistant strains don't respond as readily to common antibiotics and thus can be difficult to eradicate once infection takes hold.
A study published last week in the Journal of the American Medical Association found that Baltimore had the highest rate of MRSA infection of nine sites that researchers examined. They also found that more people in Baltimore had community-acquired infections (CA-MRSA), which means that it occurred in otherwise healthy people who hadn't been hospitalized.
The strain of MRSA that infected the USC athletes was also a community-acquired strain. The bacterium, which can lead to disfiguring skin infections, generally is passed along through skin-to-skin contact but can linger in showers, on towels and on exercise equipment.
The Trojans' MRSA battle - two hospitalizations in 2002, followed by 11 confirmed cases as well as six suspected cases in 2003 - was highly publicized at the time. By 2004, though, MRSA at USC was a nonstory.
Why? Because as USC passes the midpoint of a winning 2007 season, it also is winning the MRSA battle. In the 2004 season through this year, the football team has logged only two cases in total.
USC's response to the MRSA outbreak has been extraordinary, says David Klossner, National Collegiate Athletic Association director of education services. "Their staff recognized the situation, took steps to eradicate spreading of the infection and added monitoring measures on a scale that was not commonly found in the athletics setting."
The story of what USC did to fight MRSA is a valuable lesson and a cautionary tale not only for people who play team sports but also for anyone who has swapped sweat on a community exercise machine.
After the outbreaks at USC, which occurred at about the same time as outbreaks at a fencing club in Colorado and among high school wrestlers in Indiana, the NCAA launched a series of initiatives, including a MRSA Web site to educate players and coaches and updates to its sports medicine guidebook.
But fitness centers have not exactly rallied to the cause.
If health clubs are doing anything extra to curb MRSA transmissions, they're not talking about it. Officials at Bally Total Fitness, the Sports Club/LA, Gold's Gym and Crunch Fitness either didn't return repeated calls or declined to comment. But in fairness, no one really knows what danger fitness clubs might pose in the transmission of the bacterium.
Although health officials assume that some cases are transmitted through communal use of equipment and towels, it's nearly impossible to prove that because of the long incubation period of the bug.
Cedric Bryant, chief science officer for the American Council on Exercise, acknowledges that there's a reasonable danger of contracting something in a gym. "A set of dumbbells can be a hotbed for common bacteria as well as the handrails on the aerobic equipment, bikes and stair climbers." Nevertheless, he says, "you don't want to be a germaphobe, but following basic hygienic principles should minimize the risk."
Reducing risk of contracting MRSA at the gym and elsewhere is a simple matter of adopting common-sense hygiene routines, says Elizabeth Bancroft, medical epidemiologist with the Los Angeles County Department of Public Health.
"None of these guidelines are rocket science," she says. "Wash your hands. Keep things clean. Follow directions. They're things you learned from your grandmother or in kindergarten."
Football players and other athletes who engage in vigorous exercise for 90 minutes or more, such as cyclists and swimmers in hard training, appear to be at greater risk for contracting community-acquired MRSA because of the exercise, says David C. Nieman, an exercise immunologist at Appalachian State University in Boone, N.C. "The immune system of a marathon athlete after a race is very similar to what you'd see in an elderly person. But it's transient; it lasts about a day."
Nieman doesn't believe that fitness facilities are doing enough to educate staff and customers about the dangers of MRSA.