These days, USC'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 regularly 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 were also 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 can be easily 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.
The strain of MRSA that infected the USC athletes was a community-acquired strain, as opposed to a hospital-acquired strain, which means that it occurred in otherwise healthy people who hadn't been hospitalized. The bacterium, which can lead to disfiguring skin infections, is generally 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 nears the midpoint of the 2007 season as one of the top 10 winningest Division 1 schools in history, it is also 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 quite extraordinary, says David Klossner, NCAA 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 those who play team sports but also for anyone who has swapped sweat on a community exercise machine.
Caught off guard in 2002
The year 2002 was a bad one for CA-MRSA infections. "In 2002, we investigated four outbreaks of community MRSA, which included USC," says Elizabeth Bancroft, medical epidemiologist with the L.A. County Department of Public Health.
"We also investigated an outbreak in a newborn nursery, among men who have sex with men and at the L.A. County Jail, which is still the largest facility outbreak reported in the nation," she says.
Caught off guard by the outbreaks, the Health Department scrambled to get the word out, issuing fact sheets to consumers and medical professionals on how to prevent the spread of the bacterium, documenting the outbreaks in medical newsletters and journals and initiating surveillance programs at county hospitals. The National Collegiate Athletic Assn. also stepped up to the plate, developing educational outreach programs for coaches and trainers involved in team sports. "We took a look at the problem and knew it wasn't going away," Klossner says.
Following 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. It created a MRSA website to educate players and coaches, updated its sports medicine guidebook, which is available online, and sent prevention posters to its member institutions.
The state of fitness centers
Fitness centers, on the other hand, 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 may pose in the transmission of the bacterium.