MRSA infection growing concern in NFL locker rooms
The scene was jarring last Sunday at the Georgia Dome, straight out of the movie “Outbreak”: A Hazmat crew, wearing white jumpsuits, white surgical masks, and blue latex gloves, cleaning out and sterilizing the visiting locker room after the Buccaneers departed following their loss to the Falcons.
No, Bucs fans, the crew was not there to bleach away the memories of the team’s dreadful 0-7 start. Instead, the Hazmat workers were brought in by Georgia Dome officials to disinfect the scene of a much bigger problem than Greg Schiano’s intense micromanaging: A potentially deadly staph infection called Methicillin-resistant Staphylococcus aureus, or MRSA, that has taken root in the Buccaneers’ locker room this season.
Their season got off to a bad start in training camp when two players were found to have contracted MRSA infections — Pro Bowl guard Carl Nicks had a blister on his foot that became infected, and kicker Lawrence Tynes had an in-grown toenail that did the same. The problem has lingered all season in Tampa, with a third player, cornerback Johnthan Banks, also developing a MRSA infection this month.
MRSA is often not the deadly and unbeatable infection it is commonly portrayed. If diagnosed early, a MRSA infection can be treated and eradicated in just days, said Dr. Stephen Calderwood, chief of the division of infectious diseases at Massachusetts General Hospital.
But MRSA is a nasty bacteria that is resistant to most common antibiotics, and if it takes hold in deep tissue, bone or the bloodstream, can cause intense flu-like symptoms and potentially lead to amputation or even death. MRSA is present on the nose and skin of about one-third of the general population, Calderwood said, and an infection/transmission generally occurs when a cut or skin abrasion is not cleaned properly. MRSA transmissions are common in everyday life, with poor hygiene the most common factor.
Dr. Deverick Anderson of the Duke Infection Control Outreach Network said football players are 10-15 times more likely to contract MRSA than the general population, and that linemen and linebackers are the most susceptible to the infection. The NFL/locker room environment, with large men colliding every day and living together in close quarters, is especially prone to an outbreak. Infections also are common after surgery. It is unclear if the postoperative infections developed by Tom Brady in 2008 and Rob Gronkowski in 2013 were related to MRSA.
“It’s not like the Ebola virus or something, but it can progress fairly quickly,” Calderwood said. “The key is to recognize it and treat it early. Once it goes deeper into muscle or into the tissues below the muscle, then surgery is generally required to treat it, and surgery can be quite extensive depending on how deeply it’s gone.”
The Buccaneers are the fourth known team to have a MRSA outbreak since the NFL first identified the problem a decade ago, along with the Rams in 2003, Redskins in 2006, and Browns over several years last decade. An NFL physicians survey documented 33 cases of MRSA in the NFL from 2006-08, according to USA Today. And high schools in Carmel, Ind., and Northville, Mich., also reported MRSA outbreaks in the past two months.
Former receiver Joe Jurevicius and center LeCharles Bentley sued the Browns for contracting career-ending MRSA infections in the team facility, they claimed. The infection also ended the career of former Cowboys and Redskins defensive tackle Brandon Noble, who developed his after a supposedly routine knee surgery.
“The stitches were taken out. That night, a hot spot developed over the porthole used for the surgery,” he wrote for the Infectious Diseases Society website. “I began feeling sick — flu-like symptoms and my knee hurt like someone was lighting me on fire. By the time I was put in the hospital, the infection had spread from a quarter-sized red spot around the port to cover a good portion of my leg. It had taken about two days. One of the first doctors that I saw told my parents that if I had waited another 24 hours we could be talking about the loss of my leg or worse. Surgery was performed, and things got better once the infection was washed out.”
The Rams invited the Centers for Disease Control and Prevention to do a study on their practice facility in 2003 after five players contracted MRSA infections. Most of the initial infections cleared within 10 days of treatment, but three of the five players had recurrences.
The study, published in the New England Journal of Medicine, found that Rams trainers didn’t have regular access to hand hygiene, that players often didn’t shower before using the whirlpool, that weight room equipment wasn’t cleaned properly, and that as many as three players would use the same towel.
“It has a lot to do with hygiene, and specifically hand hygiene,” Anderson said.
“They tell you all the time in the training room, ‘Hey, shower before you come in, make sure you’re staying on top of your cleanliness,’ ” Patriots defensive end Rob Ninkovich said.
The three Buccaneers have experienced varying levels of severity. Banks’s infection was discovered early and he hasn’t missed a game. Nicks missed two games, played two, and then sat out the last three after having surgery to clean out a recurrence. Tynes got it the worst of all — he was put on an IV line for antibiotics and placed on the season-ending non-football injury list. The NFL Players Association filed a grievance against the team, claiming it waited two weeks to test Tynes for MRSA, worsening the infection. The Buccaneers, though, have certainly taken measures to rid themselves of the infection. They “nuked” their facility, general manager Mark Dominik said in late August, although doctors believe that most transmissions occur by human-to-human contact, not via inanimate objects such as weight-room benches.
They also invited Anderson and DICON to study the team’s facility — the main recommendation was to install more hand hygiene stations. Anderson returned to the Buccaneers’ facility on Oct. 11 after Banks’s diagnosis to hold separate Q&A sessions with the players and administrative staffs to educate them about MRSA.
While the Buccaneers are the ones publicly dealing with the infection, Anderson believes many mild MRSA cases go unreported.
“I think that because of the negative PR backlash, you probably have a lot of people doing their best not to report it,” Anderson said. “It’s probably more common in the NFL than even most people would think.”
Anderson wants to make clear, though, that while MRSA can potentially be dangerous, the infection can mostly be avoided with good hygiene practices.
“Post-practice showers, washing hands frequently, making sure those alcohol foam dispensers are much more readily available,” he said. “You’re going to be exposed to it if you’ve got young kids or are just interacting with people. It’s typically something that’s easily treated with an antibiotic or maybe an incision and drainage. You really only hear about the ones that are terrible, that kill people or put them in the hospital for a long time.”
A SACK FULL OF ISSUES
Front five not doing enough to toe the line
The Patriots had many question marks entering the season — Who will catch the football? Can they find two new tight ends? Can the defense stop anybody? — but the offensive line wasn’t supposed to be one of them.
The Patriots returned all five starters from a unit that allowed the fifth-fewest sacks in the NFL last year (27) and was ranked by ProFootballFocus.com as the second-best offensive line in the league. Yet Tom Brady has been sacked a surprisingly high number of times this year — 20 in seven games, tied for 10th most in the NFL and on pace for 45. The most Brady has been sacked in a season is 41 times, and his next highest is 32 (2011, 2003). Brady has been sacked four, five, and four times in consecutive games against the Bengals, Saints, and Jets, the most he has ever been sacked in a three-game stretch.
Eight of the 20 sacks have come on first down, killing drives just as they begin. But Patriots coach Bill Belichick said the sacks aren’t all on the offensive line.
“Combination of line, quarterback, running back, tight end, and receiver,” he said. “Some of that is also the combination of the previous plays. There are a lot more sacks on third and long than there are on third and short. I’d say it’s a combination of all of it. There’s certainly room for improvement everywhere, including on the coaching end . . . We all just have to do a better job all the way across the board. That includes everybody.”
ESPN analyst Ron Jaworski said the most significant factor in Brady’s “average play” this year has been the offensive line’s inability to protect him. “Tom is one of those plant, step, and throw guys, and he just hasn’t had the time to go through his progressions,” Jaworski said. “He’s getting to one . . . maybe two . . . and there are too many bodies around him.”
It seems a fitting time to talk about the cap
A few tidbits related to the Patriots and the salary cap:
■ It’s a good thing the Patriots entered the season with more than $10 million in cap space. Because as of Friday morning, they were down to approximately $5.9 million, according to NFL Players Association records, thanks to seven players landing on injured reserve and a handful moving back and forth between the practice squad and active roster.
The Patriots currently have $19.69 million on IR, although Shane Vereen is eligible to return in Week 11.
Whatever cap space the Patriots don’t use can be rolled over to next year.
■ Some injury settlements from training camp: WR Kamar Aiken ($35,648). DE Jermaine Cunningham ($37,059). TE Brandon Ford ($101,647). DE Justin Francis ($35,647). OL R.J. Mattes ($67,765). OL Chris McDonald ($67,765). DT Anthony Rashad-White ($135,529).
■ Veteran receiver Michael Jenkins filed a grievance that is costing the Patriots $120,200, while the team gets a credit of $54,412 on former receiver Deion Branch.
■ Bumping safety Kanorris Davis up to the active roster twice to play special teams cost the team $65,648 in cap space. And our favorite item on the ledger: The Tim Tebow experiment in training camp cost the Patriots all of $175 in cap space.
If you got a good chuckle out of the reports last week that the Rams contacted Brett Favre’s agent to gauge his interest in playing this year, you’re not alone.
Forget the fact that Favre, 44, hasn’t played since 2010, let alone take an NFL hit. What makes the notion of Favre playing for the Rams laughable is that they couldn’t afford to pay him. Favre made almost $15 million in base salary and bonus money from the Vikings in 2010. But the Rams, who lost Sam Bradford to a season-ending anterior cruciate ligament tear, entered last week with about $772,000 in cap space. Anyone think Favre is going to give up his cushy retirement life for a minimum salary?
Now, the Rams could have restructured several veteran contracts to come up with the necessary cap space to sign Favre, but that would have been insanely difficult and complicated. Instead, they went the much more rational route, signing two quarterbacks (Austin Davis, Brady Quinn) that cost a combined $608,824 against the cap.
Many Patriots fans are wondering if the team could get contributions in the second half of the season out of two players on the non-football injury list: wide receiver Mark Harrison (foot) and defensive tackle Armond Armstead (illness/surgery).
While it’s possible that Armstead could make an appearance later this season — especially with Vince Wilfork out for the year — it’s sounding as if 2013 is going to be a “redshirt” year for Harrison.
The two players are eligible to be activated in a couple of weeks, but it would be tough for a receiver such as Harrison, a rookie who hasn’t practiced once with the team, to jump in midstream and play in NFL games.
Dolphins coach Joe Philbin, a Worcester native, isn’t the only member of Miami’s coaching staff rooting for the Red Sox in the World Series. The staff includes several people with New England ties.
Among them: offensive coordinator Mike Sherman was Philbin’s English teacher at Worcester Academy; special teams coordinator Darren Rizzi is a former player and head coach at the University of Rhode Island; defensive coordinator Kevin Coyle coached for nine years at Holy Cross; receivers coach Ken O’Keefe is a Milford, Conn., native who played at the University of Maine and also taught at Worcester Academy; offensive line coach Jim Turner is a Braintree native who coached at Boston College, Northeastern, and Harvard; defensive backs coach Lou Anarumo spent five years coaching special teams at Harvard; defensive assistant Ben Johnson spent three years at BC; and assistant receivers coach Phil McGeoghan played for three years at Maine.
And in the front office, assistant GM Brian Gaine played four years at Maine; college scouting director Chris Grier is a Holliston native who played at UMass and spent six years in the Patriots’ scouting department; and assistant director of pro scouting Chris Shea is a Belmont native who worked at BC and Harvard.
NFL commissioner Roger Goodell should be thanking Seahawks cornerback Richard Sherman for dispelling the notion that the concussion issue is entirely the NFL’s fault. Sherman wrote for TheMMQB.com that he hid a concussion from team doctors in 2011, and “It paid off: Just as my head was clearing, Andy Dalton lobbed one up to rookie A.J. Green and I came down with my first career interception.”
Sherman said he can tell when a player has a concussion, but wouldn’t tell him to step off the field.
“I’m not going to take his health into my hands and tell anybody, because playing with injuries is a risk that guys are willing to take,” he added. “The players before us took that risk, too, but they still sued the league because they felt like they were lied to about the long-term risks. Today, we’re fully educating guys on the risks and we’re still playing. We have not hidden from the facts.”