In response to headlines such as “A new gay disease?” (Newsweek) and “Strain of superbug 'may be new HIV'” (Metro), the University of California at San Francisco’s (UCSF) Department of Public Affairs has issued an apology “regret[ting] that our recent news report about an important population-based study on MRSA USA300 with public health implications contained some information that could be interpreted as misleading.”
In addition, both the US Centers for Disease Control and Prevention and the European Centre for Disease Prevention and Control have responded to the report and the widespread misinformation that followed.
The original January 14th UCSF press release, entitled ‘Sexually-active gay men vulnerable to new, highly infectious bacteria’ was based on a study due to be published in the February 19th issue of Annals of Internal Medicine and was focused on a recently-identified strain of methicillin-resistant Staphylococcus aureus (MRSA) that is resistant to most types of antibiotic, and which appears to be more prevalent in gay men in San Francisco than in the general population. Aidsmap.com reported on the study last Tuesday.
The UCSF press release was picked up by newspapers around the world, leading to some confusing and homophobic headlines, some of which suggested that this strain of MRSA was a ‘gay disease’ or a ‘new HIV’.
It also provided ammunition for anti-gay groups, including the conservative Concerned Women for America, which issued its own press release on Wednesday, entitled, 'Epidemic feared - 'gays' may spread deadly staph infection to general population.'
In addition, many of the news stories contained alarmist misinformation about the ease of the spread of this so-called ‘superbug’, also failing to report that it is still usually easily treatable, can be prevented by simple hygiene measures, and is rarely life-threatening.
On Wednesday, the US Centers for Disease Control and Prevention (CDC), which helped finance the study, issued a statement of its own, stressing “that the groups of MSM [men who have sex with men] in which these isolates have been described are not representative of all MSM, so conclusions cannot be drawn about the prevalence of these strains among all MSM. The groups studied in this report may share other characteristics or behaviours that facilitate spread of MRSA, such as frequent skin-to-skin contact.”
They also noted that, “MRSA is typically transmitted through skin-to-skin contact, which occurs during a variety of activities, including sex. There is no evidence at this time to suggest that MRSA is a sexually-transmitted infection in the classical sense.”
On Friday, the UCSF Department of Public Affairs issued a brief statement: “We regret that our recent news report about an important population-based study on MRSA USA300 with public health implications contained some information that could be interpreted as misleading,” it said.
“We deplore negative targeting of specific populations in association with MRSA infections or other public health concerns, and we will be working to ensure that accurate information about the research is disseminated to the health community and the general public.”
The same day, the website of US news magazine, Newsweek ran a major story, entitled “A New ‘Gay Disease’?” about the study and the world’s reaction to it, and quoted one of the study’s authors, Dr Henry (Chip) Chambers, who stated bluntly, "This is definitely not the new AIDS."
The European response
On Thursday, a rapid communication from members of the HIV/STI/Blood-borne viruses project, and the antimicrobial resistance project, at the European Centre for Disease Prevention and Control, in Stockholm, was published in Eurosurveillance.
It examined the original journal article and discussed the relevance to Europe, where this strain of MRSA is rare.
They wrote that the suggestion that multidrug-resistant MRSA “may be being sexually transmitted by MSM is debatable, and more research is needed to discover if this is in fact the case.”
They pointed out their concerns with the researchers’ methodology and conclusions, noting that, “sexual risk could only be assessed by the authors using proxy-indicators. At this time there is no evidence that this MRSA strain is transmitted sexually in the classical sense of the term.”
Despite this, and despite the fact that very few cases of multidrug-resistant MRSA have been reported in Europe, they believe “three lessons can be taken from” other recently-reported sexually transmitted infections, such as LGV and syphilis, that have disproportionately affected gay, HIV-positive men “for the current situation.”
They believe that “if this MRSA strain is introduced in Europe, it may travel rapidly within the MSM community, with the potential for outbreaks.”
They warn that “it may initially remain unnoticed because of a lack of awareness about this disease and if diagnosis is done outside the regular STI and HIV care, as was also experienced with LGV.”
But they stress that “the association of MRSA with MSM does not necessarily reflect sexual transmission per se, but could be the result of intimate skin-skin contact.”
They conclude by suggesting that, “clinicians across Europe should be aware of this particular strain as a possible aetiology in case of skin infections in MSM. Pending further research, awareness may also need to be promoted among the MSM community to highlight the symptoms, prevention measures and implications.”
van de Laar MJW et al.Multidrug-resistant methicillin-resistant Staphylococcus aureus (MRSA) strain in a men-who-have-sex-with-men (MSM) community in the United States: comment. Euro Surveill 13(3), 2008.