How do I avoid the unavoidable?

February 26, 2008 3:48 PM

I'm having a sexual relationship with someone who has MRSA and Hepatitis C and I'm concerned about getting either...

She was recently diagnosed with Hepatitis C, but I knew about the MRSA. I keep reading mixed information on the Internet about both and I'm not sure what to believe. She got spots on her chest from the MRSA the other day, where as before I didn't see any open sores. Now I'm paranoid that I'm going to be infected with either or both diseases.

I am young (mid-twenties) and have a very healthy and strong immune system. We haven't had any kind of blood-to-blood contact (that I know of) but have been having unprotected sex for about a month now. Advice? Am I pretty much screwed on both accounts? Is there anyway I can continue this relationship without getting infected with either or is it inevitable?

I need to go see a doctor but haven't needed to in 10 years. I need to find a doctor first I suppose. Good thing I have health insurance. Maybe I should get a better life insurance policy before I'm diagnosed with anything?

posted by nickerbocker to health & fitness (16 answers total)

You don't need blood contact to get MRSA. All it requires is skin contact, especially if it's CA-MRSA (community-associated): your skin to her skin, your skin to her towels - this is how many athletes have gotten it - your skin and her sheets, etc. Skin to skin is the "best" way to get it. Prevention is pretty easy, though: wash with soap and water, and wash well. Fact sheet.
posted by rtha at 3:56 PM on February 26, 2008

Hit post too soon.

And it's not "unavoidable." Put a condom back on, as hep C may be sexually transmitted. Definitely do not share works with her, if that's a factor. Hep C is blood-borne, so anything that helps keep her blood out of your body is good. Wrap it up!
posted by rtha at 3:58 PM on February 26, 2008

I don't know about the Hep C, but I think you would be very wise to wash your sheets in very hot water and give your house a good wash down with some antibacterial soap. And also, any cuts at all on your body, no matter how small I would be regularly disinfecting and putting a new band aid on.
posted by whoaali at 4:09 PM on February 26, 2008

As a MRSA data point, my boyfriend contracted a case of MRSA in the form of a nasty abscess on his abdomen that needed to be expressed every few days by a medical professional. In between trips to the doctors, I changed his dressings for him (this involved putting on gloves, taking off a bandage, removing a pus-laden piece of packing, cramming a fresh bit of packing in and bandaging him back up) and I never got it.

We were reasonably hygenic - washing hands frequently, showering with normal frequency (daily) and we washed the sheets as per usual (weekly). It was very painful for him so all extracurricular activities were suspended.

He made sure to keep his towels separate from mine, he slept on top of the bedsheets (as the contact from the sheets hurt) and we both kept an eye out for any other open wounds on each other.

I hope this allays any of your immediate worries re: MRSA at this stage.

As for Hep C, keeping her blood out of your body as rtha says is a good policy.
posted by oreonax at 4:45 PM on February 26, 2008

Hep C is not really sexually transmitted. Staph A is a damn dangerous bug. An infectious disease specialist that lectured to me put it this way: "there is no one in this room so healthy that a blood-born staph infection could not put them in the ICU in 18 hours." In the hospital we will use serious contact precautions (like those described here) but that's mostly for other people's protection.

I'd be pretty careful.
posted by a robot made out of meat at 5:22 PM on February 26, 2008

Sorry nickerbocker...

It isn't unavoidable. It's a conscious choice.

If you intentionally expose yourself to these pathogens, that's the first way to raise the chances of contracting them. Young and healthy does not mean immortal or immune.

Methycillin is the last bullet, buster. You would do well to consider what a microbe that is resistant to it implies. It is one bad ass motherfucker and it can kill you.

FYI, your immune system peaks at about 18.
posted by FauxScot at 5:25 PM on February 26, 2008 [3 favorites]

Hep C isn't generally thought to be sexually transmitted, but it can be spread among household contacts. My virology professor recommended against sharing razors, rough sex (more of a problem male-to-female or male-to-male) toothbrushes, and such things. Having protected sex in general might be a good idea, as Hep C often occurs with other infections because of shared risk factors.
posted by fermezporte at 6:48 PM on February 26, 2008

One more word about Hep C: you can get it by sharing a straw if you inhale drugs.

About MRSA: I have had two fairly huge infections ON MY FACE and was given vancomycin, tetracycline, had to wash my entire body in Hibiclens for two weeks and 800 mg. of ibuprofen for the pain of the infection. I talked to my doctor about giving it to my boyfriend and the truth is, it mutates so quickly, even inside someone who's a carrier, that you cannot "inoculate" yourself against it, preemptively treat it sans symptoms or armor yourself against it. It's very common and you have a high chance of getting it at some point in your life, whether or not your partner or roommate or child or whomever has it.

My doctor let me know that if you are a carrier your body will, after 3 or 4 years, develop an immunity and you will most likely stop getting the abscesses and swellings. Of course, this is on an individual basis; people with compromised immune systems or unhealthy lifestyles may have other issues that exacerbate it (i.e., meth or intravenous drug users, HIV positive individuals, etc.).

So, in summary: you can prevent getting Hep C pretty easily. Asking how to avoid MRSA is like asking how to avoid a cold; it's sort of inevitable that you'll be exposed to it and you can't do anything about that, except wash your hands and your sheets/towels frequently.

However, if you get a bump that won't go away, gets big and red and painful, or something that hurts really bad in a weird place and doesn't get better immediately? GET IT CULTURED. You risk going to the hospital or having a huge scar or dying if you don't act quickly when you know you're being exposed to it all the time.
posted by Unicorn on the cob at 8:10 PM on February 26, 2008

Asking how to avoid MRSA is like asking how to avoid a cold; it's sort of inevitable that you'll be exposed to it and you can't do anything about that, except wash your hands and your sheets/towels frequently.

This doesn't strike me as being a true statement; MRSA is still, fortunately, relatively rare outside of certain clinical or demographic settings.

To be honest I would probably avoid sexual relations with someone I knew had MRSA.
posted by Justinian at 9:00 PM on February 26, 2008

I dated a woman for years who had hep C, and even though we had reckless unprotected sex the entire time, the doctor at the clinic I went to for testing after we broke up gave me a weird look when I told him that was my only contact with the virus. He told me that the chances of getting it through sex are so low they don't even think it's possible unless you have oozing sores on your genitals. Just don't share razors or toothbrushes and be careful of open wounds.
posted by cmonkey at 9:04 PM on February 26, 2008

Justinian, just FYI, I have had MRSA five times in the past six years and have never been admitted to a hospital, so that's not where I got it. I am a woman in her 30's who was in a 10-year marriage for three of the five outbreaks. I am not immune-compromised nor am I an intravenous drug user; I live in the suburbs. My doctor believes the most common place of transmission outside of hospitals is at the gym; according to this article and many other sources online, 2 million people a year are treated for it (and who knows how many others have it without knowing it). Yes, it's common in hospitals and nursing homes, but many children are also dying from it (a coworker of mine currently has a 10-year-old grandchild who's been in the hospital for 6 days now with it). They are thinking she got it from falling off a trampoline and scraping her elbow, so I'd say that calling it rare is fairly misleading.
posted by Unicorn on the cob at 7:53 AM on February 27, 2008

I guess we'll have to look at the facts then; as of a couple years ago the annual incidence of MRSA in the United States was something like 20/100,000. I'd say 0.02% could be called "relatively rare".

Do you have some sort of support for what you're saying?
posted by Justinian at 8:47 AM on February 27, 2008

What I'm saying is, according to the wiki on it which may or may not be totally accurate, the rate of infection in the US more than doubled from 1999 to 2005, and according to the info there, it now kills more people annually than AIDS. Implying that it's not something to worry about outside of certain settings gives people a false sense of security about susceptibility, in my mind. Especially since it is transmitted by touch alone; it's not like Hep C where blood has to be present or an STD where sexual contact is needed. It's much more transmissible than that. It may be "relatively rare" but people should still be vigilant about having boils, abscesses and the cystic bump that just won't go away cultured by a doctor to be sure. You are right about it being somewhere around 20 out of 100,000; the wiki actually states that the number is between 18 and 25.7 people per 100,000 that have been reported and treated.
posted by Unicorn on the cob at 9:07 AM on February 27, 2008

The New York Times did a feature on this a few months ago when it was appearing in a number of highschool and colleges.

The strain you get outside of the hospital is generally referred to as CA-MRSA (community acquired). It has gotten a lot more common recently, particularly in some metro areas according to my doctor.

The CDC and state health departments generally have a lot of information posted.
posted by ejaned8 at 9:14 AM on February 27, 2008

"People in long-term sexual relationships with one person do not have to change how they protect themselves during sex. They should practice safer sex, though, if one partner is worried about getting HCV.

Many people in “high risk” groups [people with STDs, etc] seem to get HCV during sex more often. This is why some experts believe that it is possible to get HCV during sex. But, if it was easy to get HCV during sex, there would probably be more new cases of people getting the virus during sex with their long-term HCV-positive partners. ... There are no known cases of HCV being given through oral sex on a man (fellatio) or a woman (cunnilingus). It is possible that the virus could be given this way, though, if a person has mouth sores, bleeding gums, or a throat infection. ...

Healthy teeth and gums may be the best way to stop the spread of diseases through the mouth. You should try not to brush or floss your teeth right before or after oral sex or deep kissing. Brushing or flossing your teeth can cause bleeding gums and tiny cuts in the mouth." (HCV Advocate, Sexual Transmission of HCV (PDF))

The risk of sexual transmission of HCV is low, but it is not zero. It becomes higher in the presence of other infections. It is more likely if the (HCV-positive) woman is menstruating, since that introduces blood. It becomes higher still if either of you have HIV. Co-infection with HIV and HCV is increasingly common.

If you are anxious about it, feel free to re-introduce condoms.
posted by heatherann at 9:33 AM on February 27, 2008

This doesn't strike me as being a true statement; MRSA is still, fortunately, relatively rare outside of certain clinical or demographic settings.

Sure, it depends on what "relatively rare" means, but we're certainly seeing many more cases of community-acquired MRSA from gyms, pre-schools, and other "abnormal" settings. I've seen a number of patients with no known risk factors who end up with a nasty MRSA infection.
posted by gramcracker at 3:58 PM on February 27, 2008