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The MRSA-Gay Connection
Press slaps its own wrist for mischaracterizing research
By Curtis Brainard Thu 24 Jan 2008 09:00 AMThe press performed a minor mea culpa over the weekend, explaining that a new multidrug-resistant and especially virulent strain of MRSA staph infection, USA300, is not the new “gay disease.”
Articles on Newsweek’s Web site on Friday and in The New York Times on Sunday, analyzed some of the overwrought reporting that followed the announcement last Monday that a new strain of USA300 is “spreading rapidly” in the gay communities of San Francisco and Boston. A separate part of the underlying scientific study also found that in San Francisco, gay men are thirteen times more likely to be infected as other city residents.
“In a matter of days, it jumped from routine press release to a medical controversy,” the Times’ Jesse McKinley wrote on Sunday. “And sure enough, the study, published online in Annals of Internal Medicine, was quickly picked up by reporters round the world and across the Internet, including a London tabloid which dubbed the disease, ‘the new H.I.V.’”
Such mischaracterizations were a problem in many of the news articles last week. Few of them made any factual errors, but their general (and perhaps unwarranted) emphasis on the infection’s link to sexual activity may have left many readers with the impression that USA300 is a sexually transmitted disease. And a few good sentences notwithstanding, the coverage obscured the fact that USA300 (though not necessarily the new, multidrug-resistant strain) is spreading in the general population, often from casual skin-to-skin, asexual contact.
This prompted Newsweek’s Karen Springen to ask, “But is there a new HIV-like public health epidemic on the horizon?” The answer, she found, is not likely. “This definitely is not the new AIDS,” Dr. Henry Chambers, the study’s coauthor told her.
But why should readers even think that, especially given that most articles weren’t entirely wrong? A few problems that are common to science journalism cropped up, including a tendency to glaze over important scientific details and to mischaracterize the science in order to emphasize its (in this case literally) sexier aspects. Take, for example, an article from Reuters last Monday with the entirely misleading headline, “Drug-resistant staph passed in gay sex - U.S. study.”
This is not what the study found. It found that USA300 is “spreading rapidly” and is more common among gay men than other populations. That it is spreading sexually is presumed because staph bacteria tend to collect around the groin, as well as in armpits and other bodily crevices-but it is only presumed. The study clearly stated (and some reporters did as well) that:
Specific sexual behaviors were not assessed or documented in clinic charts; we therefore cannot comment on the association between multidrug-resistant USA300 infection and specific male-male sexual practices.
To peg “gay sex” as the culprit in a headline is completely misleading and journalistically irresponsible.
As McKinley pointed out in the Times this weekend, the report itself offered “ammunition” to antigay groups, who responded with accusations of sexual deviancy, and media mischaracterizations only exacerbate that problem. Indeed, after the onslaught of overreaching coverage, the University of California, San Francisco researchers that published the study had to issue this apology for their press release:
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. 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.
Unfortunately, UCSF was bearing the burden of an apology that should have been made by journalists. The university’s press release was actually very straightforward. It’s more likely that reporters didn’t read the original scientific paper carefully enough. We can turn once again to the example of Reuters’ article, which noted that MRSA “is beginning to appear outside hospitals in San Francisco, Boston, New York and Los Angeles.” First of all, MRSA began to appear outside hospitals (where such staph infections are particularly common) over a decade ago. Worse still, the article does not even mention the USA300 strain, which is what researchers were actually studying, and continues to refer to MRSA generally, surely sowing confusion among inattentive readers.
This lack of specific context for USA300 was a serious problem in most of the coverage. A couple of outlets, including London’s Daily Telegraph, reported that USA300 was discovered in 1999 after four children died in North Dakota. That is completely false; those deaths stemmed from a different type of staph infection entirely. Only The San Francisco Chronicle’s Sabin Russell accurately reported (or even bothered to mention) the history of USA300, that it was discovered in 2001 and how the new, multidrug-resistant strain was discovered in 2003. The Wall Street Journal also flubbed an important detail in its story, published last Tuesday. It reported that “gay men are thirteen time as likely to have” USA300 as heterosexuals, which is true, but only in San Francisco. By omitting those last four words, the Journal implied that the finding is national in scope, which is not the case.
In fact, the possibility that the infection will go national is a big worry for the study’s lead author, Dr. Binh Diep. Many articles noted that nearly 19,000 people died from MRSA infections in 2005, mostly from a weaker form of USA300, and a lot of the public uproar last week was the result of quotes from Diep fretting that the more virulent form could “spread to the general population.” It’s a legitimate concern, but again, context was missing from most articles. The new, multidrug-resistant strain of USA300 “is presently rare” in the general population, according to the study, and there is reason to believe it is spreading “exclusively” among gay men-but that does not mean that it is exclusive to gay men.
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Tue 22 Jan 2008 11:19 AMHow ridiculous is this? CJR now has a blog devoted to science journalism whose mission statement is spotlight science news when “it falls victim to spin, engages in alarmism, perpetrates false balance, misrepresents the science in peer-reviewed literature, or displays questionable priorities in news judgment.”
So to illustrate this new dedication to Science Journalism, Mr Brainard highlights the recent spat about activist group who got all riled up about the report, lodged a complaint with the UC San Francisco whos PC drones fell in line, and this is a positive step for science journalism? While the report did not specifically say that “gay sex is a risk factor of USA 300”, the conclusion is certainly not a stretch by any means. Or to quote from the report:
In Boston, multidrug-resistant USA300 was recovered exclusively from men who have sex with men.
Multidrug-resistant USA300 MRSA infection is especially common among men who have sex with men. It might be sexually transmitted in this population.
Twenty-nine of the 30 patients with multidrug-resistant USA300 infection had a history of having male–male sex, consistent with the high incidence of multidrug-resistant USA300 observed in San Francisco ZIP codes with high percentages of male same-sex couples
Scientific studies are by nature very conservative with their conclusions, and unless the researchers fall victim to the ACT-UP lobby, a future study will most likely conclude in no uncertain terms that gays are more susceptible to USA 300 because of a general pattern of more risky sexual behavior, which would appear to be effective vector for transmission of USA300. Sticking your fingers in your ears and setting your blinders to full PC mode does not change this fact, a fact you try you hardest to gloss over in this post.