The sudden death of a 17-month-old boy in Hyde Park brought Dr. Robert Daum to the Cook County Jail. Out of town the April morning in 2004 when Simon Sparrow woke up screaming in his crib, Daum, chief of pediatric infectious diseases at the University of Chicago’s Comer Children’s Hospital, followed the case by telephone. Simon’s blood pressure dropped, his major organs began to fail, his skin turned purple and scabby, and his body bloated as if he were drowning. A day and a half later he was dead.
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David Cummings spent 18 months at the jail, from December 2004 to May 2006, for armed robbery and attempted robbery. He never came down with CA-MRSA himself, but he says he knew plenty of guys who did. According to Cummings, they often misattributed the infection to a spider bite and thought the best way to avoid breaking out in bumps and boils was to stop drinking the jail’s water supply.
When someone who hasn’t been hospitalized or received medical treatment in the last year comes down with a MRSA infection, it’s classified as community-associated MRSA. CA-MRSA causes boils and lesions that can be healed 77 percent of the time by lancing and draining. About 6 percent of cases, however, are serious or fatal. The bacteria can eat flesh, causing gangrene. It can also cause pneumonia and severe sepsis, a toxic-shock-like condition that leads to organ failure. Simon Sparrow developed sepsis, as did at least one of the other six Chicago children who have died of CA-MRSA since 2003.
Dr. Robert Weinstein, chief of infectious diseases for Stroger Hospital and an author of the May 2007 study, believes the infection could be just as common in suburban areas of Cook and Du Page counties, which have lower rates of arrest and incarceration, as it is in the city. “If you have a population that has no jail exposure,” he says, “you’re still going to see CA-MRSA if they have close person-to-person contact.” But doctors at Comer Children’s Hospital say that’s highly unlikely. A comparison of data from Comer with data from other area hospitals indicates that not only is the infection more widespread among Chicago children than suburban children, it’s more common among children on the south and west sides of the city than on the north.
Over the next few years, researchers across the country discovered CA-MRSA in halfway houses, on Native American reservations, even in the locker room of the Saint Louis Rams. Outbreaks were reported in jails and prisons in Mississippi, Georgia, and California, and a 2003 study of the entire Texas penal system–a total of 145,000 people–revealed that there had been nearly 11,000 cases of CA-MRSA between January 1996 and July 2002. One hundred and eighty-nine were serious. Three were fatal.
Daum and Rodriguez worked with doctors from each of their institutions over the course of the next three years to design a three-year study with an estimated budget of $900,000. They worked with the director of the jail guards, Scott Kurtovich, to ensure they had his support and that he understood the study’s logistical requirements, which would require frequent movement and close monitoring of detainees. According to Raba, who was at Cermak during the study’s early planning stages, it also had the support of top officials at Cermak and Cook County Jail.
