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Herd Immunity: Mapping MRSA and Other Superbugs, One Case at a Time

Herd Immunity: Mapping MRSA and Other Superbugs, One Case at a Time

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What do Beth Israel Deaconess Medical Center in Boston, MountainView Hospital in Las Vegas, and United Memorial Medical Center in Batavia, New York, all have in common?

Patients have caught a healthcare-associated infection there in recent years. You can see this for yourself with a new Google map Antidote has created to track these infections as they are reported. As Antidote noted before, many state governments aren't providing this information to the public, and the federal government isn't either. Health Watch USA made the point that it is easier to find out where cows live in the U.S. than where life-threatening superbugs live. This new map is a small step toward making it easier to know where healthcare-associated infections have hurt patients.

View Herd Immunity in a larger map

The map won't exist without you, though. Share your ideas for what should be added, what should be updated and how the map can be improved in the comments below or by emailing me at

You might remember that I did something similar in 2010 with my Doctors Behaving Badly series. That map relied mostly on filings by state medical boards against physicians who had hurt patients or otherwise violated accepted medical practices.

For this map, I'm hoping for examples that meet one of three criteria:

Was the infection or death reported in the press?

If so, send me the link. Sean Carroll at local ABC station WHAM in Rochester – can we just retire the trophy for the best broadcast call sign? – reported in May 2011 that an outbreak of Clostridium difficile at United Memorial Medical Center had been "linked to the death of three patients.  The New York State Department of Health also confirms a total of 19 C diff cases since February 28th are part of an ongoing investigation."

Was the infection or death the subject of a lawsuit?

If so, send me the case or send me the name of the attorneys involved. I'll contact them and ask for a case that I can post. Earlier this month, Nevada's Eighth Judicial District Court ruled that a lawsuit by Laura and Edward Rehfeldt could proceed for medical malpractice against MountainView Hospital in Las Vegas. According to the ruling, the couple alleged that "Laura contracted a Methicillin-resistant Staphylococcus aureus (MRSA) and went into septic shock after undergoing elective back surgery at MountainView Hospital." Rehfeldt apparently "tested negative for being colonized with or a carrier for MRSA prior to the surgery," and so she and her husband sued, alleging that the hospital and Rehfeldt's surgeon had "committed medical malpractice by failing to provide a clean and sterile hospital environment and failing to properly care for Laura."

Was the infection or death the subject of a local, state or federal investigation?

An outbreak of MRSA infections in mothers and newborns at Beth Israel Deaconess Medical Center in Boston in November 2008 prompted an investigation by the Massachusetts Department of Public Health. Patricia Wen and Liz Kowalczyk at The Boston Globe reported in April 2009:

Some officials caution that Beth Israel Deaconess alone may not be responsible for the outbreak. Dr. Anita Barry, director of the infectious disease bureau at the Boston Public Health Commission, said she was told that the infected patients at the hospital had, on average, showed symptoms 12 days after discharge, leading her to think that many may have contracted the bacteria in their communities. She also said that testing of hospital staff yielded no specific person who was infected. On the other hand, MRSA specialists said, some carriers will intermittently test negative. The 37 affected patients came from throughout the Boston area. Their only shared experience appears to be staying at the hospital.

Send your examples to or via Twitter @wheisel, or share them in the comments below. I'll map them. And together we can show the world that tracking superbugs can be painless.


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MY mother died of ten HAI's 6/24/10. It was on national news ABC WORLD NEWS 3/25/11 'SUPERBUGS' INTERNET;AND RENO AND LAS VEGAS PAPERS 7/25/10 'SUPERBUGS A RISK TO PATIENTS' I currently have had CMS postpone payment to the hospitals under Section 5001c,D theIpatient Prospective Payment System[IPPS]

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Mr. Heisel:

I applaud your efforts to ask the healthcare community to help map MRSA, the “super bug.” As you know, MRSA causes significant infections throughout the U.S. with mortality rates of up to 20 percent in certain settings. Mapping the spread of MRSA is an important step in localizing MRSA, raising awareness in high impact areas and tailoring prevention and treatment efforts to that particular locale.

I share your interest in mapping this serious health condition. In fact through my work with the National Minority Quality Forum ( I have created more than a dozen health atlases that map the prevalence of particular diseases and health conditions, such as HIV/AIDS, diabetes, childhood obesity various cancers and MRSA. We developed the national MRSA Atlas ( to help those on the front lines of MRSA to more effectively calibrate prevention and treatment efforts through use of the MRSA map. Health care practitioners can use the MRSA map to pinpoint “super bug” hot spots and thereby direct resources where they are most needed.

I invite you and your readers to check out the MRSA map at to see how it compares with the map you are creating. On our map, users can examine data by age, gender, race and ethnicity and can also overlay federal and state legislative districts on top of county data. The MRSA Atlas shows that 90 percent of MRSA occurs in just five percent of the counties in the United States. I would be very interested to learn where your readers report cases of MRSA to see how it tracks against our data.

It is my hope that we can all work together to improve early diagnosis and treatment in the hardest hit communities.

Gary Puckrein
Founder and CEO, National Minority Quality Forum (

Picture of William Heisel

Dr. Puckrein,

Great map. I'm going to explore it with my readers in an upcoming post. Let me know when you update it with new data. My email is

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I will tweet about this and Google's Antidote. In your criteria is it also useful to ask about measures the hospitals involved in the HAI disease and death have taken to reduce MRSA, CLABSIs, etc. since being called out for preventable harm to patients?

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What if the hospital behind the HAI disease or death has taken measures to bolster infection prevention. Shouldn't that be included in your criteria (above). You can't imagine how many hospital teams are working on the problem with so many factors inside and outside the hospital as contributors... the latest being drug resistant bacteria that long preceded antibiotics... and so many more.

Picture of William Heisel


The criteria I listed are just for the purposes of deciding whether to put an incident on the map. I'm trying to make sure that established infections are posted. I think your point is well taken, though, and if any health care facilities that have been mapped would like to send me information about the steps they are taking in rsponse to an infection, I'd be happy to post those, too.


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