Increased Risk of Dangerous Infections From The Bay

An unusually hot summer is creating conditions for greater risk of infections from vibrio, a bacteria that can cause serious illnesses in people who swim in warm, salty waters with open cuts, or eat raw, contaminated shellfish, according to a report from the Maryland Department of the Environment and Maryland Department of Health and Mental Hygiene.

The conclusions of the state agencies are similar to those of a report released last summer by the Chesapeake Bay Foundation, which found rising numbers of reported vibrio infections around the Bay, with the increase likely caused by a warming climate and high levels of nutrient pollution.

The photo above is of waterman Mark Allen, who nearly lost his leg to an infection that his doctor concluded was vibrio. Allen spent months in the hospital.

“My leg got so hot, it started to blister and turn black,” recalled Allen, a fourth generation waterman from Hague, Va. “The fever was bad enough that my lips peeled.”

David Paulson, a Maryland health department spokesman, said that watermen and other people who expose themselves to Bay waters in this summer's unusual heat should wear bandages over any cuts, and try to wash their hands afterwards to avoid infection.

 "Anyone who is fishing should wash their hands,” Paulson said.  “It is better to be safe than sorry.”

Twenty-four vibrio infections have been reported so far this year in the state, but those numbers are likely to rise as more cases are confirmed and as the year continues, Paulson said.

Because populations of vibrio bacteria –- a naturally-occurring saltwater organism -– tend to rise in warm, nutrient-rich conditions, fishermen and swimmers are at added risk this summer because it is hotter than normal, with six or seven heat waves so far, state officials said.

“We’ve seen recent infections associated with swimming or working in brackish bay waters and Maryland’s water temperatures have been higher than normal this summer,” said Frances Phillips, DHMH Deputy Secretary of Public Health Services. “While we want everyone to enjoy fresh Maryland seafood this summer, we also want people to be aware of how to protect themselves from illness and infection.”

A Chesapeake Bay Foundation report last year found that the number of reported vibrio infection cases in Maryland had risen to 33 in 2008 from 18 in 1999, although the reason for the increase is not clear and an increase in reporting could have played a role. Last year,  in 2009, 33 vibrio cases were again reported in Maryland, about half of them skin infections and half illnesses from eating raw or undercooked seafood, according to the Maryland Department of Health and Mental Hygiene.  Some of the infections from eating oysters may have come from shellfish imported from out of state.

In Virginia, the numbers of reported infections grew from 12 in 1999 to 30 in 2008, according to last year’s CBF report, which was based on state health department statistics. In 2009, the state received 29 reports of vibrio infections. And through August 16, Virginia had recorded 16 vibrio cases so far in 2010, according to the Virginia Department of Health.

The Maryland Department of the Environment, in its press release, said that nutrient pollution and high water temperatures can play a role in the multiplication of the naturally-occuring saltwater bacteria, along with the right salinity levels. This echoed the conclusions of CBF’s report.

"Recent research has suggested that nutrients (pollution) may play a role in vibrio concentration," the state agency reports. "Vibrio vulnificus bacteria are not commonly found in the winter when water temperatures are low, but may be common in the summer and early fall when water temperatures are warm."

The Bay Journal's new blog reported last week that four cases of vibrio infections have popped up in Calvert County so far this summer, prompting the Patuxent Riverkeeper to advise people to inform themselves about the disease and how to avoid it.

For more facts on vibrio, visit this website from the Maryland Department of Health or this site from the Maryland Department of the Environment.

The (Southern Maryland) Enterprise on August 18 published the following account of a person who became seriously ill from vibrio:

When Mauro Lanzisera, a part-time waterman, returned from early morning crabbing to his Broomes Island home around noon on July 2, he had a quarter-sized cut on his left leg. By 10 p.m., his leg hurt so badly his wife took him Calvert Memorial Hospital, where he was checked for a broken leg and sent home with orders to return in two days.

Lanzisera's foot started to swell and when he arrived back at the hospital a doctor who had treated Hurricane Katrina victims in New Orleans recognized the infection as vibrio. Lanzisera stayed in the hospital for four more days before he was transferred to the R. Adams Cowley Shock Trauma Center in Baltimore, where he remained until July 26 before transitioning to a rehab center in Annapolis.

Lanzisera underwent four surgeries at the trauma center, the last one involving the removal of tissue and muscle from his right leg to replace dead tissue on his left leg. Skin was also taken from his left thigh to complete the operation. A doctor told Lanzisera before the surgery that amputation was a possibility However, Lanzicera is now expected to make a full recovery.

"My prognosis is good … but I still can't walk and probably need another surgery," he said.

Lanzicera spoke about his condition with friends and environmentalists but originally did not want his name revealed to the media. He said he changed his mind when he felt local health departments were not doing enough to educate the public. He has since appeared on local news stations detailing his ailment and advising others on how to avoid contracting vibrio.

"There's some bad things in the water and you just got to be aware of them," Lanzicera said. "If you have a cut or scratch and you go in the water and a few hours later it's bothering you, seek medical treatment right away."

After hearing about Lanzisera's case, former state senator and longtime Patuxent River advocate Bernie Fowler asked the Maryland Department of the Environment to test the water near Broomes Island.

"I consider this a very serious matter and I'd like to see somebody come down and test the water as soon as possible to make sure it's safe to go into," Fowler said. "I don't think it's something you can exaggerate too much."

While vibrio infections are "not a very common occurrence," they can be serious and should be treated immediately if symptoms arise, Calvert County Health Officer Dr. David Rogers said. Symptoms include redness, soreness, swelling and pus around a skin abrasion and vomiting, fever or headache if ingested.

Rogers warned against creating a "fear and panic in people" over an illness that is relatively rare and said "It's easy for people who are not experienced or professionals to overreact."

(The above 10 paragraphs are from the Enterprise news story.)

Article and photo by Tom Pelton

Chesapeake Bay Foundation

Comments

[mrsa infection]

Infections can go very dangerous if left unattended. Always practice personal hygiene for this.

[nat]

Wow! Thats really crazy.I used to live in Virginia and swam there.I was little and don't remember about anyone talkin about a diese.That is really CRAZY!
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[utah dermotologist]

Medicating it on an early stage is necessary.

[health care]

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