Swimmers with wounds: beware of bacteria

Swimmers in Florida are being
warned to stay out of the water if they have open wounds and cuts because of
deadly bacteria that have claimed the lives of 31 people in the past five
years.

Swimming in the sea has long been
considered a panacea for cuts and scrapes, but doctors are warning that in some
cases, this can prove deadly.

Vibrio vulnificus occurs naturally
in warm coastal waters, infecting open wounds and causing serious illnesses for
those with weakened immune systems. It is more commonly seen among patients who
have eaten under-cooked or raw seafood, like oysters.

According to the Florida Department
of Health, 138 people were infected with the bacteria between 2005 and 2009,
and 31 died.

Bacteria not seen in Cayman

Dr. Kiran Kumar, medical officer of
health at the Cayman Islands Health Services Authority said there have been no
local cases of the bacteria.

“We have never had any deaths following
an infection after swimming,” said Dr. Kumar, adding that there had been no
reports from the hospital lab on any vibrio vulnificus cases.

Dr. John Addleson, a local general
practitioner recalled seeing one case in Cayman several years ago, but said it
was unclear whether the patient had contracted it through a cut or by ingesting
seafood.

“It’s an opportunistic infection
that affects people with immune systems that are run down,” said Dr. Addleson.

Vibrio vulnificus is a bacterium in
the same family as those that cause cholera.

According to the Miami Herald, in
Miami-Dade County, there have been two vibrio vulnificus-related deaths in the
past five years.

The newspaper reported that one of
the victims, 86-year-old Shirley Malavenda went swimming with her husband last
August at Matheson Hammock Park’s man-made atoll, where she swam twice a week.
There she contracted the bacteria through a small scrape on her left leg.

Four days later, she was rushed to
hospital in septic shock. Doctors amputated her leg in a bid to stop the
spreading infection, but she died a month later.

When a person gets infected with
the virus, the wounds become inflamed and swollen, and fever, chills, pain at
the wound site, decreased blood pressure causing septic shock and blood-tinged
blisters will often develop. Nausea, vomiting, and diarrhoea are symptoms
associated with consuming the bacteria.

Anyone showing those symptoms
should go to hospital and seek medical help.

According to the Centers for
Disease Control and Prevention, Vibrio vulnificus bloodstream infections are
fatal about 50 per cent of the time.

Victims usually die within 24-48
hours as the bacteria quickly spread through the bloodstream and begin
destroying tissue.

Most healthy individuals are not at
risk from the bacteria, but those at high-risk include people with liver
disorders, including hepatitis, cirrhosis and liver cancer; hemochromatosis;
diabetes mellitus; and those with immunocompromising conditions, such as
HIV/AIDS, cancer, or undergoing their treatments.

People who take prescribed
medication to decrease stomach acid levels or who have had gastric surgery are
also at risk.

Florida’s health department is
educating doctors to recognise and treat symptoms quickly.

If caught early, antibiotics like
tetracycline and doxycycline can treat the infection, although amputations are
often done to prevent death.

Precautions

The Centers for Disease Control and
Prevention advises the following, especially for immunocompromised patients,
including those with underlying liver disease:

•Do not eat raw oysters or other
raw shellfish.

•Cook shellfish (oysters, clams,
mussels) thoroughly.

•For shellfish in the shell, either
a) boil until the shells open and continue boiling for five more minutes, or b)
steam until the shells open and then continue cooking for nine more minutes. Do
not eat those shellfish that do not open during cooking. Boil shucked oysters
at least three minutes, or fry them in oil at least 10 minutes at 375°F.

•Avoid cross-contamination of
cooked seafood and other foods with raw seafood and juices from raw seafood.

•Eat shellfish promptly after
cooking and refrigerate leftovers.

•Avoid exposure of open wounds or
broken skin to warm salt or brackish water, or to raw shellfish harvested from
such waters.

•Wear protective clothing (such as
gloves) when handling raw shellfish.

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