Bacteria sickening residents

People with open wounds advised to avoid water

Wednesday, Aug. 18, 2010

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Part-time waterman Mauro Lanzisera was infected with vibrio in July. He was hospitalized and had to undergo several surgeries.

Hot temperatures are often cause for people to don swimwear and seek relief at a local beach, but swimmers may want to think twice before diving into the Chesapeake Bay or its tributaries if they have any open wounds.

Summer climates plus nutrient pollution annually create a warm broth perfect for breeding vibrio, bacteria that cause skin and blood infections and intestinal illnesses.

Reported cases of vibrio are in line with past figures, but last week above-average temperatures spurred state agencies to advise that citizens avoid ingesting raw or undercooked shellfish and contact with bay waters if they have open cuts, scrapes, burns or sores.

As of Monday afternoon, 24 cases of vibrio have been reported in the state and more are expected over the next month or so, Maryland Department of Health and Mental Hygiene spokesman David Paulson said.

The state received reports of 33 vibrio cases in both 2009 and 2008, but a good portion of those cases occurred in August and September, Paulson said.

Annual figures have not changed much since the early 2000s, when the state began requiring statewide reporting of vibrio cases rather than from just the Baltimore and Washington, D.C., metro areas, Paulson said. Cases average around 30 a year — 25 were reported in 2007, 31 in 2006, 25 in 2005 and 29 in 2004, Paulson said. But this summer's record temperatures could drive up reports of vibrio, which flourishes in warm water.

"We will likely see higher numbers," Paulson said.

Of the cases reported to the state, four have come from Calvert County, three skins infections and one via ingestion, said the Calvert County Health Department Health Officer Dr. David Rogers.

While vibrio infections are "not a very common occurrence," they can be serious and should be treated immediately if symptoms arise, 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."

That people should avoid eating raw or undercooked shellfish or bringing open wounds into contact with bay waters is "sound advice," but public notices are unnecessary, Rogers said.

"These are things that are generally known," he continued. "For example, should we post a sign in the woods warning that you may get poison ivy?"

The health department recently posted an alert concerning vibrio on its website.

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 to 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 "If [the operation] doesn't work," he said. Lanzisera 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.

Lanzisera 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," Lanzisera 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."

Vibrio infections are especially tough on those with liver disease or high blood iron, said Rita Colwell, a professor at the University of Maryland and Johns Hopkins University and former president of the National Science Foundation. Colwell has been studying vibrio in the Chesapeake Bay for nearly four decades and was cited heavily in a July 2009 Chesapeake Bay Foundation report on the risks of bacterial infection and nutrient poisoning in the bay.

"It's a nasty infection," Colwell said. "It's very invasive and it's tissue destroying." In rare cases, it can be fatal, she said.

Nationwide, about 30 people die from vibrio infections each year, Paulson said, adding that of the state's 24 cases, eight have resulted in hospitalizations but there have been no deaths.

Local watermen have been aware of vibrio for years and will often keep a bucket of bleach water onboard their vessels to sterilize wounds, Calvert County Waterman's Association President Tommy Zinn said. July and August are "hot bacteria months in any water," but no association members have been infected this year, Zinn said.

"We keep an eye on it and we take precautions and so far, so good," he added. For residents, Zinn said "they just need to use common sense and not go into the water with an open wound or open sore," just like someone with a cut on their foot should not walk around outside barefoot.