Skin lesions hit swimmers

Skin lesions hit swimmers Surfers, fishermen cautioned about cuts By RAY WEISS Staff Writer Daytona Beach News Journal Last update: 22 October 2003 The same mysterious bacterial skin infection that struck offshore commercial fishermen in Port Orange has hit some local surfers and swimmers, hospitalizing at least two.
Dr. Jeff Parks, an Ormond Beach dermatologist, said he has treated at least eight patients in the last two months with the painful and contagious crater-like lesions that start as small pustules and can expand to the size of silver dollars within days. He said his patients with methicillin-resistant staphylococcus aureus, better known as MRSA, ranged in age from 3 to 40 years old. While the cause is difficult to pinpoint, Parks said each patient had swum in the ocean right before contracting the illness. Bacterial infections are common among commercial fishermen and others who handle fish. But Parks and others are perplexed about why and how so many people are contracting this particular strain of bacteria, which is believed to be acquired only on land. Until this year, Parks said he hadn't seen a single case of MRSA in "people who have casual contact in the water." "Normally, it's land-borne. But I think it is in the water, or on an organism in the water," he said. "It's happening to people who are not exposed on land." The bacterial infection usually affects people with weakened immune systems, including cigarette smokers, often in hospitals, nursing homes and other medical facilities. Left untreated, it can result in massive infection, amputation and even death. "All my patients were otherwise healthy. They had no obvious traumatic cuts," he said. "Traditionally, there needs to be an opening" for the bacteria to enter. Gary Hill, the 36-year-old kitchen manager at Our Deck Down Under, works next to the Port Orange Marina where at least 10 offshore commercial fishermen have contracted the bacterial infection in recent months. A twice-a-week surfer, he went to Halifax Medical Center in Daytona Beach on Sunday, concerned about two suspicious lesions on his right leg, after reading a News-Journal story about the bacterial infection. Hill immediately was admitted and placed on intravenous antibiotics. He said a doctor about two weeks ago misdiagnosed "the little pimple" as an infected hair follicle. Subsequently, the lesions spread, developing into half dollar-sized open sores on his thigh and armpit. Hill said he last surfed about three weeks ago. Recently, he said he went out on a one-day charter-fishing trip, but no one else aboard became infected.	Staphylococcus aureus is also known as "staph" and methicillin-resistant staphylococcus aureus is commonly referred to as "MRSA." Staph bacteria generally is one of the most common causes of skin infections in the United States. Staph also causes bone infections, pneumonia and life- threatening bloodstream infections. Staph bacteria are commonly found on the skin or in the nose of healthy people. An estimated 25 to 30 percent of the U.S. population has staph bacteria in the nose at any given time. MRSA is commonly found among people in hospitals and health-care facilities, usually in patients who are elderly or very sick or who have open wounds. Cases of MRSA in the community have been associated with sharing contaminated items, having active skin diseases, living in crowded conditions and playing contact sports. Regular staph infections and MRSA infections are not routinely reported so a precise number of cases is not known. Only a small number of the estimated 100,000 people hospitalized with MRSA each year are believed to have contracted the disease outside the hospital. The best way to prevent infection is to practice good hygiene. Keep hands clean by washing with soap and water. Clean and cover cuts and abrasions. Avoid contact with other people's wounds. SOURCE: Centers for Disease Control and Prevention
"They're treating me for what they believe is MRSA," he said by telephone Monday from his hospital room. "They just did a culture today, and will have the results tomorrow." Jonelle Hartbrodt's 18-year-old son, Jared, who lives and surfs in New Smyrna Beach, was hospitalized a month ago in Orange City with three golf ball-sized lesions, diagnosed as MRSA. "I almost lost him. He was so sick," she said. "It was very close to the bone under his arm. There was a hole with lymph tissue coming out." Hartbrodt, who lives in Deltona, said her son underwent strong antibiotic therapy and sterilized dressings were regularly changed. He has fully recovered. "We had to treat him like he had leprosy," she said. "It was unbelievable what he went through." Dr. Howard Rodenberg, who heads the Volusia County Health Department, said MRSA is not a reportable disease like West Nile virus. But he said that as of Monday, there were two current documented local cases of the bacterial infection. "Whether or not it is related to the ocean, we do not know. I suspect that this particular bacteria probably is not," he said. "We haven't found anything else going on in the state similar to this." Rodenberg said the Health Department "does not perceive (there's) a new hazard," but will continue to investigate. Meanwhile, he recommended that anyone with open cuts or sores either avoid the ocean or cover themselves with waterproof dressings before going in. "It's nothing unique to the ocean," he said. "They should do the same if they're playing in a pit of mud or swimming in a lake."

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