Md. briefs doctors on microorganism U.S. agency plans Pfiesteria workshop on health effects

September 06, 1997|By D. Quentin Wilber and Jonathan Bor | D. Quentin Wilber and Jonathan Bor,SUN STAFF

OCEAN CITY SUN STAFF WRITER MICHAEL DRESSER CONTRIBUTED TO THIS ARTICLE. — OCEAN CITY -- While Maryland officials briefed the state's doctors yesterday on the microorganism that has killed fish and apparently sickened people, a federal agency was asking representatives of Atlantic seaboard states to join in learning more about the health effects.

The U.S. Centers for Disease Control and Prevention in Atlanta ++ plans to convene a workshop where officials from coastal states will share information about the toxic dinoflagellate, Pfiesteria piscicida, or related organisms.

Dr. Michael McGeehin, an official with the CDC's Center for Environmental Health, said he hopes all states from Delaware to Florida will be represented.

The meeting would be in Atlanta, probably late this month.

Maryland health Secretary Martin L. Wasserman said this week that he supports interstate cooperation on the subject.

A chief purpose will be to arrive at a better case definition -- a clear set of symptoms that can be attributed to Pfiesteria poisoning. "Once we have a case definition," McGeehin said, "then we can go and set up surveillance systems to look for this syndrome."

Meanwhile Rep. Wayne T. Gilchrest, a 1st District Republican, has called for a congressional inquiry into the Pfiesteria outbreaks in the Pocomoke River and elsewhere.

The Eastern Shore congressman, who serves on the House subcommittee on fisheries conservation, said Thursday that he has asked the panel's chairman, Rep. James H. Saxton, a New Jersey Republican, to schedule hearings as soon as possible.

Cathy Bassett, Gilchrest's press secretary, said yesterday that one issue is whether federal funds were needed for Pfiesteria research.

At the semiannual meeting here of the Medical and Chirurgical Faculty of Maryland, a group of about 70 doctors received its first scientific briefing on the subject.

"This is an important group of people to reach and an easy place to reach them." said Dr. Diane L. Matuszak, the state associate director of community and public health.

She joined Dr. Ritchie C. Shoemaker of Pocomoke City, who first treated patients suffering from Pfiesteria-related illnesses, in advising doctors to watch for patients exposed to river water who complain of of burning skin, respiratory irritation and memory loss.

Briefing called important

Doctors were told to immediately call the state health department or their local health offices about suspicious cases.

The briefing was important, several doctors said, because they were able to hear directly from experts about human illnesses linked to Pfiesteria piscicida and two similar microbes.

Since early last month, scientists believe the organisms have been killing thousands of fish in the lower Pocomoke.

The governor announced Aug. 29 that researchers had linked toxins in the water to human illness and closed a seven-mile stretch of the river. Virginia joined in the closure.

Yesterday, all was quiet on the Pocomoke. Scientists believe Thursday's low morning temperatures in the 40s probably quelled the microbe.

A team of doctors assembled by the state health department drew the link between Pfiesteria and human illness after examining 11 people who had complained of symptoms. Four of those affected were state employees who had done water sampling on the lower Pocomoke; others were watermen.

Two additional watermen declined to go through a full battery of tests, but changed their minds after hearing about the findings, according to Wasserman. They will soon be tested, he said, probably in Baltimore.

More than 50 people have called a toll-free number to report ailments that might have resulted from contact with Pfiesteria-laden waters, but officials said that only a few of the callers appear to have symptoms that qualify.

Brain scans done

Wasserman said the medical team will probably finish its analysis of the original 13 people affected before examining additional patients. Key information might come from the results of sophisticated brain scans that were done at the Johns Hopkins Hospital.

Shoemaker, a family practitioner, used slides showing bloody fish and a patient with bug-bite sized sores to illustrate five case studies.

His most striking case, a Department of Environment employee, displayed nearly all Pfiesteria-related symptoms: memory loss, skin burning and wheezing.

Shoemaker offered advice about treating symptoms, but could not add more because so little research has been done on the subject, he said.

"I sent one patient to the known expert on the subject in North Carolina," Shoemaker said. "He had seen one patient. I sent him his next two."

Dr. Carol Bender, an internist form Bethesda, said she found Shoemaker's remarks about his patients' symptoms enlightening, because she knew of no medical articles that were published on the subject.

Patient suffering

"I have a patient who's been suffering from a week of diarrhea," Bender said. "I'm going to go home and ask him if he was at the shore or near the river this week."

Dr. Gary Rosenberg, an allergist in Baltimore, said he knew some his patients came to the Eastern Shore to vacation or fish and would keep an eye on those who suffered from asthma-like problems -- another symptom.

"I don't think my patients will be coming to me and complaining about memory loss," Rosenberg said. "But they might be suffering from symptoms that I treat. Every doctor here could end up dealing with this problem on some level."

Hot line

The state urges people who believe they have Pfiesteria-related symptoms to call a hot line operated by the Maryland Infection Control Network. The toll-free number, answered between 8 a.m. and midnight, is 1-888-258-8989.

Pub Date: 9/06/97

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