Pfiesteria may have sickened 5 people

Md. medical officials document cases from past 3 years

April 04, 2001|By Heather Dewar | Heather Dewar,SUN STAFF

Maryland medical officials have documented five cases of people who might have been sickened by Pfiesteria during the past three years, though no confirmed fish kills have been attributed to the toxic microorganism since 1997.

Dr. Glenn Morris, director of the University of Maryland School of Medicine's Pfiesteria research program, said yesterday that the five people all have symptoms consistent with an illness known as estuarine associated syndrome, which was first identified after a major outbreak of Pfiesteria on Maryland's Pocomoke River in 1997.

The symptoms include memory loss, headache, skin rashes, burning skin and eyes, breathing problems, and gastrointestinal illness. All five patients had at least three of those problems, Morris said, though none of the cases was as severe as those reported in 1997.

All five people have been on waterways where the fish-killing microorganism is known to exist - most of them more than once, on several different rivers during a period of several years, Morris said. But because Pfiesteria rapidly changes from benign to toxic forms and back again, "I have no idea whether these people really were exposed to Pfiesteria," he said.

"We have five question marks," Morris said. "It's hard to know what these people have."

The new finding, which has just been reported to the federal Centers for Disease Control and Prevention, adds urgency to a long-standing question about whether Pfiesteria can make people sick at levels too low to cause fish kills.

Because Pfiesteria appears to be widespread in Maryland's tidal waters, and because no fast test can tell when it is harmless and when it is dangerous, public health officials use fish kills as one of their main cues for deciding when to keep people away from potential trouble spots.

Maryland officials have not closed any rivers to the public because of Pfiesteria since 1997. Morris said the latest findings are not definitive enough to justify setting more cautious standards for closing water bodies, and a state public health official agreed.

"We're going to continue with the same system we've had set up since 1998," said Amy Chapin, acting director of environmental health for the Maryland Department of Health and Mental Hygiene.

For now, Chapin said, health officials don't have any better options. "The problem is that we can't definitively diagnose" the Pfiesteria-linked syndrome, she said.

"It's unfortunate that we couldn't measure something in their blood and know definitively what it is. I think that people should still use common sense and not swim or recreate in areas where they see a lot of fish with lesions or strange fish behavior," Chapin said.

Rob Magnien, who supervises Pfiesteria monitoring for the Maryland Department of Natural Resources, said the finding "means we've still got to keep a close eye on those areas where we're seeing Pfiesteria on a regular basis and where we're seeing problems with the fish," short of fish kills.

"We're going to be very aggressive in monitoring those areas," Magnien said.

Morris said that out of 1,800 people who called a state Pfiesteria hot line complaining of illness, these five cases were the only ones that doctors decided could have been caused by the toxic microorganism. One of the patients became sick in 1998, one in 1999 and three last year, he said.

Morris declined to identify the patients, describe their symptoms or say where they lived. Some, but not all, are watermen, he said. Four of the five reported that they had been exposed to Pfiesteria and gotten sick from it before - three in 1997 and one since then, he said.

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