Anglers face dangers from vibrio vulnificus bacterium and fish handler's disease

Early detection, treatment can save the lives of infected fishermen

December 22, 2013|By Brian Compere, The Baltimore Sun

When Charlie Schneider came back one day in June after being out fishing near his Tilghman Island home, he noticed he was getting chills. His left ankle itched and got worse and worse through the evening. It eventually started to throb a bit, and he couldn't sleep. At 2 a.m., he asked his wife to get an ice pack before discovering that his ankle had swollen to twice its normal size.

He didn't know what had caused the reaction, but his decision to go straight to the hospital ultimately helped save his legs — and his life.

Schneider, 66, was suffering from an infection caused by the vibrio vulnificus bacterium, which exists naturally in saltwater but is more prevalent in warmer water, said Martin Carter, a retired Department of Health and Mental Hygiene Laboratories Administration employee who speaks to fishing groups about infections, such as this one, that fishermen can be exposed to.

Vibrio infects victims through open wounds exposed to warm saltwater or through the consumption of raw oysters carrying the bacterium. While the bacterium is much less prevalent in colder seasons because it multiplies more prolifically in warmer water, Carter said “really it's not a good idea to eat raw oysters in the summertime.”

Schneider hadn't eaten any oysters, though, and both he and Carter said Schneider is a healthy person. Although healthy people are more likely to fight off the spread of infection than those with weakened immune systems, Carter said, healthy people such as Schneider are not immune. He had exposed scrapes and scratches on his ankles to the water while fishing, and that was enough for infection.

When he went to a hospital the night he discovered the infection, he was put on antibiotics, but the medical staff didn't know what he was suffering from. After going to his family doctor only to find a similar result, he returned to the hospital the next morning to see an infectious-disease specialist.

He asked the specialist if he had contracted mycobacterium marinum, also known as fish handler's disease, which he knew about thanks to Carter; she was surprised he knew what that was but said it was vibrio — something she couldn't treat there. He was taken to the University of Maryland Shock Trauma Center.

At the center, Dr. Thomas Scalea told Schneider's wife that if he had arrived there just 12 hours later, he would have died. By that point, the infection had spread to both legs and he was “very, very sick.”

“My wife said she didn't realize a body could swell like that,” Schneider said. “It's pretty serious stuff.”

He spent the next three weeks in an intensive care unit and endured nine surgeries to cut the infection out while staying ahead of its spreading. He said his legs looked like a fish when it's being made into a filet. A 10th surgery was a skin graft, after which he was taken to another hospital for three weeks to eventually regain the use of his legs.

After first going to a hospital to get the infection treated June 19, he could walk again with the assistance of a cane on Labor Day. Now, he can't walk too far or stand for too long because his legs swell up, though the condition is improving, he said.

Schneider also lost the whole summer for fishing, which he used to do five days a week or more sometimes, and not being able to do so “devastated” him, he said.

“Not being able to move, I couldn't do what I love to do,” he said. “But the skin grafts took, I got both my legs and I'm alive, so I'm a happy man.”

Schneider was lucky: The Associated Press reported Oct. 11 that 31 people in Florida had been infected with vibrio this year, and 10 of them died.

Fish handler's disease

As Schneider knew, vibrio is not the only disease fishermen and others on the water can be exposed to. Jonathan Mitchell, 55, of Brooklyn Park learned about fish handler's disease the hard way.

While fishing under the Key Bridge during the summer about four years ago, Mitchell said, he slipped while cutting up some chum and nicked his thumb with his knife. It took awhile to notice any negative effects, he said, but his thumb became very stiff and all his fingers also soon stiffened until his hand “just about turned to stone.”

Mitchell, who fishes recreationally once or twice a week, went to his endocrinologist, who couldn't identify the problem; he then went to the Johns Hopkins Hospital emergency room, where medical staff treated him with antibiotics for a couple of days, but this didn't solve the problem. He went back to his endocrinologist, who sent him to a disease specialist who recognized the disease right away, Mitchell said.

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