Shark Week
Written by Dr. Pia Boben Fenimore
It’s that time of year when many of my patients are heading to the beach. No coincidence at all it is also Shark Week on television, which is a quick way to make even the bravest ocean lover think twice about swimming. Considering the rare incidence of attacks, and the incredible benefits of a family vacation to the ocean, sharks should not hold us back from ocean swimming. However, there are some critters who get much less attention than sharks, that can cause problems and are worthy of a few warnings.
Vibrio Vulnificus
It is important that I start by saying this is a very rare bacteria and that only about 200 serious infections are reported in the US each year. However, these bacteria have become more and more resistant to antibiotics, and therefore prevention has become critical.
V. Vulnificus (or some call it just Vibrio) are bacteria that can live in coastal waters and brackish water. Research indicates that water above 18 degrees Celsius (64 degrees Fahrenheit)and with salinities between 15-25 parts per thousand is the ideal medium for V. Vulnificus. In the past these bacteria were only found in tropical waters but warmer ocean temperatures have caused this organism to thrive and become a bigger threat. According to data from the Environmental Protection Agency the sea surface temperature has increased by approximately 0.13 degrees Celsius each decade for the past 100 years. Previously this germ was found only in tropical areas but due in part to rising sea temperatures it is moving northward. Recently V. Vulnificus has been reported in the Chesapeake and Delmarva Bays. Vibrio Vulnificus can cause infection by invading open wounds. The immune factors that our body releases into an open wound serve to strengthen Vibrio making them more invasive. It can be very aggressive and lead to intensive care, amputation, or death. Consuming seafood (usually raw oysters)which carry V. Vulnificus can also cause gastroenteritis, and widespread infection. It is the leading cause of seafood related fatalities in the US. Infection usually presents with sudden onset of fever, vomiting, diarrhea, and abdominal pain within 7-14 days of ingestion of contaminated food. Wound infections typically show signs within 7-10 days of exposure to infected water and often begin as a small purple/black area in the wound. The infection is called necrotizing fasciitis and is commonly referred to as “flesh eating bacteria” although that is not medically accurate. People with co morbid conditions that weaken their immune system such as diabetes are more at risk. Infections are treatable with broad spectrum IV antibiotics and surgical debridement. Interestingly a vaccine is in development using eels as the host. Prevent infection by:
Avoiding saltwater or brackish water exposure to open wounds when the water temperatures are warmer
Washing any cuts/scrapes acquired in the ocean immediately
Do not eat raw oysters which have been harvested from warm water locations
Jelly Fish
Most of the jellyfish that we see on the Eastern Seaboard are harmless, but some can inflict painful stings. Jelly fish tend to come closer to the shore during warmer weather and are more likely to be on the coastline after summer storms. Beaches will often post warning signs when jellyfish are abundant, if you see this type of posting; swimming should be avoided. Stings usually feel initially painful and then often become itchy.
Any stings should be reported to the lifeguard immediately.
If you are stung; wash the area with saltwater and pull off any remaining tentacles.
White vinegar poured on the sting will provide an instant soothing effect.
If trouble breathing, worsening pain, or fever develop seek medical attention urgently.
According to research the folklore remedy of having someone urinate on a jellyfish sting is not effective and in fact can sometimes make it worse. After the acute period the sting can be treated like a bug bite with a topical steroid cream, antihistamines, and ice. Fun fact: jellyfish have one opening that serves as both a mouth and an anus... yuck.
Sea -Lice
Sea -Lice are not actually lice, they are tiny jellyfish larvae. Outbreaks are caused by shifts in water currents and are more common during the summer months. Beaches typically post warnings during sea-lice infestations. Swimmers may notice a tingling or prickly sensation on the skin while in the water. When the larvae become trapped by bathing suits, hair, or boogie boards they release their stinging cells which can cause pain, rash, and itching. If sea lice exposure occurs remember the following:
They cannot survive outside of saltwater, so a quick rinse after swimming will remove them from the body.
More severe reactions such as fever, headache, blisters, nausea, or vomiting can occur but are rare.
People are more susceptible to sea -lice induced rash if they have been exposed before.
Rash can be treated with a topical steroid cream such as hydrocortisone and/or oral antihistamines.
Sunscreen may help to prevent sea lice irritation since it blocks penetration by the larvae.
Invasive bacteria, stinging creatures and rash producing larvae sound like part of the TV drama of Shark Week, but they are real. Fortunately, they are rare, and preventable. Anyone for a swim?
