I thought I'd pass this along which I received in the mail tonight: First message:
"Last week I had an unwelcome and nasty visitor invade my presence. What follows is an account what happened. I offer it in the hope that no one else will experience the same thing. The visitor's name is vibrio vulnificus. At least that is what the doctor thinks (I'll explain this later) I became friendly with. You may be more familiar with a subspecies of vibrio (V. cholerae) commonly known as cholera. V. vulnificus is usually caught by eating contaminated shellfish, particularly oysters. It can also be introduced through an open skin lesion like a cut. There are two manifestations-under the surface skin and into the bloodstream, where it is particularly onerous. I have the skin version, which is not exactly benign. The bacterium likes warm salt or brackish water. While found mostly in the Gulf Coast Region where monitoring takes place, our North Carolina water does offer a nice spawning environment for it. The strong suspicion is that I picked it up while diving under our boat to clean barnacles off our depth sounder, which was not working. I was diving with only a bathing suit on and scraped my leg on a piling covered with barnacles. I have a wet suit and probably would have avoided this unpleasantness if I had worn it (like the Admiral suggested) and let it take the abrasion instead of my skin. The cuts appeared minor, so I cleaned the wound off with some peroxide, smeared some antiseptic ointment on it and covered it with a bandage, figuring that would be that. Was I wrong!!! The scrape occurred Tues afternoon. Early Wed morning during a nocturnal visit to the toilet, I noticed that my leg hurt. I still didn't think much of it--just a nasty scratch. Wrong again. By the time I got up Wed morning, my leg HURT (shouting intended for emphasis). Again, still attributing the discomfort to an ordinary scratch, we adopted a wait and see attitude. I felt rather lousy Wed, so spent most of the day in bed. The next morning I could not get out of bed without help. My leg had started to swell and was getting red. It was doctor time and he worked us in that morning. He ordered blood drawn for a white count, asked me what happened, looked at my leg, and immediately ordered two antibiotics and a pain killer. He marked my leg with a pen so we could watch the progress of the infection and set an appointment for late Friday, telling me that hospitalization would be in order if the infection could not be stopped from spreading by then. When they did a second white count on Friday, it had dropped from the 22,000 per whatever unit they use to 16,200. The normal is like 8000. The antibiotics were working. This bacterium is nasty and dangerous. It moves fast. I went from being reasonably ok Wed afternoon to being unable to walk without assistance THE NEXT DAY. Because of this and because it is difficult to get good culture material to specifically id it, they don't usually try, relying instead on assessing the activity leading up to the problem. It takes a few days to grow the culture and with the high failure rate in getting a good one, they rather start treatment immediately. The other scary thing about this bug is the mortality rate--25-55%. The doctor said that if we had waited one more day before getting treatment, I could have been in real trouble. This is definitely a potentially life threatening germ, and I am lucky things up to now turned out the way they did. We had planned to go out on the boat Wed and I don't want to think about what the outcome could have been had I waited until Wed to dive, just brushed off the scrape as something trivial and proceeded out. Recovery will take some time. The doctor said to expect only gradual improvement over the next four days or so and to keep our eyes open in case this bug finds a way to bring in some reserve troops. I still can't walk without help and still have excruciating pain even with the pain medication, although it is somewhat less than it was a couple of days ago, thank God. I also need to say that I am very fortunate to have the Admiral to lean on in more ways than one. The big point I want to make here is not that we should curtail our normal activities, whatever form they may take, and withdraw into a sterile box, but to be always alert to clues that something serious is afoot, no matter how seemingly innocuous they appear. I don't know how many superficial cuts and scrapes I have had that I routinely treated, as I did this one, without further incident. But this time it was different." And someone else's reply: "Vibrio vulnificus!!! In June of 2001, I spent three weeks in the hospital with the infection, and came very close to having my right foot and lower leg amputated. In my case, the bacterial infection became blood-borne, and the white count virtually went "off the charts" before the culture was back from the lab so they could know which antibiotic to use. I learned later that the mortality rate when the bacteria becomes blood-borne is 55%. The way I was infected was in seemingly minor accident. I was simply throwing a net casting for fishing minnows when I made a bad throw, in which the leadline slightly grazed the back of my hand--did not even break the skin. It was simply an abrasion which looked a little red after I washed off the black mud from the back of my hand by swishing it in the water. The abrasion was so slight that did not even draw blood. Within six hours, I developed a heart murmur, had fever spiking to 104, and my right foot became suddenly immobile. In the hospital, the first concern of the physicians was the possibility of amputation. Even after it was determined I would not loose my foot, the plastic surgeon was of the opinion I would require skin grafts to replace the tissue which detached from my ankle due to the severe swelling and rupture of the skin. By some miracle and the constant work of the plastic surgeon over a few weeks, the skin reattached itself and I did not have to have the grafts. Now two years later, my only symptoms are a much enlarged right foot and leg, but believe me when I say that I am so glad to have my foot still intact. What I learned from this experience is that the vibrio vulnificus bacteria resides in ALL salt water, and that it tends to be more active (and aggressive) in warm brackish coastal water during the summer months. Since my episode I ALWAYS carry a little bottle of Clorox (in an eye dropper bottle) in my pocket anytime I am on the boat or fishing from the shore (which I often do). What I learned from my ordeal is that if you IMMEDIATELY flush with the bleach any abrasion to the skin, or puncture or cut or even scrape the skin while wet from salt water, the bleach it will instantly kill the bacteria. The key is "IMMEDIATELY." Also as a precaution now, every time I pull up the anchor on Merry Mary and get my hands muddy, I immediately wash my hands with antibacterial soap and then douse them with Clorox, just as a precaution. In the interest of "happy boating" if anybody on the Tartan list wants to see some "dirty pictures" (disgusting photos of my foot in the various stages of decay while in the hospital), contact me back channel and I'll send you some pix which will heighten your awareness and raise your precautions about skin cuts in the presence of salt water. It may make you a more prudent sailor!" _______________________________________________ http://mailman.xmission.com/cgi-bin/mailman/listinfo/montgomery_boats
