By Gerald R. Winegrad

As my last column documented, the Chesapeake Bay and our local rivers harbor naturally occurring flesh-eating bacteria that can lead to loss of limbs from necrotizing fasciitis, and death. Cases of infections are increasing as global warming heats our waters, triggering more bacteria and algal growth. The failure to significantly reduce polluting nutrients from human activities exacerbates the problem as these nutrients fuel the growth of algae and bacteria that feed on them, especially during the warmer months from May to October. This is when bacteria counts can be 100 times greater than winter months.

Last week’s column focused on Vibrio vulnificus, the most dangerous life-threatening bacteria. Less toxic but also hazardous and much more prevalent is Mycobacterium marinum. It can lead to cutaneous infections with ulcers, skin nodules, and decaying tissue. It is frequently referred to as fish handler’s disease as this pathogen is common in rockfish and those who handle them. The fish exhibit skin ulcers and internal lesions, leading to emaciated fish. Surveys in Maryland and Virginia show that 80% to 90% of stripers by 5 years of age carry some form of Mycobacterium. Could this be affecting rockfish populations? 

After my column last week, a distraught father contacted me about his 15-year old son’s long battle with a Mycobacterium marinum infection in his finger contracted while handling rockfish on the Chester River in August 2020. Despite doctor visits and a three-day Anne Arundel Medical Center hospitalization, the infection was not correctly diagnosed or treated. In January, as the infection began necrotizing his flesh, Washington Children’s Hospital doctors correctly identified the bacteria and ordered the proper intravenous antibiotics that subdued the infection.

After six months of treatment, the infection finally calmed down. See Luke Helfenbein tell his story at: www.Lukefhd.com which he and his dad wish to share to alert others.

According to the Anne Arundel County Health Department website, “The majority of reported Maryland human cases of Mycobacterium marinum occur in Anne Arundel County.” This naturally occurring organism multiplies in warm, nutrient-enriched waters with an optimal growth temperature of 86º F. The phosphorus and nitrogen nutrients fueling it are primarily caused by agriculture, stormwater runoff, car and power plant emissions, sewage treatment plants, and septic tanks.

Vibrio vulnificus is also prevalent in summer months in the bay and accounts for 8% of its aerobic bacteria. From 2007 to 2017, reported Vibrio vulnificus infections shot up in Maryland from 25 to 68, the highest incidence in the mid-Atlantic. When water temperatures exceed 68ºF, this flesh-eating organism can be found in all oysters harvested in the bay and the Gulf of Mexico. This is why the majority of reported cases of Vibrio vulnificus infections come from eating raw seafood. The National Oceanic and Atmospheric Administration now publishes charts estimating the concentration in the bay’s summer waters, which health departments refuse to use as an indicator of possible dangerous infections.

 Then, there is the most “famous” case of Bay water infections — Pfiesteria piscicida — the so-called “cell from hell” that gave rise to “Pfiesteria hysteria” in 1997. Vast stretches of water, mostly in Somerset County, were littered with dead fish with ugly sores. Many folks who handled fish were sickened with some still not fully recovered. Maryland’s seafood industry lost an estimated $43 million in sales. Agricultural runoff, especially from the poultry industry, was a key causative factor.

Many people who have watched the overblown fictional movie “Jaws” (1975) are likely hesitant about going for a swim in the ocean. But the truth is unprovoked shark bites of humans are extremely rare, with 57 cases globally in 2020 resulting in 10 deaths and only 33 confirmed cases with three deaths in the U.S. Compare this with Centers for Disease Control and Prevention estimates of 80,000 vibriosis-related U.S. illnesses annually, mostly from raw seafood consumption. Unlike waterborne infections, shark bites and fatality rates have been declining for decades.

“Jaws” dealt a devastating blow to shark populations but there has been little meaningful response to deal with the thousand-times-more-common waterborne infections. One reason is that such infections are under reported.

They are also deliberately kept from the public by state and local health departments and other officials to prevent any negative economic effects and political fallout. Contrary to the deliberately calming health warnings online, these cases are not rare. I have learned of many cases anecdotally, not by any research or sampling. And, these health departments refuse to test beach waters for high levels of these bacteria because they know how much the concentrations in most waters will far exceed Environmental Protection Agency safety standards.

There also are many reports of skin infections in dogs who come into contact with bay water.

Given all this bad news, what should be done?

First, we must act to drastically reduce emissions that cause global warming as well as nutrient flows to the bay. You can start by conserving energy at home and by your driving choices. Our electric bill for the last four months to run our all-electric home, a plug-in hybrid/gas Prius, and a lawn mower, was a total of just over $200. We purchase 100% wind power.

You can act to stop stormwater pollution and eliminate lawn fertilizers and switch from septic tanks to a wastewater treatment plant. Stormwater runoff and septic tank leakage greatly increase the prevalence and toxicity of these dangerous organisms especially here in Anne Arundel County. That’s why health departments impose no swimming and no direct water contact rules at all beaches after rainstorms of 0.5 inches or greater for at least 48 hours.

We need to spread the word and force our health departments to warn folks about the dangers of these waterborne diseases, not just after rainstorms but through the warmer months of May to October. Mandatory reporting of all cases of waterborne diseases, mild and severe, should be required by health care professionals to assure appropriate epidemiological studies can be carried out to learn more about these diseases and their prevalence. These professionals should be informed of the presence of these infections, what to look for in diagnosing them, and how to properly treat them.

Water quality sampling for these disease-causing organisms should be done regularly.

Health departments and the Department of Natural Resources need to issue regular public notices through the media about the dangers posed by these toxic organisms. Their messages should indicate precautions that can be taken to avoid waterborne diseases, especially for those most susceptible, including the immunocompromised or those with diabetes or chronic liver disease. Here’s what needs to be emphasized:

Avoid water contact if you have open skin cuts, scrapes, or sores, but if you choose to have water contact, always cover cuts with a waterproof bandage; wear gloves in handling fish, oysters and crab pots and when you may otherwise get cuts or scrapes; wash hands thoroughly with soap and water after water activities or use a waterless cleanser; and if you are cut and see any sign of infection, immediately seek medical attention and inform your doctor of the water contact for an early diagnosis and adequate treatment, including antibiotic therapy — this can save your life or a limb.

None of this is happening.

I write these words reluctantly as I do not want to scare anyone from enjoying water activities in this Land of Pleasant Living. My children, grandchildren, nieces and nephews all regularly swim, fish, crab, paddle board, and kayak in Oyster Creek and love to play in the bay from our nearby beach. I still tend my crab pots but with gloves on and a long sleeve shirt. But until we can fix the problems, caution is warranted.

Gerald Winegrad represented the greater Annapolis area in the Legislature for 16 years, where he championed efforts to restore the Chesapeake Bay. He served on the tri-State Chesapeake Bay Commission and taught graduate courses in bay restoration and wildlife management he authored. Contact him at gwwabc@comcast.net.