Ocean
Watch
Monday, April 22, 1996
Sick sailor will likely
bring anti-Vibrio drugs next trip
RECENTLY, I read a news story about a sailor with a leg
infection who Navy SEALs rescued near Fanning Island.
Because Fanning has no airstrip, four SEALs loaded with
medicine parachuted from a plane, swam to the anchored sailboat and
started intravenous antibiotics on the sick man. Soon after, they set sail
for nearby Christmas Island where the Coast Guard flew the man to Tripler
Medical Center.
Wow, I thought. Now there's some serious attention for
a boo-boo of the leg.
Was the whole thing really that urgent? Didn't this
cruising sailor have antibiotics on the boat? Is this one of those
eat-you-up infections?
I called the sick sailor, Dave Baker, who invited me to
come visit him at Tripler. There I found a pleasant, articulate man,
previously in excellent health, with an enormous dressing over his left
calf and ankle.
I also learned that yes, it had been urgent; yes, there
had been antibiotics on the boat (but not the right ones); and yes, this
was one of those extremely virulent infections.
Dave was still reeling over the incident. It began as
an everyday fishing affair: A tuna thrashing in the cockpit of the boat
poked Dave's ankle with the hook in its mouth.
"The hook got you good?" I asked him.
"No, it barely scratched my skin," he
replied. "I just had two tiny marks where the points touched
me."
THE next day, however, Dave and his companion saw
trouble brewing. The ankle began to redden and swell, and blisters crept
up his calf.
In spite of taking both kinds of antibiotics from their
medical kit, Dave's temperature shot up. The leg, and the man's overall
health, deteriorated rapidly.
After describing these symptoms over the radio to
Honolulu, the decision was made to do the SEAL rescue. It probably saved
Dave's life.
Doctors on this case believe the culprit bacteria
infecting Dave's wound was Vibrio vulnificus, a notorious organism known
for its fast and lethal punch.
Vibrio bacteria occur naturally in warm seawater and
estuaries throughout the world. Researchers recently identified Vibrio
species on rocks, on marine animals and in the water surrounding pristine
islets 185 miles from Baja.
Vibrio vulnificus usually enter the body either from
eating contaminated raw shellfish (about 60 percent of cases) or through
marine wounds. These bacteria multiply rapidly, quickly overwhelming the
body's defenses.
COMPARED to Staph and Strep infections, Vibrio
vulnificus infections are rare. When they do occur, however, they can
cause amputation or death.
In Florida, from 1981 through 1992, 72 people were
infected by eating raw oysters. Thirty-six of those died. During that same
period, 53 Florida people got the same infection from wounds. Eight of
these victims died.
Most deaths occur in people with liver disease or in
those with damaged immune systems. Healthy people, however, can also
succumb, especially without appropriate antibiotics.
Few cases of Vibrio infections occur in Hawaii, but
this is still a bug to watch out for.
Although any wound can become dangerously infected,
Vibrio infections spread remarkably fast, and quickly look like the worst
infection you've ever seen in your life.
Sailors, fishermen and others in remote areas should
carry antibiotics that kill Vibrio as well as the more common Staph and
Strep. Get these prescription drugs, and instructions on their use, from
your doctor.
Fortunately, Dave Baker will live and return to his
boat on two good legs. And, I'm sure, in his two good arms will be a load
of Vibrio-effective antibiotics.
