The Capital August 6, 2006
Bacteria in water sent men to hospitals, linked to one death
By E.B. FURGURSON III Staff Writer
Chilly Orme has been working and playing in the bay all his life.
But the waters that have provided his family a living for 50 years nearly killed him this summer.
A mere scrape on his shin became seriously infected after he waded into Bear Neck Creek just off the Rhode River the day after torrential tropical rains in late June.
"I've been around the water all my life," he said, still healing from the infection. "Now I am almost scared of it ... No, I am scared of it."
A couple of days later, another resident of the area, Keith Rinehart, made the mistake of running his jet ski down the creek. It was the same day county officials closed the waterway and put out a warning to avoid contact with the water because of high levels of enterococci, a bacteria found in human waste.
Two days later, Mr. Rinehart was at Anne Arundel Medical Center for five hours of intravenous antibiotics.
"The doctors there gave me a look like, 'you dummy,' " he said.
He knew the creek was closed and saw signs posted in the Carrs Wharf Road neighborhood.
These tales underscore what county health officials have warned: Stay out of "natural waters" for two days after a major rainstorm and keep out when the water temperature goes above 80 degrees if you have a cut or open sore.
That is what both men had in common, a small cut or scrape on their legs. Within a couple days of getting their feet wet, both saw their legs get red, infected and swollen. One had to have his leg sliced open to relieve the pressure.
But worse things can happen.
In early June, Washington businessman William Bergman went sailing on the Chesapeake Bay on the boat he kept at a West River marina. He, too, had a small cut on his leg.
Within days, he was in a Washington hospital with symptoms similar to the two Mayo men. Doctors thought he had a flesh-eating virus and were preparing to remove his leg when a final test came back negative for the flesh-eating virus. He was whisked to intensive care.
Several hours later he was dead from a massive sepsis infection.
What bacteria caused his death is unclear. Mr. Bergman's family has declined to talk about it.
Mr. Orme's infection came from two sources. His discharge papers from the hospital note signs of both vibrio vulnificus, one of three major forms of a naturally occurring bacteria, and a staph infection.
An exposed cut or wound will soon become infected through simple contact with water tainted with vulnificus. Aside from the bright red swelling, blistering and peeling layers of skin, the infection can lead to sepsis and death if not treated aggressively.
The old adage about not eating oysters in any month without an "R" in its name was based on one of the three forms of vibrio bacteria. Vulnificus is a cousin to vibrio cholerae, which causes the disease of the same name.
Storm load
Dr. Katherine Farrell, the assistant county health officer, said the bacteria her office tests for is found in the fecal matter of warm-blooded animals.
If counts reach 104 colonies per 100 milliliter of water, a beach can be closed. Other less frequently used and tested beaches can have a benchmark of 154.
But some counts reported by the area's riverkeepers following big rains are in the stratosphere. Soon after the downpours in late June, some measurements on the South River topped 30,000 parts per milliliter.
When two beaches at Sandy Point were closed last weekend, peak counts there were 731 and 685 colonies per milliliter. Both beaches have since been reopened.
But problems sparked by vibrio can happen even when other counts are low, Dr. Farrell said.
"Vibrio is more related to water temperature," she said. "There is still a risk even if the water is clean."
Waterways sullied by a sewer spill, like the one that occurred in Mayo and was reported by the county June 29, can boost vibrio populations said Byron Crump, a bacteria specialist with the University of Maryland Center for Environmental Science in Edgewater.
"They feed on the organic carbon, regular organic matter from the land or sewage," he said.
He said storm runoff without sewage boosts vibrio concentrations, too.
"The flush of nutrients also aids their growth. Algae releases carbon when it is growing … a big source of food for bacteria," he said.
It appears that vibrio infections are on the rise.
The Department of Health noted one case of vibrio vulnificus infection was reported in 2004, three cases in 2005 and two cases so far this year, both reported in the past month.
The flush of storm water is like a double whammy, especially if it is coming off impervious surfaces. Those surfaces warm the water, raising the temperature, which vibrio loves. It also decreases salinity, which some studies have shown also foments the spread of the bacteria.
Anne Arundel Community College biologist Sally Hornor said she thinks bacteria may be living longer because of the high water temperatures.
"And the water you wade in is warmer," Dr. Hornor said. "Those shallower waters are really cooking right now and (there is) a higher bacteria count."
She said the county sees high bacteria counts after a heavy rain as she analyzes samples for area riverkeepers.
Since the area has had little rain since the big storms in late June, her latest samples from the South, Severn, West, Rhode and Magothy rivers are "pretty good. The counts are not that bad since we have not had rain."
She and other scientists and officials said they think it is crucial to get the word out about staying out of the water just after a substantial rain, and staying out of warm waters if you have a cut or other wound.
As the two men in Mayo learned, if conditions are ripe for bacteria even short contact with the waters can be dangerous.
Mr. Orme is still fighting the infection. He has a knot on his leg at the spot of his wound that doctors are keeping an eye on. He's been to the emergency room, a local wound center, and has seen infectious disease clinicians.
"It is a pretty sobering experience," he said. "It's scary."
WHEN NOT TO SWIM
These are recommendations from Rhode/West Riverkeeper Bob Gallagher for those who intend to swim in the bay.
Avoid water contact:
• If you have a cut, puncture or other wound.
• For at least two days after a typical summer downpour and longer after bigger storms.
• When the water temperature is in the mid-80s and the water is murky, discolored or when noticeable amounts of algae are present.
Published August 06, 2006, The Capital, Annapolis, Md.
Copyright © 2006 The Capital, Annapolis, Md.
