Do You Have Fish Handler’s Disease?

 

Having the vast ocean as our playground is without a doubt an incredible blessing for anglers in these parts. The remarkable local fisheries and bountiful aquatic and marine life of the Eastern United States offers almost endless opportunities for anglers and watermen of all sorts with little effort. But as with most anything in life that seems too good to be true, there is a draw back here and there. One of those draw backs is a condition some local angler’s have encountered called Fish Handler’s disease. This disease is completely treatable and is a common ailment among individuals associated with any type of marine environment, salt or freshwater. How many times have you been on or near the water and scraped your knee on that darn cooler handle you have been meaning to repair, or threaded the hook through the bait and right into your finger, or more likely, while de-hooking that undersized dink, he had the ungrateful nerve to stab you with that stealth dorsal fin while releasing him? Then it is easy to understand why anglers tend to be susceptible to multiple wounds of war with obvious risks while caught up with the busy pace of our fishing passion.

What is it?
Water is the source of life for more than just fish and other well-known marine critters; it also supports all types of microscopic bacterial life. Some of these bacteria can cause harmful diseases and conditions in certain fish and other aquatic life, but mostly marine bacteria hang out most anywhere there is water, including oceans, bays, estuaries, lakes, swimming pools, and even home aquariums. One particular type of bacteria residing in water and occasionally afflicting marine species has the fancy name of Mycobacterium marinum. This bacteria is carried by most fish, crabs, oysters, and even barnacles within infected waters, and the Mycobacterium marinum bacteria can also be acquired by humans via a break in the skin such as a scratch, cut, bite, or puncture, while handling fish, marine life, or structures related to open waters. If the Mycobacterium are able to establish themselves within the breached skin area of a person, an infection referred to by researchers and doctors as Fish Handler’s disease may develop. This condition has also been called “aquarium disease,” and “swimming-pool granuloma,” and basically starts as a skin condition, which can be easily treated once it is properly identified.

What are the symptoms?
Fortunately the course of this bacterial infection tends to be more annoying than anything, usually presenting initially with mild to moderate symptoms, which are very often overlooked by the angler in the beginning. In fact, the main common detail I have noted among anglers who have encountered this condition is the complete lack of recollection of any injury related to an aquatic environment at all. Because this particular bacterium grows so slowly, weeks will usually pass before the infected individual realizes that anything is really awry, and by then all past nicks and scratches are long forgotten. The most frequently affected areas tend to be the extremities, which include the arms, legs, hands, feet, fingers and toes. This is the case for two reasons: first, because the extremities are the most likely part of the body to be exposed to an injury while handling and maneuvering around infected organisms or objects, and secondly because the Mycobacterium marinum bacteria cannot proliferate in a warm body environment, therefore the cooler temperature of the arms and legs lend to a more suitable home for the unwelcome visitors. The symptoms of Fish Handler’s disease can vary from person to person, but in general, a bluish-purple spot or raised area may exist on the skin at the point of entry of the bacteria. But most people begin to notice a problem when a finger, wrist, joint or tendon of the extremity becomes sore and tender, or feels “stiff,” or swollen. Often anglers will complain of advancing arthritis or bursitis-like discomfort, and over time this sensation can creep up the extremity to the next joint. Some people have complained of non-healing sores, one or more bumps under the skin, and even rashes. The most tell-tale component is the slow-growing nature of the infection, making it almost under-cover until it sneaks up on it’s host and surprises the individual with the uncomfortable condition. A word of caution though, this condition should not be taken lightly. If Fish Handler’s disease is ignored for a long period of time and continues to spread unchecked, very serious and even life-threatening situations can arise requiring aggressive and immediate advanced care.

Treatment:
Although treatment is usually quite simple and the symptoms are easily resolved with antibiotic therapy, the general local physician often may not recognize the condition, and therefore it can go under-treated until it is properly diagnosed. Be patient though, even with the proper treatment, the infection can still take months or even years to resolve. So, if you suspect you may have Fish Handler’s disease, visit your doctor, and take along this article and the following treatment information as a helpful supplement. Although more documentation and research may be helpful, it appears that Fish Handler’s disease may be more prevalent, especially among anglers, than researchers originally suspected. Dr. David Muffelman, a dermatologist familiar with Mycobacterial infections, sees several new cases of Fish Handler's disease each month in his local practice. To treat the infections properly and completely, he recommends the following antibiotic regimens for a minimum of six weeks: Doxycycline or minocycline, 100 mg tablets, twice a day, for six weeks. Two other good choices are Biaxin (Clarithromycin) 500 mg, twice a day or Bactrim DS one tablet, twice a day both for a six week period. If additional treatment is required, or more severe symptoms develop, it is recommended that the individual seek care from a specialist such as a dermatologist without delay.

Recommendations and Prevention:
According to researchers at the Virginia Institute of Marine Science, handling or eating sickly-looking fish does not increase the risk of acquiring Fish Handler’s disease, but if you do come across fish with open sores or other lesions, it is recommended you release them and search for healthier-looking fish. Wearing gloves, long sleeves and long pants, along with utilizing de-hooking devices while handling marine life can also help avoid injuries. After handling any fish, or after any exposure to open water, washing your hands and your equipment with soap and clean water will help decrease the chances of happening upon this pesky bacterium. If an injury does occur, washing the wound with soap, and applying an antibacterial ointment may be helpful.

It is certainly impossible to avoid the occasional nicks and scratches associated with work or recreation on the water, but the proper information concerning marine-related afflictions can save anglers a lot of time and headaches.

More information concerning Mycobacterium can be found at the Virginia Institute of Marine Science web site at www.vims.edu and The Bay Journal web site at www.bayjournal.com.

Special thanks to information and guidance provided by Dr. Howard Kator, Jon Lucy (VA Sea Grant Advisory Services), and Martha Rhodes, researchers at the Virginia Institute of Marine Science of the College of William and Mary. Also special thanks to Dr. David Muffelman, private practice dermatologist, Gloucester, VA.

 

   
 

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