Deadly bug hits beaches

By Lyse Comins Time of article published Feb 4, 2012

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A Durban doctor, who contracted a deadly flesh-eating bacteria through a cut on his leg while surf-skiing in the ocean, is lucky to be alive and not to have lost the limb.

Dr Peter Breedt of Hillcrest, a surf-ski enthusiast, is one of several people who have got sick after surfing or swimming at city beaches in recent months.

And, as we enter one of the hottest months of the year, one of the country’s leading water-quality experts, microbiologist Professor Eugene Cloete, dean of Stellenbosch University’s Science Department, has warned about the dangers of swimming in the sea if one has cuts, wounds or chronic liver disease.

Breedt said that, together with a medical colleague, he had diagnosed that the naturally occurring bacteria, Vibrio vulnificus, had eaten away the tissue of his foot after he had gone paddle-skiing from Ushaka Beach to the Bluff and back, in November. His wound has still not healed.

“I had a little scratch on my leg and I went surf-skiing. The water was really smelly with a sulphur kind of smell,” Dr Breedt said.

“I have spoken to surgeons who say they see it quite often and that you can get it from swimming in river mouths,” Breedt said. Breedt said he started feeling sick and a black area developed on his foot six hours after surf skiing.

“I took lots of antibiotics and had three operations to cut away the dead skin and I had skin grafts,” Breedt said. “It’s hard to believe that from being healthy one minute I could get so sick.”

Breedt said he believed he was alive because he was a doctor and had acted quickly.

Professor Cloete described Vibrio vulnificus as one of the most dangerous pathogens that occur in the ocean – it grows where salt concentrations are high and temperatures warm.

“The vibrio genos can grow in salt water when the ambient temperature is between 15°C and 35°C. It has been found in shellfish and in undercooked oysters.

“However, if you get it into a wound it causes septicaemia and shock and if it gets into the bloodstream you will get very sick.”

Cloete said the mortality rate was up to 50 percent if the bacteria entered the bloodstream and treatment within 48 hours was vital.

“If you go beyond 48 hours the fatality rate increases,” Cloete said.

“If you have got sores you should not be going into the sea because you are exposing the body to potential contamination, not only to vibrio vulnificus but to a number of organisms. I would not go into the sea with cuts, and if you scratch yourself on the rocks you could be exposed.

“People with chronic liver disease are more vulnerable because (if swallowed) it can enter the blood through the gastro-intestinal tract.”

Cloete said he was not sure if the minimum infective dose had been established but if swallowed the bacteria would cause diarrhoea and vomiting.

“It is more rare than other water-borne diseases and not even as common as salmonella and e.coli. But we might think it is rare because it is not well reported.”

The only other reported case of vibrio vulnificus infection in Durban was in 2002 when fisherman Eric Erasmus died after he contracted the bacteria while collecting sand prawns in Durban harbour.

author RW Johnson had his leg amputated in 2009 after cutting himself on a rock, but the bacteria, aeromonas hydrophila, was believed to have been responsible for his infection.

eThekweni Municipality deputy head of water and sanitation, technical support, Frank Stevens, said the water was tested five times a month at 33 beaches, including Wedge, North Beach and uShaka. He said the city spent R3 million annually on monitoring.

Stevens said vibrio vulnificus was found globally and was not part of normal beach water testing anywhere in the world.

“The public should avoid swimming in close proximity to river mouths and stormwater outlets within 24 hours of a storm event. Heavy storms, such as were experienced in December, are likely to impact beach water quality until such time as the river returns to its normal flow,” Stevens said.

He said the city measured e.coli and enterococcus following US and EU standards.

“The quality has generally been good but unacceptable levels are experienced from time-to-time, usually due to high-rainfall events which result in, for example, flushing of paved areas and the surcharge of manholes,” Stevens said.

When levels were unacceptable the public was warned on boards at the beach and on the city’s website, he said.

Sewage from waste water works was controlled in terms of the Green Drop programme in which the city was the best performing metro, he said.

“Stormwater is a problem faced in every city. First-flush interventions have been put in place but do not solve the problem. All citizens need to take their actions into consideration,” Stevens said.

Three of a group of five surfers, who swam in the sea at Wedges Beach last week, said they had become violently ill with gastroenteritis.

Lee van Vuuren said the water was murky but they had not thought much of it until they woke up the next day vomiting.

Another surfer who got sick, Craig Knott, said: “We surf quite a bit in and around the piers and the water quality has not been great for quite some time but supposedly it’s just the storm water drains running but it’s almost like sewage in some cases – and smells.”

Dean Sepprings said he had had contracted an ear infection and a post-nasal drip.

Evan Basson said he had also become ill. “I can’t say it is the water but it was strange that we all swam and got sick,” Basson said.

Hillcrest mother Trisha Sandeman said she swam at the beach two weeks ago and had accidentally swallowed sea water.

“I am fit and I eat well and the following day I felt like I was coming down with a cold and my throat was inflamed. I had terrible sinuses and was off work and have only recovered now,” she said this week.

A Durban surfer, who asked not to be named, said earache had become common among local surfers and there was concern about sea water quality. “I personally have been very sick and had diarrhoea and a bad stomach,” she said. - Independent on Saturday

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