Outdoor Alabama Weekly
Read Previous Columns by David Rainer
Be Aware of Signs of Vibrio Infection
By David Rainer
Alabama Department of Conservation and Natural Resources
As happens on occasion, my youngest daughter asked if I had read the story about a man from Ocean Springs, Miss., who died after a fishing trip in the Gulf of Mexico.
She started reading the symptoms from the story.
“Vibrio,” I said. “What does the story say?”
She said it didn’t indicate a cause but mentioned the man’s underlying health problems.
The next day, she said, “You were right. They updated the story and it was vibrio vulnificus.”
I point this out not to cause panic or dread, but to inform people who enjoy our coastal waters about precautions to ensure it will be a safe and enjoyable excursion.
Vibrio vulnificus is a bacteria in the same family as cholera and parahaemolyticus (which causes digestive distress), according to Environmental Toxicologist John Guarisco with the Alabama Department of Public Health (ADPH).
Vibrio vulnificus is normally found in seawater because it requires salt to live. Guarisco said the family of bacteria has been around since before the human species inhabited the coastal areas.
“There are two different types of illnesses you get from vibrio,” Guarisco said. “You can get the stomach variety that will cause vomiting, diarrhea and abdominal pain. If your immune system is compromised or you have chronic liver disease, it can lead to a systemic infection, which can be potentially fatal.
“The one we get most of our phone calls about are the ones with skin infections – when an open wound has been exposed to warm sea water, or you get stuck with a hook, a fin or a spur on a marine invertebrate. It’s the same thing as before. If you’re immuno-compromised, you’re more prone to infection.”
The vibrio bacteria is usually aggressive once it compromises or overwhelms the immune system. Quick action may be needed to keep the infection from becoming severe.
“What we tell people to look for is localized pain,” Guarisco said. “If the area around the wound gets hot or stays red. Certainly if you see red streaks going up a limb, get to the doctor right away.
“If you have an open wound or get wounded, clean it real good with soap and water. Treat it like when you were a kid. The first thing that happened was it got washed out with soap and water, whether you liked it or not. Then it got painted with Mercurochrome or rinsed with alcohol or peroxide. Then they’d bandage it and watch it. If there was any redness or swelling that didn’t seem reasonable, they hauled you off to the hospital.”
Jeff Chambliss, an inshore fishing guide from Orange Beach, Ala., knows all too well about the effects of vibrio vulnificus. He has the scar on his leg to prove it.
Chambliss was on a three-day fishing excursion with friends to the Chandeleur Islands when an innocent fin prick caused him a great deal of pain and suffering.
“We were wade-fishing, and I had a bunch of fish on a stringer,” Chambliss said. “A wave pushed the stringer up against my leg and something stuck me, either a fin or a tooth. I was standing in some hot, nasty, off-color water because if you waded out into the pretty water, the sharks would steal your stringer.
“I noticed it when I got stuck. I made a mental note when I got stuck, but it wasn’t bleeding so I didn’t think it was a big deal.”
Because Chambliss was a relatively healthy adult, it took two days for the vibrio to make headway into his system. But he does think his actions on the trip contributed to the infection.
“Two days later, I started having some pain,” he said. “We were staying up until 2 o’clock, playing cards. Then we’d get up 5 o’clock and go fishing again. So I only had a few hours’ sleep the whole trip. On Sunday, on the way home, a knot came up on my leg where I got stuck. By that night, I was throwing up. My leg started hurting worse. It started swelling. I got sicker. I finally got to the hospital in Mobile about 2 a.m. I told the doctor I thought I had that fish funk everybody was talking about. He said he agreed. He said I had vibrio. His brother was an infectious disease specialist.”
Chambliss was immediately admitted to the hospital, but his injury occurred before doctors developed the new technique for treatment of excising the flesh from the wound area.
“They started me on three different kinds of antibiotics,” he said. “They swapped one out every 12 hours to try to find one that would work. They pumped about $30,000 of antibiotics through me before they finally found one that worked.”
Chambliss said his leg was now swollen to a size similar to someone with a rattlesnake bite. He went into surgery to have doctors debride the wound and cut away the dead flesh.
“They thought at one time they were going to have to take my leg off,” he said. “But they finally got to healthy tissue. The next morning, they took me to rehab. They started unwrapping all the gauze and my leg kept getting smaller and smaller. When they finally got the gauze off, it was about the size of my wrist about halfway up my calf. That’s how much they had to cut away.”
After a skin graft, Chambliss left the hospital after 30 days. Several months of rehab followed to regain the strength in his leg.
He was able to resume his guide business the next year, albeit with a large scar on his calf. He said new customers will inquire about what happened to his leg.
“That doesn’t happen every day, but the scar is pretty noticeable,” Chambliss said. “Most of them ask me what kind of motorcycle I wrecked. I ask them if they’ve ever heard of a saltwater crocodile. When they say yes, I say that’s not what did it.”
Chambliss says he now is especially aware of treating and monitoring any cut or stab wound, but he fully believes his immune system would have handled the vibrio if he had been smarter.
“I think the fact I didn’t get enough sleep is what finally got me,” he said. “If you’ve got a weakened immune system and you get stuck, the vibrio can enter your bloodstream and cause problems within a couple of hours. It was a couple of days before it got me. I was out in the hot sun in August and not getting enough sleep. I wore myself down and the vibrio took over.”
Guarisco said the ADPH gets calls about water safety in the Gulf and occasionally a call about vibrio.
“I tell them it’s not like this happens every day,” Guarisco said of vibrio. “Some people get infected, but they fight it off. If you have an underlying medical condition, you should closely monitor any wounds. I’d be extra vigilant from May through October when the water is warmer and the organism is more active.”
ADPH recommendations are that any cut or puncture wound that occurs in coastal waters should be cleaned and disinfected thoroughly and monitored for redness and swelling.
“To use a military term, use your situational awareness,” Guarisco said. “If you get cut while you’re fishing, be more observant. If you have any kind of questions in your mind, go see a physician. It’s not worth losing a finger or limb. If that wound is not getting better the next day, you need to go see somebody right away.”
PHOTOS: Capt. Jeff Chambliss returned to the helm of his inshore fishing boat about three months after recovering from a serious vibrio vulnificus infection. The infection required surgery on his right calf to remove the tissue necrotized by the vibrio. Only scars remain from Chambliss’ bout with the bacteria that inhabits the saltwater environment along the coast.