Saltwater Infection, Sad Ending

[DB]

http://www.chron.com/disp/story.mpl/met ... 79618.html" onclick="window.open(this.href);return false;

With the elevated water temps, Vibrio levels go way up...so aside from leaving the raw oysters alone, you also have to be mindful of breaks in the skin.

As a surgeon, I have cared for individuals with these infections and once they set in, even aggressive surgery does little to alter the outcome.

I would recommend that any superficial wound be cleaned on the spot with chlorhexidine, and serious consideration be given to seeing a doc for a deep puncture. Anybody with an underlying medical (esp liver or kidney) problem who gets a saltwater-contamined injury is taking a risk if they don't get medical attention. Maybe a dose of the proper antibiotic right after the injury could have changed the outcome in this unfortunate case.

I cover existing skin breaks with Tegaderm or Opsite when I'm on the salt or in the O.R. as nasty bugs abound in both places !

[TexasGringo]

Wow. Very scary stuff. I've gotten to where I won't go wade if I have an open cut of any kind.

[Arlon]

Pretty sad. Close to 20 vibrio related deaths a year along the coast. Vibrio kills a lot more people than most realize. Cuts/abrasions in salt water need to be taken real seriously.

[Chief Brody]

http://www.chron.com/disp/story.mpl/met ... 79618.html

With the elevated water temps, Vibrio levels go way up...so aside from leaving the raw oysters alone, you also have to be mindful of breaks in the skin.

As a surgeon, I have cared for individuals with these infections and once they set in, even aggressive surgery does little to alter the outcome.

I would recommend that any superficial wound be cleaned on the spot with chlorhexidine, and serious consideration be given to seeing a doc for a deep puncture. Anybody with an underlying medical (esp liver or kidney) problem who gets a saltwater-contamined injury is taking a risk if they don't get medical attention. Maybe a dose of the proper antibiotic right after the injury could have changed the outcome in this unfortunate case.

I cover existing skin breaks with Tegaderm or Opsite when I'm on the salt or in the O.R. as nasty bugs abound in both places !

D.B. - tegaderm or opsite - are they otc? We mostly talk about using peroxide - I carry it in my first aid kit - that not good enough?

[Paddlefoot]

It's good to hear the advice of a medical professional on this issue! What is chlorhexidine? I assume that Tegaderm or Opsite are some kind of dressing....is that correct?

[jfiddy]

http://www.chron.com/disp/story.mpl/met ... 79618.html

With the elevated water temps, Vibrio levels go way up...so aside from leaving the raw oysters alone, you also have to be mindful of breaks in the skin.

As a surgeon, I have cared for individuals with these infections and once they set in, even aggressive surgery does little to alter the outcome.

I would recommend that any superficial wound be cleaned on the spot with chlorhexidine, and serious consideration be given to seeing a doc for a deep puncture. Anybody with an underlying medical (esp liver or kidney) problem who gets a saltwater-contamined injury is taking a risk if they don't get medical attention. Maybe a dose of the proper antibiotic right after the injury could have changed the outcome in this unfortunate case.

I cover existing skin breaks with Tegaderm or Opsite when I'm on the salt or in the O.R. as nasty bugs abound in both places !

Thanks for the great information! I'm sure there are flesh eating bacterias in freshwater as well.

[vincent]

Very Sad...I'd like to see the data correlating the number of vibrio deaths and people with Hep C...seems very common in the fatalities.

[ecofly]

very sad. poor guy. sad to loose an outdoorsman.

[nolexus]

Chlorhexidine is also used in non-dental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Hibiscrub, ChloraPrep, BIOPATCH, SOLU-I.V. and Exidine. It is also a component of the household antiseptic Savlon. It is used for general skin cleansing, a surgical scrub, and a pre-operative skin preparation. Due to other chemicals listed as inactive ingredients, the cleanser solution is not suitable for use as mouthwash. It is often used as a rubbing agent prior to the use of hypodermic or intravenous needles in place of iodine. Chlorhexidine is contraindicated for use near the meninges, in body cavities, and near the eyes and ears. At the 2% concentration, it can cause serious and permanent injury with prolonged contact with the eye or if instilled through a perforated eardrum. Nevertheless, a topical solution of 0.02% chlorhexidine is recommended by the US Centers for Disease Control and Prevention (CDC) as treatment for keratitis caused by Acanthamoeba. As a scrub chlorhexidine is not recommended on persons under two months of age .

Had to look that one up in the all mighty wikipedia

Got it on the list of things to buy for the first aid kit

[Barnacle Bill]

Chlorhexidine is also used in non-dental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Hibiscrub, ChloraPrep, BIOPATCH, SOLU-I.V. and Exidine. It is also a component of the household antiseptic Savlon. It is used for general skin cleansing, a surgical scrub, and a pre-operative skin preparation. Due to other chemicals listed as inactive ingredients, the cleanser solution is not suitable for use as mouthwash. It is often used as a rubbing agent prior to the use of hypodermic or intravenous needles in place of iodine. Chlorhexidine is contraindicated for use near the meninges, in body cavities, and near the eyes and ears. At the 2% concentration, it can cause serious and permanent injury with prolonged contact with the eye or if instilled through a perforated eardrum. Nevertheless, a topical solution of 0.02% chlorhexidine is recommended by the US Centers for Disease Control and Prevention (CDC) as treatment for keratitis caused by Acanthamoeba. As a scrub chlorhexidine is not recommended on persons under two months of age .

Had to look that one up in the all mighty wikipedia

Got it on the list of things to buy for the first aid kit

Can someone translate please?

[Paddlefoot]

Chlorhexidine is also used in non-dental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Hibiscrub, ChloraPrep, BIOPATCH, SOLU-I.V. and Exidine. It is also a component of the household antiseptic Savlon. It is used for general skin cleansing, a surgical scrub, and a pre-operative skin preparation. Due to other chemicals listed as inactive ingredients, the cleanser solution is not suitable for use as mouthwash. It is often used as a rubbing agent prior to the use of hypodermic or intravenous needles in place of iodine. Chlorhexidine is contraindicated for use near the meninges, in body cavities, and near the eyes and ears. At the 2% concentration, it can cause serious and permanent injury with prolonged contact with the eye or if instilled through a perforated eardrum. Nevertheless, a topical solution of 0.02% chlorhexidine is recommended by the US Centers for Disease Control and Prevention (CDC) as treatment for keratitis caused by Acanthamoeba. As a scrub chlorhexidine is not recommended on persons under two months of age .

Had to look that one up in the all mighty wikipedia

Got it on the list of things to buy for the first aid kit

Can someone translate please?

You're gunna die, Bill!

[Barnacle Bill]

Chlorhexidine is also used in non-dental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Hibiscrub, ChloraPrep, BIOPATCH, SOLU-I.V. and Exidine. It is also a component of the household antiseptic Savlon. It is used for general skin cleansing, a surgical scrub, and a pre-operative skin preparation. Due to other chemicals listed as inactive ingredients, the cleanser solution is not suitable for use as mouthwash. It is often used as a rubbing agent prior to the use of hypodermic or intravenous needles in place of iodine. Chlorhexidine is contraindicated for use near the meninges, in body cavities, and near the eyes and ears. At the 2% concentration, it can cause serious and permanent injury with prolonged contact with the eye or if instilled through a perforated eardrum. Nevertheless, a topical solution of 0.02% chlorhexidine is recommended by the US Centers for Disease Control and Prevention (CDC) as treatment for keratitis caused by Acanthamoeba. As a scrub chlorhexidine is not recommended on persons under two months of age .

Had to look that one up in the all mighty wikipedia

Got it on the list of things to buy for the first aid kit

Can someone translate please?

You're gunna die, Bill!

Yes, but what choralckakahydrozine crap do I need to put on me to recover from that death?

[DB]

Sorry for the techno lingo. Hey, I had to look up "chartreuse" when I first came on the boards here

You can get opsite/tegaderm on ebay...it's like cellophane wrap but sticky on one side. It forms a decent barrier between your skin and whatever critters you dont want on it and its low profile, so you wont know its there. Just remember to peel it off after the trip and wash off.

Chlorhexidine (CHG) is in a lot of cleansers, should be available OTC. The deal is that it persists for a long time on the skin and kills a wide range of ogranisms.

Slickest way to carry it is peel-packed with a sponge/brush impregnated with CHG...just add bottled water to it and you're good to go. Also can get it on ebay. Usually in boxes of 50 and about $1.00 apiece so maybe a griup could get together. and order some.

http://cgi.ebay.com/30-CHG-4-Surgical-S ... .m20.l1116" onclick="window.open(this.href);return false;

[Facehook]

Would carrying a squeeze bottle of hydrogen peroxide offer a close enough alternative to a CHG cleanser?

[Cherry MAC]

Would carrying a squeeze bottle of hydrogen peroxide offer a close enough alternative to a CHG cleanser?

Unfortunately, despite the satisfying fizzyness, hydrogen peroxide does not kill bacteria. You can also buy tegaderm at a medical supply pharmacy OTC if you don't want to try to order some. Probably could also buy the Chlorhexidine scrubby sponges there, too, but I have never looked for them.

CM

[nolexus]

Just got back from Wallymart and found a product called Hibiclens that contains chlohexidine gluconate . Says on the bottle " great for : hand washing , general & skin wound cleanser , pre-surgical skin prep , surgical hand scrub

I'll spend $6.00 for something to put in my yak anyday compared to losing a leg ... arm , or worst scenerio, my life

Just thought I needed to give a heads up

tight lines

[DB]

Unfortunately, despite the satisfying fizzyness, hydrogen peroxide does not kill bacteria. You can also buy tegaderm at a medical supply pharmacy OTC if you don't want to try to order some. Probably could also buy the Chlorhexidine scrubby sponges there, too, but I have never looked for them.

CM

Do not mess with CM when it comes to wound care. Also, the peroxide is very light sensitive and after unsealed loses it's "fizz" pretty quick.

[Davy Jones]

Please correct me if I am wrong, but didn't someone on another post suggest using clorox? Would this work? Just curious.

[Facehook]

Just got back from Wallymart and found a product called Hibiclens that contains chlohexidine gluconate . Says on the bottle " great for : hand washing , general & skin wound cleanser , pre-surgical skin prep , surgical hand scrub

I'll spend $6.00 for something to put in my yak anyday compared to losing a leg ... arm , or worst scenerio, my life

Just thought I needed to give a heads up

tight lines

The guys on 2cool seem to like the Hibiclens product as well. Can't afford the $50 bulk purchase on ebay, but $6 isn't too bad.

[Cherry MAC]

Please correct me if I am wrong, but didn't someone on another post suggest using clorox? Would this work? Just curious.

I suppose you could use 1/4 bleach to 3/4 saline solution (aka "Dakin's solution in the medical community). I guess I'd rather use Hibiclens on the wound.

Do as I say not as I do, but I skinned my knee in the surf last weekend and didn't treat it in any way at all!

[oleyakker]

We go through this every summer, its so sad to see someone lose his life for any reason like this, especially when it is so preventable. Anyone who is in the saltwater in this part of the country, with hepatitis, diabetes, or in any way immunosuppressed needs to take extra precautions. This topic is hardly an unknown. The poorly written news article in today's Chronicle doesn't help much either. Before some reporter puts a story about one of these tragedies in the paper, it would be nice to see him do his homework and write a factual report instead of a hysterical, half researched, piece like this guy wrote today.
As for any of us otherwise, reasonably healthy folks, a large dose of common sense, taking immediate care of any wound in salt water, especially, hot semi stagnant , salt water, would go a long way. Carry appropriate first aid gear, use it, and pay attention to your wound, scratches, cuts, hook pricks, fin sticks, whatever. IF YOU ALREADY HAVE AN OPEN WOUND...DON'T GO IN THE SALT WATER WITHOUT PROTECTION. IF YOU GET A WOUND, TREAT IT IMMEDIATELY..

[OlSalty]

Ok i have to ask, how many of you guys been out in the water with cuts and scrapes being submerged in the water? Yet u are still here without ever getting this monster. This bacteria has been here for a long time. There have been reports of people getting this however seldom. In the rio grande, bays, gulf and other warm water rivers. Theres even a case from brazil where a child got it in a swimming pool! They explained that even though the pool was meticulously maintained with chlorine that day there was a great number of people, and urination. That it allowed the bacteria to survive and entered into the boys little cut on his hand. Now that makes me wonder when in schlitter. You see the bacteria is not widespread in the water. You have to submerge your wound in the small particular spot the bacteria may be at. It is not in the water like an oil spill.
The point is, you are more likely to lose a limb by a shark than to contract this bacteria. So put on some sunblock, slab yourself with the medication mentioned above, wrap urself with the plastic also mentioned above and put on a chainmail shark suit (search shark suit). Then you can go and enjoy ur favorite water sport without any worries.

[DB]

We go through this every summer

Yep But because a lot of unfortunate endings could be avoided, this is probably a good thing. There was a story recently in the Saltwater Fishing mag about one of the noted guides in the Port M. area who got a stingray stick, and developed a serious, season-ending foot infection. He waited to get treatement like many of the individuals with bad outcomes did.

The point is, you are more likely to lose a limb by a shark than to contract this bacteria.

Probably not, since there are several hundred Vibrio-related illnesses each year, and many cases go unreported.

A few facts about the Vibrio germ from the CDC...

There were 4754 illnesses reported data from 1997 -2006

1210 of them (25%) were wound (non-food) infections

10% of those individuals required amputation, 17% died

About 75% of the cases occurred during recreational activities in the gulf states

So a message board read by individuals (and plenty of noobs like myself) who paddle, wade, and generally soak in saltwater for long periods of time while playing with sharp objects and handling spiny, toothy critters is a great place to raise awareness in a high-risk population.

OK, I admit it...

[elcoyote]

Chlorhexidine is also used in non-dental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Hibiscrub, ChloraPrep, BIOPATCH, SOLU-I.V. and Exidine. It is also a component of the household antiseptic Savlon. It is used for general skin cleansing, a surgical scrub, and a pre-operative skin preparation. Due to other chemicals listed as inactive ingredients, the cleanser solution is not suitable for use as mouthwash. It is often used as a rubbing agent prior to the use of hypodermic or intravenous needles in place of iodine. Chlorhexidine is contraindicated for use near the meninges, in body cavities, and near the eyes and ears. At the 2% concentration, it can cause serious and permanent injury with prolonged contact with the eye or if instilled through a perforated eardrum. Nevertheless, a topical solution of 0.02% chlorhexidine is recommended by the US Centers for Disease Control and Prevention (CDC) as treatment for keratitis caused by Acanthamoeba. As a scrub chlorhexidine is not recommended on persons under two months of age .

Had to look that one up in the all mighty wikipedia

Got it on the list of things to buy for the first aid kit

Can someone translate please?

You're gunna die, Bill!

Were I you, I would be more worried about the bulk orders of Penicillin since you lived in Laredo for a while.

[OlSalty]

There were 4754 illnesses reported data from 1997 -2006

they are including all variants of vibrio. Such as vibrio cholerae not just the flesh eating one. It's like including all incidents involving sea life. IE.. Catfish, jellyfish, sea urchins, stingrays, etc...
Your preventive measures are right on. I just hope there isn't any mass hysteria as with the facemasks and the swine flu. If you have a cut/scrape treat it. If it seems like it is getting infected have it looked at. Just keep enjoying life and deal with the issues as they come.