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FAQs about Pet-fishing & Human Health: Bacterial
Infections
Related Articles: Wounds Articles, Moray
Eels Bite, But Are They Venomous? by Marco Lichtenberger,
Related FAQs: Petfishing and Human
Health 1, Petfish
& Health 2, Petfishing & Human Health 3, & FAQs on: Petfishing Concerns:
Getting Poked, Spined, Stuck,
Envenomized (injected),
Bitten, Poisoning (ingesting),
Skin et al. Contact,
Companion Animal Involvement,
Troubleshooting/Fixing,
Parasitic Cross Zoonoses,
Turn About's Fair Play...
Stingrays, |
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Sick Goldfish ... RMF's go 7/28/06
I would like to ask you a question about my goldfish. She is losing
her orange color, having difficulty getting up to the surface of the water, and
when she does make it up (with great effort) she gulps air and then descends
again.
She spends most of her time just laying on the bottom of the tank, and she is
listing to one side.
<All bad signs>
While searching the Web for answers I read about fish tuberculosis. My fish
seems to have many of the symptoms. This concerns me
(because I don't know if it is or isn't, and I don't know what to do for
the fish) and also because it said that this disease is transferable to
humans.
<Yes>
While I washed my hands afterwards, I did clean out the tank by hand, stirring
up the gravel, washing off the rock, etc.
<Unless there are breaks in your skin...>
My cat also drank from the fish tank while I was transferring the fish to a
bowl. Should I be concerned about the possibility of TB, how could I know for
sure if this is what my fish has, and what can be done for the fish?
<Not able to tell from here... however Mycobacterial transference is not likely>
If it is not TB, then I thought it could be a swim bladder problem (my fish
does have trouble with constipation), but
why is she losing her color?
<Could be several influences>
Thank you for listening to my question. Any help you could give me is most
appreciated.
<Have you read here:
http://wetwebmedia.com/FWSubWebIndex/gldfshdisease.htm
and the linked files above? BobF>
Sick Goldfish ... Tom's much better go 7/28/06
<<Greetings. Tom here today.>>
I would like to ask you a question about my goldfish.
<<Fire away.>>
She is losing her orange color, having difficulty getting up to the surface of
the water, and when she does make it up (with great effort) she gulps air and
then descends again. She spends most of her time just laying on the bottom of
the tank, and she is listing to one side.
<<Not good, certainly, but having "peeked" at the remainder of your post, I've
noticed that you haven't included any of the very important information that
would be useful here. What "type" of Goldfish, tank size, type of filtration,
water parameters (critical!), diet, etc. From our perspective, it's like asking
us why you just sneezed. A cold? Hay fever? Allergies? Someone tickled your nose
with a feather? Sounds a bit silly but I think you see what I mean. Fish can
display very similar symptoms from a wide variety of causes.>>
While searching the Web for answers I read about fish tuberculosis. My fish
seems to have many of the symptoms. This concerns me (because I don't know if
it is or, isn't, and I don't know what to do for the fish) and also because it
said that this disease is transferable to humans.
<<Possible? Yes. Likely? No. I understand your concern but I would suggest that
it's not warranted. What you've described thus far could simply be due to your
pet being in too small of an aquarium or living in water conditions that are
sub-par. At this point, I really don't know.>>
While I washed my hands afterwards, I did clean out the tank by hand, stirring
up the gravel, washing off the rock, etc. My cat also drank from the fish tank
while I was transferring the fish to a bowl. Should I be concerned about the
possibility of TB, how could I know for sure if this is what my fish has TB, and
what can be done for the fish?
<<I think you should be "aware", as we all should be. Concerned? No. To know for
certain would require a laboratory and a pathologist. A couple of indicators
would be a sunken stomach or detention (sinking) along the back of the fish.
Protruded eyes, loss of scales, lesions on the body of the fish would also be
indicative but not definitive. As for what can be done for the fish in the case
of TB, there are some treatments that would likely be out of the realm of the
typical hobbyist. In all likelihood, the animal couldn't be treated
effectively.>>
If it is not TB, then I thought it could be a swim bladder problem (my fish does
have trouble with constipation), but why is she losing her color?
<<Here, we go back to my earlier comments. Goldfish, regardless of their
opportunistic feeding habits, require lots of vegetation in their diets. They
don't process proteins well and become "compacted" when fed a diet that is too
high in these. Much information on our site about the appropriate diet for
Goldfish as well as the environment that they require to thrive.>>
Thank you for listening to my question.
<<Not a problem at all.>>
Any help you could give me is most appreciated.
<<If you wouldn't mind, I'd like you to give me your name when you post again.
Tom>>
Re: Sick Goldfish 7/28/06
Thank you for your reply, Tom.
<<Good to talk to you again, Debra.>>
I do not know the technical name for the Goldfish--she is orange in color,
having a regular, slim, not a "fancy" body type, with a black dot on her tail
(which has always been there).
<<What you have is either a Common Goldfish or a Comet Goldfish. Both are very
similar with the Comet staying a bit slimmer than the Common as it matures. Both
can attain 12"-14" in length at adulthood. (Can't blame you if you just did a
"double-take".)>>
She is now about 2.5 inches long from mouth to tail tip. She is in a two gallon
tank.
<<Way too small but I'll get back to this as we go on.>>
It used to have an air stone, but I put a charcoal and "sponge type" filter in
the tank when I found out that it would do a better job of filtering out the
ammonia in the tank.
<<Good...with a proviso. While the airstone will do nothing for the ammonia, it
does agitate the surface water of the tank and helps in oxygen exchange. This is
where your Goldfish is getting its air to breathe. The larger the surface area,
the more oxygen that enters the tank. The fact that she's gulping air indicates
that she isn't getting enough oxygen from the water. (Small piece of "trivia": A
fish's gills are much more efficient in extracting oxygen from water than our
lungs are in extracting it from the air. We can "afford" this inefficiency
because oxygen is so plentiful in our environment compared to a fish's. I add
this for emphasis as well as a bit of extra information.) Side note: activated
carbon is effective for no more than 3-4 weeks.>>
I changed 80% of her water about every 1-2 weeks, with periodic full tank water
changes. When she got sick, I did a full tank change
and rinsed her rock, gravel, sides of the tank, and plastic ornamental plants as
I do periodically.
<<When ammonia/nitrites are an issue, this amount is likely appropriate but, for
now, I'd prefer to see you change out 15%-20% once a week. This presupposes that
your ammonia/nitrite levels are at 0 and nitrates are below 20. A fish store can
test a sample of your water for you if you don't have a test kit...which I would
highly recommend getting.>>
Previously, I was using regular filtered tap water for the water changes with
several drops of "stress coat" to condition the water,
but when she got sick, and I consulted a pet shop, they recommended that I use
bottled water, which I did (I still added a couple of drops of Stress Coat,
too).
<<Neither "filtered" tap water nor bottled water are the best choices here.
Filtering water removes elements that fish need, so-called "trace elements"
though major and minor elements would be involved, as well. We almost always
recommend that you acclimate your fish to whatever source of water you have at
the tap - without filtering. Adding a good quality dechlorinator - one that
eliminates chlorine and chloramine - is all you need to do. (Chloramine is a
combination of chlorine and ammonia, used in increasing numbers of areas because
chlorine alone dissipates so quickly. Chloramine does not. Stress Coat TM) only
removes chlorine, by the way. If your source of water is treated with
chloramine, you'd be introducing ammonia to the tank.>>
I called my cat's Vet but was told that they don't see fish.
<<About what you'd expect from a "cat doctor". :)>>
They gave me the number for a fish Vet at U of P. I left several messages, but
no one called back yet. I was told the Dr. was only in intermittently--so I
turned to the Internet, and your postings for help.
<<Along with your commitment to your pet, we might just get this turned
around.>>
My Goldfish was very healthy prior to last week (except for the chronic
constipation--I did try the peas in the past, but it seemed to only help a
little-). She is still hanging on at the bottom of the tank, but is staying in
one spot and if I put food in, she will struggle to rise to the surface, but
she mainly gulps a lot of air when she is up there.
I don't know the chemical status of the water, but I just changed it all with
the bottled water, so I don't think there is an ammonia
build up.
<<Goldfish excrete ammonia through their gills just like we exhale CO2.
Regardless of the lack of fish waste/detritus in the tank, ammonia is going into
the water. Back to what I mentioned about aquarium size now, your Goldfish needs
to be in, at least, a 30-gallon tank. Commons and Comets are generally
considered to be "pond fish" because of their adult sizes. Unless kept in a
sufficiently large indoor tank, you'll ultimately run into one problem after
another. Growth will be slowed/stunted leading to health problems like bone
disease. Most importantly, despite your best efforts, a two-gallon tank can't
dilute the toxins in the water adequately to provide a high-quality environment
for your fish. Any measurable amount of ammonia in the tank will cause the gill
membranes to swell/thicken (basically being chemically burned) to the point that
your fish will start to suffocate. The "immediate" thing to do now is put the
airstone back into the tank and turn that "bad boy" up high! And, start making
plans to get a much larger aquarium...>>
She is very pale. When she is at the bottom, she lists to one side a bit. She
does not look particularly emaciated, though. In fact, she looks fat like she is
still constipated--and there are no visible lumps, bumps,
discolorations or spots (other than the one that she was born with), her eyes
are not abnormal. She definitely has some sort of equilibrium issue, but she
doesn't really fit nicely into any one disease category.
<<All typical of water quality issues with the possible exception of the
constipation.>>
When I first got her, I fed her the small pellet type food. When even the small
pellets looked too large and hard (I would crush them a bit) I tried the flake
food, but I think she prefers the pellets, so when she got sick, I switched back
to the pellets).
<<She needs vegetable matter in her diet, Debra. Goldfish don't process proteins
at all well. Zucchini, spinach, shelled peas (which you've tried) among other
common veggies are all good for her and will keep her "cleaned out". Brine
shrimp also act as a laxative because of their "roughage". Also, do a search on
our site regarding Epsom salts. Many folks have good success with a treatment of
these.>>
I hope this gives you more information, although I know it must be difficult to
diagnose a fish sight unseen. Thank you for your time and any help you can give.
<<I've probably given you more than you necessarily wanted here, Debra, but I've
hit what I believe are the key points. Bigger tank, more filtration, aeration
and diet. A little overwhelming, perhaps, but this is what your pet needs.>>
Sincerely,
Debra
<<My best to you and your Goldfish. Tom>>
Re: Sick Goldfish 7/28/06
Dear Bob F.,
Thank you for your prompt reply. I did peruse the site you listed plus
many others, but my fish did not fit nicely into any of the disease categories,
so I was still puzzled. I will copy Tom's email to me and my reply to Tom's
email FYI.
<I see (place) all>
I hope that this information will shed more light on the matter, and that the
problem may have a solution. And yes, my hands did have breaks in the skin from
playing with my cat who accidentally scratched me, and from torn cuticles, that
was why I was concerned.
<... might be worth a visit to a medical center if you are indeed concerned>
I also quarantined my fish in a large glass salad bowl while I was changing
the water in her tank--I bleached out the salad bowl and washed it with
antibacterial soap --along with my improvised "net", a slotted kitchen spoon
(we do not have a dishwasher) but now I wonder if I should just discard the
bowl and the slotted spoon I used to transfer the fish with.
Sincerely,
Debra
<Mmm... there are a myriad of degrees-of-infectious microbes in most everyone's
experience every day... I strongly suspect you have nothing to fear here. I
would not discard these implements. Bob Fenner>
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Re: Lugol's Dip and Gorgonians, Pete, will you take a look at, refer? &
bacteria f', human dis. – 4/10/07
<Yowsa Pete! Thanks as usual for this dissertation! BobF>
Dear Mark:
Bob forwarded your email to me and asked me to lend a hand with
your dilemma. It's very difficult to say what may have caused the demise
of your H. kuda but I would be happy to share my thoughts on the matter with
you for whatever it's worth, sir.
Like all fish, seahorses do occasionally develop various granulomas, malignant
neoplasms, tumors and fibrosarcomas associated with certain diseases or the
aging process, but these primarily affect internal organs. Furthermore, such
growths are not characteristic of Vibriosis and, judging from the symptoms you
described -- or lack thereof -- it seems unlikely that a Vibrio infection was
involved in this case.
I am more concerned about the possibility that the tumor may have been
a granuloma symptomatic of a Mycobacterial infection. Granuloma disease
is caused by gram positive, acid-fast bacteria from either the genus
Mycobacteria or the closely related genus Nocardia invading the tissue and
internal organs and organ systems. Both of these bacteria can affect the skin as
well as the internal organs, causing nodules and granuloma. And both
Mycobacteria and Nocardia can be transmitted to man, causing a localized,
unsightly skin rash after entering through a cut or break in the skin.
Here is an excerpt from my new book (Complete Guide to the Greater Seahorses in
the Aquarium, TFH Publications, unpublished) that discusses mycobacteriosis in
more detail, Mark. It may help give you a better idea whether or not the tumor
you noticed could have been associated with granuloma disease:
MYCOBACTERIOSIS, A.K.A. PISCINE TUBERCULOSIS
Mycobacteriosis is also known by the following synonyms: fish tuberculosis,
piscine tuberculosis, granuloma disease, swimming pool granuloma, fish
tank granuloma, and acid-fast disease (Aukes, 2004; Leddo, 2002a). Like all
fishes, seahorses are susceptible to Mycobacteriosis. It is not uncommon in
wild-caught seahorses obtained from pet stores and is the second most commonly
seen bacterial infection of syngnathids at large public aquaria after Vibriosis
(Bull and Mitchell, 2002, p20).
Cause:
Fish tuberculosis is caused by pathogenic Mycobacteria, of which
two different species are the primary culprits: Mycobacterium marinum
and Mycobacterium fortuitum (Giwojna, Sep. 2003). Unlike most bacteria the
plague fish, these Mycobacteria are gram-positive, and take the form of
pleomorphic rods that are acid-fast and nonmotile (Aukes, 2004). When cultured
on solid media, they form cream-colored to yellowish colonies (Aukes, 2004).
Mycobacteriosis is worldwide in distribution (Giwojna, Sep. 2003). All
fish species are considered susceptible to it (Aukes, 2004). Although this
disease can in fact infect almost all fish, certain species are more vulnerable
than others (Giwojna, Sep. 2003). The most susceptible species are
freshwater tropicals such as black mollies, all Gouramis, Neons and other
tetras, all labyrinth air breathers, and most species of the Carp family
(goldfish and Koi, for example), Aukes, 2004.
Mycobacteria are ubiquitous and waterborne, and the aquatic environment is
considered the disease reservoir for fish tuberculosis (Aukes, 2004).
Mycobacterium marinum has been cultured throughout the world from swimming
pools, beaches, natural streams, estuaries, lakes, tropical fish tanks, city
tap water and well water (Aukes, 2004; Leddo, 2002a). Human epidemics of granulomatous
skin disease have occurred from swimming in infected water, and in fact, this
mode of human infection is far more common than infection from exposure to
infected fish tanks (Aukes, 2004; Giwojna, Sep. 2003).
Clinical Signs:
There is a very severe or peracute form of this disease, in which fish can
simply be found dead without showing any telltale signs or symptoms (Bull
and Mitchell, 2002, p20), but that is quite rare. In my experience,
Mycobacteriosis is a chronic disease that progresses quite slowly in aquarium
fishes (Giwojna, Sep. 2003). It may take years for an infected fish to develop
any symptoms of apparent illness and much longer before it becomes fatal (Aukes,
2004).
The glacial progression of the disease makes it difficult to diagnose. Some
early signs to look out for include lethargy, fin loss, emaciation, skin
inflammation and ulceration, edema, Popeye, and peritonitis (Aukes, 2004).
There may be superficial skin lesions that take the form of small subdermal
lumps or pus-filled nodules of granulation tissue (Bull and Mitchell, 2002,
p21).
These are simply the outward manifestations of a systemic infection that may
already involve many of the major internal organs (Bull and Mitchell, 2002,
p21). In later stages, nodules may develop in muscles or skeletal structure and
deform the fish. (Giwojna, Sep. 2003).
As difficult as slow-moving TB may be to diagnose while the infected fish is
alive, once the victim expires, postmortem examination will reveal
clear, unmistakable signs of Mycobacteriosis (Giwojna, Sep. 2003). The
telltale granulomas will appear as gray or white nodules in the liver, kidney,
heart and/or spleen (Aukes, 2004). There is often black, necrotic tissue eating
away at the internal organs, and there may also be skeletal deformities.
Diagnosis is then confirmed by the presence of acid fast bacteria in tissue
sections (Giwojna, Sep. 2003).
Treatment and Control:
There is no practical method for treating mycobacteriosis or
granuloma disease at the hobbyist level. As discussed below, good
aquarium management can prevent Mycobacteria/Nocardia from becoming
problematic. Prevention is the watchword for this condition.
Transmission:
The bacteria can be transmitted through the water from open ulcers,
through contaminated food (including live foods such as shrimp or molly fry),
via feces of infected fish, or through the consumption of infected, dead or
dying fish in the tank (although the latter does not apply to seahorses), Aukes,
2004.
Contributing factors:
This disease is not highly contagious and does not seem to spread from
fish to fish readily (Aukes, 2004). However, fish TB it is often associated
with poorly kept or dirty tanks with poor water quality (Aukes, 2004). Chronic
stress from factors such as overcrowding, malnutrition, or aggressive tankmates
often plays a role as well (Giwojna, Sep. 2003).
Mycobacterium, the causative organism, is believed to be ubiquitously present,
making it very difficult to eliminate it entirely. However, if good aquarium
maintenance and management is followed, including vacuuming of the gravel along
with good filtration and regular water changes, combined with a nutritious diet
and the addition of an enrichment product rich in vitamins, the problem can be
minimized and eliminated as a cause of mortality (Aukes, 2004).
Any dead fish should quickly be removed and disposed of properly. Diseased
live fish should be isolated and treated in a hospital tank (Giwojna, Sep.
2003).
Transmission to Man:
The seahorse keeper should be aware that piscine tuberculosis is one of
the few forms of fish disease that is communicable to humans (Leddo, 2002a).
This transmission usually manifests itself as an unsightly skin rash involving
one or more granulomas on the arms of the fish-keeper (Leddo, 2002a). In severe
cases, these nodules of inflamed tissue can become large and disfiguring.
They can spread and be very difficult to eliminate. The granulomas often take
some 2-4 weeks after exposure before manifesting themselves, so the individual
is frequently unaware of how he or she contracted them and the condition very
often goes undiagnosed (Giwojna, Sep. 2003). The Mycobacteria that cause the
disease typically gain entry through a break in the skin such as a cut, scrape,
or abrasion on the hand or arm of the aquarist (Leddo, 2002a). Although
unsightly, the granulomas themselves are not a serious problem and are almost
always localized and most certainly curable in healthy individuals. But for
those of us whose immune systems are compromised by AIDS, kidney disease,
diabetes, liver dysfunction, chemotherapy or the like, the infection can
sometimes become systemic or, on rare occasions, even life threatening
(Giwojna, Sep. 2003).
Awareness is the appropriate response to the risk posed by fish tuberculosis.
The seahorse keeper should be aware of the remote possibility of being exposed
to Mycobacteria via his aquarium, and take appropriate precautions, but there
is certainly no need to be overly concerned (Giwojna, Sep. 2003).
The aquarist should merely remain aware of Mycobacteria and follow the usual
sensible precautions. Nets, aquarium accessories and equipment, and any other
items that may come in contact with the fish should be sterilized between uses
to prevent cross-contamination (Giwojna, Sep. 2003). Avoid mouth-siphoning of
the water in a Myco-positive tank (use a hand pump instead).
Mycobacterium cannot penetrate intact skin -- it only causes infection
after entering through open wounds or source, so make full use of aquarium
gloves and don't place your hands or arms in the aquarium if you have any cuts
or scrapes (Giwojna, Sep. 2003). Handle sick fish carefully, dispose of deceased
specimens properly, and scrub up afterwards. Do NOT dispose of dead fish by
flushing them down the toilet, as this is a prime way to spread disease. Place
the fish carcass in a plastic bag or wrap it in some foil and dispose of it with
the solid waste of the household. And don't feed dying fish to larger
carnivorous fish, since this an excellent way to spread infection (Giwojna, Sep.
2003).
One thing hobbyists who are worried about fish TB can do to allay their concerns
is to get their seahorses and live foods (crustaceans such as shrimp are known
vectors for Mycobacteriosis) from a High Health facility such as Ocean Rider
rather than from their local fish store (Giwojna, Sep. 2003). Seahorses at OR
are routinely screened for pathogens and parasites by independent
examiners from an outside agency (DVMs with the Department of Agriculture), and
I know for a fact that Mycobacteriosis is one of the diseases they specifically
check for (Giwojna, Sep. 2003). Thus far, multi-organ histopathology has found
no granulomas and tissue sections have revealed no acid-fast bacteria --
conclusive proof that Ocean Riders are free of Mycobacteria. <Close quote>
That's the rundown on mycobacteriosis or granuloma disease, Mark.
The very similar Nocardia is a gram positive, acid-fast, filamentous bacteria
and is even more insidious than Myco. Nocardia is closely related to the
Mycobacteria that cause piscine TB or granuloma disease and, like Mycobacteria,
it can affect the skin as well as the internal organs, causing nodules,
granulomas and pyogranulatomous cysts. And like Mycobacteria, Nocardia can be
transmitted to man, so be sure to take appropriate precautions if you suspect
granuloma disease may have caused the death of your H. kuda.
Here is some information from Paul Anderson explaining how
professional aquarists typically deal with Mycobacterium/Nocardia:
Fellow Seahorse Enthusiasts:
Mycobacterium is a genus of bacteria that are ubiquitous in almost
all environments. Mycobacterium infections occur in many (if not all)
vertebrate taxa (e.g., mammals, birds, fish, etc.). Some studies that have
looked at prevalence of infection of Mycobacterium in wild animals have often
found that a small percentage of wild animals are infected, even without
clinical signs.
The most common Mycobacterium species found in seahorses are M. marinum, M. chelonae,
and M. fortuitum. There is currently no cure for mycobacterium infections in
fish. The options available are to 1) depopulate and disinfect the system, or 2)
maintain the fish but prevent cross-contamination by observing strict
biosecurity protocols. The second option is often chosen by public aquaria with
long-standing displays, when aquaculture/production of the infected fish is not
an issue.
Many mycobacterium spp. can cause disease in humans, especially if the species
is a rapidly growing one and/or if the person is immunocompromised. Of the
three species mentioned above, M. marinum is a slow grower, and grows at
25 degrees Celsius incubation, but not at 37 degrees Celsius. The other two
are rapid-growing species and grow at both temperatures of incubation.
The significance of 37 degrees is that it is human body temperature. While
most infections of otherwise healthy people are limited to lesions on the
extremities (even with infection by a rapid-grower), there is a greater risk of
the rapid-growers to cause systemic disease (especially in immunocompromised people).
In a Myco-positive tank, the best option is not to come in contact with water or
fish; wear gloves (sleeved gloves if necessary). Avoid mouth siphoning (use a
hand pump). Having said that, in an aquarium situation mycobacterium
only causes infection if it enters a wound; it cannot penetrate intact skin.
Effective disinfectants against mycobacterium include spraying with 70%
Ethanol and allowing the equipment to air-dry, and bleach baths (I use 50ppm
bleach baths with a minimum contact time of one hour, this has been reported to
be effective against M. marinum) followed by sodium thiosulfate
neutralization baths. Ultraviolet light sterilization is also recommended in
Myco-positive systems. If you've got Myco-positive tanks among other systems,
common sense suggests performing husbandry on these systems last in your rounds.
A note on ethanol: I have found in my experience that seahorses are
very sensitive to ethanol, so I advise being very cautious to avoid overspray
into tanks (while we're€™re on the topic, has anybody else observed this?)
Check out the following for more information about mycobacterium infections in
fish/aquaria:
<_http://edis.ifas.ufl.edu/VM055_
(http://edis.ifas.ufl.edu/VM055) >
<_http://www.mdsg.umd.edu/Extension/finfish/FF9.html_
(http://www.mdsg.umd.edu/Extension/finfish/FF9.html)
>
Mainous, M.E., and S.A. Smith. 2005. Efficacy of common disinfectants against
Mycobacterium marinum. Journal of Aquatic Animal Health 17: 284-288.
Paul Anderson
Ph.D. Candidate
Department of Fisheries and Aquatic Sciences
University of Florida
That's the situation when Mycobacteria is confirmed in an aquarium, Mark.
As long as you observe the proper precautions and practice good aquarium
management, it's a problem the aquarist can sometimes live with...
Nocardia is a different matter. When Nocardia is confirmed in an aquarium, the
only real recourse is to break down the entire aquarium, discard the live rock,
substrate, and invertebrates, sterilize everything, and start over from
scratch. The problem is that Nocardia is saprophytic -- it doesn't require a
host to survive and it will persist in your system indefinitely. These bacteria
live off any kind of dead or decaying organic matter; in nature they are
commonly found in soil and wastewater -- in your tank, Mark, they are no doubt
entrenched in your substrate, live rock, filters, everything -- where they act
as a disease reservoir, ready to infect any new fish and invertebrates (or
careless humans) they encounter when the opportunity presents itself.
The risk of cross-contamination of your other tanks and specimens is
great, compounded by the fact that human health (primarily yours, Mark) is also
at risk from this organism. If your H. kuda was infected with Nocardia,
then everything in your 25-gallon aquarium has been exposed to these bacteria
and is potentially a source of infection. Leading the tank lay fallow
indefinitely will not help with Nocardia whatsoever. If Nocardia killed your
kuda, you must consider all the equipment, decor and specimens in the tank to be
contaminated, Mark -- treat them like you would toxic waste or any other
biohazard.
Even your invertebrates are a risk. Your coral, macroalgae, etc,. are all
sources of organic matter, and can therefore harbor Nocardia and carry the
infection.
Do NOT disperse your live rock, substratum, Gorgonia and soft
corals, macroalgae, equipment or accessories from the 25-gallon tank to your
other aquaria, Mark, or you will be inoculating them with Nocardia and spreading
the infection to all your tanks! And you must be extremely careful to
avoid accidentally cross-contaminating your other tanks from your 25 gallon
aquarium. Any nets, hydrometers, or other equipment used in your 25-gallon
aquarium should be sterilized after every use and not placed into or used in
any other tanks.
Avoid working in infected aquarium with your bare hands, scrub/disinfect
your hands and arms thoroughly after working on the tank, and do not place your
hands in the 25-gallon tank and then place your hands in another aquarium.
These bacteria can even be transferred from one aquarium to another by splashing
water droplets or as an aerosol via the mist generated from a protein skimmer
or an airstone. Be careful!
That is what I typically advise hobbyists when Nocardia has been confirmed in
their aquaria, Mark. I hesitate to recommend such drastic measures when Nocardia
or Mycobacterium have not been confirmed. And the tumor that you described is
not typical of the pyogranulatomous cysts that characterize Nocardia. They most
often present as greyish-white pimple like lesions on the skin.
They are often motile when manipulated and may release a cheesy exudate when
compressed. That does not sound like the hard mass you detected beneath the
skin near the vent of the H. kuda.
So you're going to need to use your own judgment, Mark. To be 100% safe, you
could discard the contents of your 25-gallon aquarium, sterilize everything, and
start over from scratch. Or you could dip the live rock, Gorgonia, and corals
with Lugol's solution as a precaution and then trust to good aquarium
management to keep the seahorses in your 40-gallon aquarium healthy and
happy. Since Mycobacteria and Vibrio bacteria are virtually ubiquitous, and
normally only become problematic when the seahorses have been stressed and
their immune systems have been impaired, I might be inclined to take the latter
course in your case. If you can provide your seahorses with optimal water
quality, a nutritious diet, and they stress-free environment, the chances are
good that your livestock will not be affected by granuloma disease or
Vibriosis.
Starting out with seahorses from a high-health aquaculture facility that you
obtain directly from the breeder will further increase your chances for
success. As an added precaution, you may also want to consider installing an
ultraviolet sterilizer on your 40-gallon seahorse tank after it has cycled
completely and the biofiltration is well-established.
Best of luck with your new seahorse tank no matter how you decide to proceed,
Mark!
Respectfully,
Pete Giwojna, Ocean Rider Tech-Support
Re: Lugol's Dip and Gorgonians, Pete, will you take a look at, refer? –
4/10/07
Dear Bob:
<Pete!>
I'm always happy to help when I can, sir.
<And you do a fine job of it, I assure you>
When I receive inquiries from aquarists regarding Mycobacteria/Nocardia, I feel
it is very important to provide them with as much information as
possible because of the possibility of human transmission and because they may
be confronted with the decision as to whether or not it's necessary to
depopulate their aquarium, sterilize everything, and start over from
scratch. So I make it a point to try to arm them with all the facts they need
to make an informed decision in that regard.
<Yes... and one of the principal reasons for my encouraging the publication of
your book, your articles (as well as others... including my own!) to get
"complete answers" to folks... in a speedily manner>
Hopefully, once we get my new book on seahorses published and into the hands of
the hobbyists, there won't be a need for us to devote so much time discussing
these issues on the forums.
<Heeeeee! You'll see...>
Happy Trails!
Pete Giwojna
<And to you, Bob Fenner, out in HI, at times visiting with Carol and Craig and
their (now four year old!!!) boys, Dylan and Cooper>
|
Swallowing water
Hi Bob,
I have a marine tank (46 ga.)that has been up for about 5 months. I houses
a blue damsel, percula clown, coral beauty, yellow tang, cleaner shrimp, and
a few crabs and snails. During routine maintenance this weekend while
siphoning water out for a water change, I guess you could say that I
swallowed a bit of water trying to start the siphon. I remember
"drinking"
some of the ocean water as a kid at the beach, but I'm sure the water in our
tanks is a little more "full of waste" than the ocean. It happened 2
days
ago. I feel fine. Anything I should worry about? Thanks.
<Not really... unless you have ulcerations... open wounds in your buccal
cavity... you're more than likely fine... I have swallowed actual gallons of
water from fish tanks over the years... though I am the "Jimi Hendrix"
of siphoning at this late stage. Bob Fenner>
Jason
Human Poisoning from Sarcophyton?
Anthony- After a somewhat panicked web search, I came across your article:
http://www.reefkeeping.com/issues/2002-06/ac/feature/
on coral propagation in Reefkeeping magazine. I say
"panicked" because while I was attempting to cut a
diseased portion of a Sarcophyton species off, I inadvertently cut my finger in
the process. The cut was shallow; so shallow that I did not realize I
cut myself until the "operation" was complete, and it did NOT draw
blood. However, I'm worried about any toxic reaction. It's been two
hours as I write this, with no sign of rash or anything at the cut site, or any
symptoms that can't be explained by panic disorder. Are there any warning
signs/window of time I should be looking out for a "bad"
reaction? Is it possible I introduced something harmful or lethal via
this shallow cut? I feel incredibly stupid for (a) doing this and (b) e-mailing someone I don't
know about it, but I'd really like the opinion of an authority on this so I can
rest easy or get myself to the hospital. Thank you very much for your time..
-Todd
<Cheers, Todd. Very glad to hear about the propagation efforts! Sorry to hear
you got a scare :p No worries though my friend. Nothing imminent is likely
regarding a poisoning or allergic reaction. What risk there is no worse than the
same risk of being bit or stung by a non-venomous fish or even simply putting
your hand in the tank on a daily basis
with a hangnail or other non-related wound. Specifically, there are nasty
microbes in all aquatic environments and specifically we fear Vibrio or
Mycobacterium. Your first step of course was/should be to cleanse the wound thoroughly with
soapy water and then use a disinfectant (antibiotic cream, peroxide, or the
like). The doctor is unlikely to be necessary but do call at least to get his
advice. Really... the concern here is more from a septic infection from the
razor than anything the coral could impart. Sarcophytons are specifically noxious to other corals and aquatic invertebrates
with regard for allelopathic compounds. Again, since this is not an overtly
poisonous (to humans) animal and you didn't even draw blood... it seems likely
that you will have a very nice holiday week. The only poisoning that I see as
being likely in your near future is alcohol poisoning tomorrow night <G>.
Happy New Year, my friend. Anthony>
Sore Fingers...Infection from My Saltwater Tank?? - 8/13/03
Hi all at WWM. I have a pretty serious question to ask of
you, I hope someone can get back to me (I've sent you another email
about some live rock with no response so I hope this one makes it)
First off, I love your site and have learned a great deal from you
all! Me and my fish appreciate all the hard work u put into
it. I am just venturing into the hobby of saltwater fish and have
just completed setting up my tank. About 5 or 6 weeks ago I purchased
some live un-cured Lalo rock from an online store. When it arrived I
rinsed in some saltwater which took me quite a while
and placed it in the tank. As I was finishing up I noticed that my
thumb (also my first 2 fingers but more so my thumb) on my right had had gotten
very tender and was a bit red. I put it off to abrasions from
handling the rock etc. But, over the course of the next
few days my thumb and fingers felt worse. They were reddish/purplish,
slightly swollen, warm feeling and felt like
razors or pins were in the pads of my thumb and the same 2
fingers. Anyway, over the course of the next 5 or 6 weeks all my
fingers except my pinkies (and they are starting to get sore now a little bit)
have developed the same symptoms. All those symptoms seem to be
isolated to the pads of my fingers. Now this morning I noticed that I
have like these little white circle/spots/bumps under the skin but some are
raised slightly. They hurt when I try to feel them, again like a
razor is in there. They look like white things about the size of a
sesame seed pushing up from under my skin on the pads of most of the
fingers. I also have a few that are now on the side of my finger. I
went to my doctors today and they had no idea what it was. They put
it under the heading contact dermatitis and to come back in 2-3 wks if it didn't
get
better. I told her that I was concerned that I may have gotten something from
handling the live rock with no gloves on (maybe even crystals of some sort got
caught under my skin??) She thought I was basically crazy and said she wasn't
aware of any infections etc. that I could get from live rock (she didn't even
know what LR was till I told her!) I really hope you have an idea or suggestion
as to what this may be. I have done extensive research on your site
and also found names of things (infections etc.) and done a web search but I'm
still not sure of what this is. I hope its not marine
TB, I don't think it looked like the pictures I saw but I'm getting
worried that it is going to get worse instead of better. (its already been like
6 weeks and hasn't gone away)
Please, any help would be of great help. As I
said, 2 of my others emails never got answered (maybe not great ??
LOL) but if for some reason you do respond to me without using the reply
button, the "0" in my screen name is actually a
zero, not the letter o. Desperately awaiting a reply, Jan
<Jan... please do seek another doctors opinion. Also, read our coverage on
diseases and mycobacterium as well as another former a colleague of ours (may
not apply to you... but I hope it frightens you into wearing gloves properly to
handle live rock!). My first impression from your symptoms stated was that you
got calcareous spicules embedded into your skin from handling a sponge (common)
or that you got setae (bristles) from segmented worms in there. This would
definitely cause a prickly feeling like fiberglass in the skin. Please do seek a
doctor with experience in aquatic pathogens. Likely little to worry about... but
do play it safe. Speedy recovery, my friend! And please do give us a follow-up
later. Kindly, Anthony http://www.wetwebmedia.com/Wound.htm
http://reefkeeping.com/issues/2003-07/sp/feature/index.htm
>Sore Fingers... Infection from My Saltwater Tank: Follow-up - 8/21/03
Hi crew at WWM...I just wanted to give you a follow up email about my
fingers.
<much appreciation!>
So as it turns out my symptoms were getting worse over the past week - the
little bump things started to move up the sides of my fingers, they appeared on
the palms of my hands and near my wrist. Then Saturday morning I woke
up and the joints in 3 of my fingers were really sore.
<yowsa...>
I called my Dr's office and got an appointment with the infectious disease
doctor who finally saw me today....as it turns out I do in fact have a
mycobacterium marinum infection.
<Doh! I hate when that happens>
(I'm pretty ticked at my Dr. as I originally asked her to look up M. Marinum and
she told me to calm my "bacteria imagination"
down. Obviously she had no clue eergh)
<don't be too upset... keep in mind that few doctors (inland particularly)
ever see the pathogen. Most go a lifetime and never do. You did the appropriate
thing by seeking other opinions and research>
Luckily I don't have the TB type but a different strain I guess?
<yep... really no biggie at all when caught early. Just some meds and the
need for a lot of yogurt after the antibiotics <G>>
Anyhoo, I just filled a prescription for a pretty strong antibiotic
which I'll take twice daily for at least 3 months.
<ah, yes... have had several friends go through this... your tummy will be a
but upset afterwards, but none the worse for wear>
Hopefully they won't bother me - he said they were pretty strong and some people
get sick etc. from them.
<heehee... fruit and dairy will not be your friends for a while. Eat them
strategically with green bananas, rice and olives to ...er, counter the effects.
Doh!>
Guess we'll have to see.
I really wanted to thank Anthony (he happened to be the one to reply to my
original email) for getting back to me with his input and suggesting I see the
infectious disease doctor.
<very welcome my friend>
I guess I've learned my lesson, I really had no idea all the lil'
nasties one could get from an aquarium.
<they are rare... but it is very important to wear gloves when working with
aquatics and most any creatures in animal husbandry. Few are toilet trained
<G>>
I will surely wear gloves whenever my hands/arms go into the tank!
<very good investment>
I've only had the tank a few months and I'm learning so much from your
website. I'm on here everyday reading every saltwater subject you
have! I'm glad that this ordeal hasn't scared me away from the
hobby.
<excellent to hear and very intelligent. Truly a rare happenstance. No need
to avoid your love and passion for the sea because of it>>
Probably not possible... besides the clean up crew I only have 2
fish, well 3 if you consider my "evil" blue damsel a fish
LOL but I could watch them all day! My daughter and I will sit up
late at night with the flashlight checking out the live rock
creatures....amazing! Once again, you guys and gals are
terrific. My fish and I thank you for all the hard work you put into
maintaining the site.
<very very welcome my friend!>
One more thing, I've been trying to purchase Bob Fenner's book CMA
and thought I had seen it available for sale on your web-site.
<actually from Di his wife direct, but they have been in Indo for the last
two weeks... will be back next week>
I went to purchase it yesterday and can't seem to find the link
anymore. Is it now only available thru the 3 web-stores you have
links for (Di's store etc.)
<not at all... er, that is.. if you don't want it signed... it is on
Amazon.com and numerous other mail order aquatics places (Custom Aquatic,
MarineDepot, Champion Light and Supply, That Pet Place, Barnes and Nobles,
etc)>
I really wanted an autographed copy and Di's store wouldn't put the order thru,
some error or something so I figured they may have run out.
<ahhh, yes... some glitch due to their absence no doubt. Do try them again
next week my friend>
If you could let me know if its possible to get it through your site still I'll
get it here otherwise I'll just order it un-autographed ;-) online
somewhere. Jan
<best regards, Anthony>
|
Sore Fingers... Just an Update/Reply
Hi again WWM (and Anthony, my "reply" guy).
<cheers, dear>
Just happened to be browsing your site (oh alright, I'm here reading
everyday!) and happened to see a reply from a Dr. to my "finger
dilemma" post.
<ahhh, yes... Dr. Allen>
If I could clarify my "being ticked at my Dr." reply that would be
great ....the only reason I was a lil' upset at my Dr. was because when she told
me she had no idea what it was and lets go with c. dermatitis for a few weeks
and see if it goes away, I gave her a paper with the name of (what I
thought I had) Mycobacterium and asked if she wouldn't mind just looking it
up for me - not only did she refuse to look it up she chuckled at me and told me
to "calm my bacteria imagination down"! Mind you that I
live on the East Coast/Boston area so very near the ocean and also telling her
my fears of handling the live rock, I think she should have made an
effort to at least check it out for me while I was there (I even told her about
this site, which is where I originally read of it, and she didn't want to
know...)
<yes... agreed, the dismissive attitude even without your coastal residency
is indeed disappointing>
I just wish she was a big enough person/dr. to admit she had NO idea and either
look it up for me or immediately refer me to someone else, instead she told me I
had c. derm and that was it...
<truly disappointing>
And yes, I will be sure to inform her that I actually *do* have what
I asked her to look up for me and not just an over active "bacteria
imagination" lol...maybe it will help some other patient out.
<exactly>
By the way...any idea of about how long it takes for the antibiotics to start
working some magic? I know its only been about 10 days but my fingers
are still sore/sorer, more bumps appearing <hmmm... variable for folks but
slow. Many stay on the treatment for ~ 4 months to kick it. Quite long as
antibiotics go>
and now I have a stomach ache [sic] a lot of the time c/o the antibiotics LOL.
<I can only imagine!>
(not to mention that now I'm wicked creeped out thinking maybe I have
bugs/parasites in my fingers - just kidding, that's just my bacteria
imagination kicking in I guess LOL )
<ha!>
The infectious dis. Dr. told me that they may not work at all and we may have to
switch to a different type of antibiotics.
<correct... 'tis what I recall from friends>
I may give a call back to him but was trying to be patient/optimistic. To
make a long email even longer.....I got Mr. Fenner's book, CMA, yesterday and I
LOVE it. I believe I've already read it from cover to cover!
<outstanding... and do share your wisdom in kind>
Today I am going to order the Reef I. book as well.
<did get your order... kind thanks!>
(I really admire both Anthony and Bob not only for their wealth of knowledge-and
humor- but for donating their time to help us all out on this great site (as all
the crew on WWM does!)
<its a labor of love>
Does the RI book cover sump design/ideas - I wouldn't have thought it to but I
think I read a reply here that stated there were like 100+ pages designated to
that subject?
<roughly 20-30 for sumps/refugiums... the balance to components like plants,
algae, live sand. And yes... indeed described refugium styles>
As I said in my last email, I've only had my 55g tank for about 3
months so I'm still doing a lot of adding/upgrading to it. I
want to add a protein skimmer ASAP but wanted to install a sump first to house
all the equipment and free up the space in the main tank (think I'll put the
sump in my basement where I have lots of extra room and plumb it up) I
have no idea on how this is done so I'll have lots of reading up on it ahead of
me! (change topic)
Any thoughts on compact fluorescent lights... I'm off to order the custom
SeaLife 260W - 2 10k, 2 actinic - with 4 moonlights for my tank which will be
home to fish/inverts and some *easy* cor
A Doctors Input on Fish TB - 8/22/03
<Cheers, Doc :) >
Glad to see on today's post that Jan got to see an infectious disease specialist
as recommended.
<yes... whew!>
Thanks for advising going easy on the primary care doc. You are right that most
of us have never seen this pathogen.
<yes... so true. Certainly not fair to blame your doctor about some rare and
obscure pathogen. Its unrealistic to expect your doctor, or electronics
technician or broker to know every possible thing there is to be known in a
given industry. Common sense should compel one to get other opinions if
necessary for an intelligent consensus (fortunately this aquarist did)>
I only learned about it when I became a marine aquarist. People should never be
afraid to question their doc (we're only human) and seek second opinions if they
are skeptical of the first one.
<true, true... not a bad thing at all. And surely not taken as a slight by
good doctors either.>
It would be worthwhile to politely inform the first doc of the final diagnosis
so that he/she will be aware of this possibility if seeing an aquarist in the
future.
<ahhh... good point. I wish I had though to mention it. Will be posting as
always.>
Steve Allen, MD
<kind thanks as always, Anthony>
A Nasty Owee 12/9/2003
Good morning,
Yesterday while cleaning my tank I had a small cut on my thumb. <Did you cut
yourself before putting your thumb in the aquarium or on something inside?> I
accidentally touched the elegance coral and was stung by it. <Ouch!> My
thumb is now swollen, red and tender. <Either a toxic reaction or an
infection.> Should I go see the doctor or give it some time. <Go to the
doctor ASAP. If this redness is spreading, you may have cellulitis, a
potentially serious infection requiring antibiotics.> Also, what
is the active ingredient in the poison. <Uncertain. I could not get any
specifics on the Internet. Most of these toxins are a mix of noxious
things--local irritants, anticoagulants, neurotoxins. Most reactions are
localized burning & swelling, but can be more severe depending on type &
amount of venom. Allergic reaction can be severe. Some aquarists have had neurological
symptoms like numbness & tingling, loss of taste. Check here for more info: http://www.emedicine.com/wild/topic18.htm>
Thanks, <You're welcome. I hope this heals quickly, Steve Allen>
-Brent
<There's a lesson here for all. It is best to wear arm-length gloves when
messing around in your reef tank. Here's one source: http://www.drsfostersmith.com/product/prod_display.cfm?pcatid=3871&D=gloves&R=7795&Ntt=gloves&Ntk=
All&Dx=mode+matchallany&Ntx=mode+matchallany&Np=1&N=2004&Nty=1 Also,
NEVER EVER put your unprotected skin into the water if you have an open wound
(scratch, laceration). The tank is a veritable cesspool of potentially
infectious agents and broken skin is an easy access point for them to infect
you. Intact skin is your primary line of defense against infection.>
Fish germs and other yucky microbes--Eww! (12/08/2003)
hello,
I got a question here. If we handle a fish which are sick like, body fungus,
gill disease, or other disease with hand without glove, will the disease effect
us? or is there any side effect to us?
thanks. sorry for my bad English. hope u reply a.s.a.p
<While many fish diseases can't infect humans, some do, so it pays to be
cautious. Bacteria are very good at entering the body through the slightest
break in the skin (cut, scratch or scrape) and some (Vibrio, Mycobacteria) can
cause nasty infections. Fungus is probably less likely, as are the various
parasites. Fish tapeworms have been known to infect humans. If you got tapeworm
eggs on your hand and touched your mouth you might get infested.
The best bet is to always wear gloves if you need to handle your fish.
Latex-free surgical-type gloves from the local store will provide good protection. If
you're going to put your hand in the tank, it's best to wear arm-length aquarium
gloves. In any case, always wash your hands thoroughly with hot, soapy water or
use an alcohol-based skin cleanser after handling anything that's inside your
aquarium. Steve Allen>
Mycobacter marinum
Hi Bob-
While surfing my favorite fish site I came across your article on
Mycobacter marinum. I too had acquired the infection-twice.
The first time I went to the ER I was given some antibiotics that didn't help.
By my third visit to the ER I was immediately sent to our local plastic surgeon
(the infection was in my right index finger.
I was rushed into surgery within 30 minutes and stayed in the hospital for 6
days. It was 4 days before the source of the infection was found.
<Lucky just the same...>
For this I received massive doses of antibiotics both orally and by I.V. My
finger and hand remained swollen for 6 months until my second bout of it. By
this time I knew what was coming and got to the Dr. in time to stave off the
severity of before.
The surgery involves opening the infected site and SCRAPING the infected area,
on me it was the ligament sheath, flushing the open wound for 6 days (the wound
needs to stay open so the infection does not get trapped inside and the wound
has to heal from the inside out)
and then to top it off I need physical therapy 3 times a week for 5 weeks to get
mobility back, even then it was a bit stiff and swollen.
<Yes... very painful, inconvenient, frightening>
It's been since Jan 7 of this year since the last bout of this. My finger just
now looks to be normal size.
Best precaution??? ARM LENGTH VINYL GLOVES & a MAG FLOAT!!!
Cause of infection: getting scrapped by live rock while cleaning the inside of
the glass.
Lesson learned!!!!..............................Lance
<Thank you for sharing your harrowing experiences. You have helped many
others. Bob Fenner>
More Mycobacteria transzoonoses... It's not "just a scratch"
Friend of mine is at the hospital now with an infection he kicked up with a
cut in the aquarium. They are telling him he has a form of Tuberculosis and want
to operate. I saw an article about an infection or bacteria that can be picked
up this way but cant locate it. Can you help. I mentioned this to him a week ago
but he laughed it off. Thanks
<Not, NOT a "laughing matter". Please have your friend and his
health practitioner read here: http://www.wetwebmedia.com/Wound.htm
and more importantly, the associated FAQs file (linked, in blue, at top). These
"aquarium wounds, infections" can be VERY serious indeed. I wish your
friend (and they are fortunate to have friends like you) good health, recovery.
Bob Fenner>
Re: Mycobacterium
Thank you, my friend has been diagnosed with Mycobacterium marinum and they
will operate this week to remove two granulomas. Aquarists need to be made
more aware of this hazard. He was told he could have faced amputation if he
had ignored it much longer. Thanks for your prompt response. Paul
<And you for your input. Will be posted, shared. Bob Fenner>
Cleaning Fish Tank Can Lead to Infections
NEW YORK (Reuters Health) - Owners of tropical fish be warned: Cleaning the
fish tank without wearing gloves may get you a bacterial skin infection,
especially if you have an open cut or abrasion on your hand or a depressed
immune system.
Writing in the medical journal Clinical Infectious Diseases, Dr. C. Fordham von
Reyn and colleagues from Dartmouth-Hitchcock Medical Center in Lebanon, New
Hampshire, describe eight adults who developed sores, mostly on the arms, after
cleaning their fish tanks.
In six of the eight individuals, lab tests showed the culprit to be
Mycobacterium marinum, a bacterium first identified in dead aquarium fish in
1926. This bug was found to infect humans in 1951 after being isolated from skin
lesions.
The use of chlorine in swimming pools has drastically reduced the number of skin
infections among swimmers. Today, most reported skin infections linked to the
bacterium come from contact with fish tanks.
Antibiotic therapy took care of the infection in most cases. But one patient's
infection failed to resolve after about two years of drug treatment as well as
attempts to cut out the sores. This patient had a depressed immune system. He
had psoriasis, melanoma, and was taking steroids. .
Fish-tank exposure is the source of "most cases" of M. marinum skin
infections, the researchers warn, and may be preventable by using waterproof
gloves.
SOURCE: Clinical Infectious Diseases, August 1, 2003.
<Thanks Miguel... a growing (awareness) concern. Bob F>
Health Concerns (3/17/04)
Hi Crew, <Steve Allen tonight>
I wish to thank you for your help in the past with my evolving for
tank into a full blown reef system. <We are always glad to help.> Through
browsing your site I came across the sections regarding bacterial and viral
infections which could possibly be passed from tank/animals to humans,
especially regarding the "various respiratory ailments" mentioned.
Tank specifications are:- 230G marine FOWLR evolving slowly to reef.
(I do siphon water out by mouth for the record) <Many people do. I'd suggest
spit & rinse right away after, maybe even with Listerine, but I'm
paranoid.>
I'll try to cut a long story short. 1yr 5 mths ago I had what I
though was a minor throat infection, the symptoms being a very dry throat and
later in the weeks that followed, the feeling of a golf ball sized lump in my
throat, bellow the "Adams apple" area. All very frightening until one
morning at 2am I found I could hardly breath. I asked my wife to drive me to the
hospital
ER unit which she did. I was sent home with the diagnosis that I had a sore
throat !!!........That's another story!
Later that day I went back to the hospital and was immediately
admitted and put on antibiotics IV. The resultant diagnosis was "Epiglotitis"
(a swelling of the vocal chords <actually, its the epiglottis, the
lid that prevents food from going down the trachea>) which can be very
serious indeed. <Scary disease, can be fatal. Many young children used to get
this from Haemophilus influenza B (Hib). Thankfully there's been a great vaccine
available for more than a decade. As a pediatrician, I have not seen a childhood
case in 10 years. It is rare in adults, but can be caused by other pathogens. I
almost lost an adult cousin to it.>
This all came with hundreds upon hundreds of tiny (but fairly painless) ulcers
which completely coated my mouth and throat. <Definitely not Hib.> They
tested for cancer and all else but had no idea where this had come
from........They were completely at a loss, had no idea. Until, somebody asked
"Do you keep any unusual
pets"?..............Well the answer was yes and still they were none the
wiser.
My question to you my good friends is, have you ever heard of
anything even remotely like this before? I am really struggling to get anywhere
with this as I am still suffering from the lump in the throat and the very dry
throat. This is over a year now and although it comes and goes it is still of
some concern. <Understandable. I trust you have seen an ENT specialist and
had a laryngoscopy and perhaps an MRI. I am not aware of anything from your tank
that would likely cause such a thing, unless you have some known toxic fish or
invert in there. With your problem, I would certainly advise not starting siphon
by mouth, just to be safer. Since no infectious pathogen was isolated and you
are still having problems, I'd suspect it is some sort of allergic/inflammatory
reaction to an irritant or toxin that you are inhaling from somewhere. Do you
get hives ever? Wheezing or asthma symptoms? Do you work with hazardous
materials in your job? It might be worth consulting an allergist or an
environmental physician.>
Any help at all you may be able to offer will be very much
appreciated With much gratitude. <You're welcome. I hope this helps a bit. I
suggest you continue to work with your doctors on this one. I hope this problem
is solved for you soon.> Simon
Health Concerns 2 (3/17/04)
Many, many thanks for your quick reply. <You're welcome.> Yes I realize
the swelling is the epiglottis but for general purposes some people may not know
where ones epiglottis is ;-) I have seen the ENT specialist and she had several
looks at the state of the
epiglottis which was indeed very bad and according to her if I had left it any
longer I would not be here now! <Good thing you went in>.> What is
really puzzling me is the fact that they cannot decide whether it is bacterial
or viral? I would have thought if it were viral then IV antibiotics would not
have helped much but they did reduce the swelling a great deal. <Bacterial
diseases are diagnosed by culturing bacteria from the infected area. Sometimes
we are unable to get anything to grow in culture even when it is there. The fact
that antibiotics helped suggest there was some bacterium involved because, as
you obviously know, antibiotics are not effective against viruses. Specific
viruses are more difficult to diagnose unless there is a specific, unique
syndrome such as chicken pox. We often fail to get a definitive diagnosis in
viral infections.>
I am not presently suffering from any more of the hundreds of little
ulcers, have not had those for a year now so am just concerned about the lump
and the dryness in the throat. Never had Hives. I do not work with any hazardous
materials. Have had several laryngoscopies. No asthma, no wheezing. <I just
noticed you hail from the UK. It sounds like you NHS specialists are being
thorough.>
Thank you so much for your prompt reply. This has reiterated my own
concerns ie the problem could be "environmental" but I do have to get
to the bottom of this. <Yes. I hope you do soon.> Again if you hear of or
find out anyone else has suffered anything similar
would you be kind enough to let me know. <Do consider posting this dilemma on
the forum at www.wetwebmedia.com The forum "Zo's Bar &
Grill" is read by a lot of our users and if any o them have any ideas,
they'll chime in.> Cheers.........Simon <I hope you are restored to full
health soon. Steve Allen.>
Pet-fish owees!
Bob:
This picture accompanied a brief article about Mycoplasma marinum in a recent issue of the New England Journal of Medicine. This is a teaching slide, so it should be acceptable to post as fair use for education our readers.
Steve
<Yowzah. Will post... but not near dinner time. Bob F> |
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URGENT! Medical question: Aquarium related Human
Skin Infection (8/13/04)
Greetings crew,
And greetings to you as well....Leslie here for the crew this evening>
I have a quick and urgent question for you.
<Sure I will do what ever I can to help that's what I am here for.>
I am in medical school and a fellow classmate of mine has a
patient that they are following with a rather serious infection.
<Utto, sorry to hear that>
My colleague--knowing of my avid passion for marine aquariums--
requested my help. It seems their patient cut his arm on some rock
(assumed live rock) in their marine aquarium 5 days ago. It is now
a very serious sub-dermal infection taking up the majority of their
forearm--serious enough for hospital admission.
Lab results and cultures are pending (won't be ready till tomorrow
night at least). The patient is currently on broad-spectrum IV antibiotics.
<Well it sounds like your friend's patient is in excellent hands, however
enlisting the services of a consulting an Infectious Disease Specialist
might be appropriate. >
My question to you (that was asked of me) is this: What microbe is most likely
to have infected this patient?
<Well the first thing that comes to my mind is Mycobacteriosis caused by
the organism Mycobacterium marinum.
I am not a Physician but I do work in the medical field as a
Registered Nurse and I have had personal experience with this
particular infection.........my experience is written up in this article
which you may find helpful.....
Mycobacteriosis: An Infection You Could Acquire From Your Aquarium
which was published in FAMA but can be found here as well
http://www.syngnathid.org/articles/mycobacteriumInfection.html>
What are the most likely characteristics?
<The articles and references listed below will give you a pretty good picture of
the characteristics as well as the clinical course, but basically the organism
causes a localized nodule/s typically on the upper extremity. These are
erythematous ranging from 0.5-3.0 cm in diameter, may be tender and/or actively
draining. I can tell you mine was quite painful.
As an addendum to my article I experienced what at the time I thought
were premature peri menopausal symptoms with "hot flashes". Well since my infection was not diagnosed until it was almost completely
resolved .....in retrospect what was actually occurring were mild
low grade fevers of 99.9 to 100.3 with associated chills alternating
with diaphoresis, on a regular basis, for over a year and long after the
lesion on my arm had almost completely resolved. My annual skin test
for TB was always negative prior to this infection. Now is falsely positive and
additional evidence that despite not having the lesion cultured that I did in
fact have this infection. >
Assuming the aquarium was the source, and it came from the rock,
I am assuming it is an aerobic organism. That is about all I can get from
my knowledge. I have no idea if it would be gram positive/negative, motile, coagulase+/-, etc.
< If M. marinum is the culprit then it is a moderate-growing, non motile
photochromogenic, acid-fast bacilli which did not come from the rock as it
is a water borne pathogen. >
Any information you have on this would be most helpful.
Here are several references I have found interesting and informative.....
Mycobacterium marinum: The Fish Disease You Could Catch by Steven Pro: http://reefkeeping.com/issues/2003-07/sp/feature/index.htm
Mycobacterium Marinum Infection of the skin:
http://www.emedicine.com/derm/topic281.htm
Mycobacterium Marinum Main Index:
http://www.medicinenet.com/mycobacterium_marinum/index.htm
Atypical Mycobacterial Diseases:
http://www.emedicine.com/derm/topic930.htm
http://www.fpnotebook.com/DER129.htm
http://www.medicinenet.com/mycobacterium_marinum/article.htm
There is a photo here in the New England Journal of Medicine in Images in
Clinical Medicine:
http://content.nejm.org/cgi/content/full/350/9/e8
This article lists a few other aquatic organisms that cause human disease: http://www.freshwater-aquarium-fish.com/articles/human_aquarium_pathogens.htm
Thank you and once again, you (the WWM Crew) are a true
credit to the hobby and a wonderful resource.
<You are most welcome. I hope this information is useful. Please let us know
what the results of your friend's patient's work up reveal and thank you for the
accolades. Best of luck to you both in your studies and careers, Leslie.>
Photo
Dear Bob,
On your site there was a picture (Steve Pro's
"owee"...www.wetwebmedia.com/TopicsPIX/Wounds/HandStevePro.jpg)
I am writing a medical-biological book on dangerous marine animals and I would
like to ask if I can use the picture for the book?
With kind regards,
John
<I am the photographer. Is this book of a commercial nature or more
instructional? Bob Fenner>
Re: Photo
Hi Bob,
Although it is used by a few organizations as a instruction book it is
mainly commercial. It is not supported by the government or something.
John
<I see. As it is only one image and the topic intended I am inclined to grant
its use. Please do credit myself as the photographer and WetWebMedia as the
source. Bob Fenner>
Re: Photo
The sore was caused by an infection of Mycobacterium marinum. I wrote
an article about it here
http://reefkeeping.com/issues/2003-07/sp/feature/index.htm If there is
any other information or if you have any questions, feel free to ask me.
Sincerely,
Steven Pro
<Thank you Steven. I do hope/trust that this writer will ask re disclosing your
name in association with the photos use. Bob Fenner>
Hand Photo
I saw the picture of my hand on the main page of your website.
<Yes, though Mike.K doesn't quite agree, thought it was about the best
"poster image" for the new "scientific index" for WWM>
For
your information and that of your viewers, the infection cleared up
after three months of three times daily antibiotics. I cannot remember
which antibiotic it was because I had to change three times before we
found one I could take. At the end of the treatment time, I was cured
of the Mycobacterium infection but had a new problem. Being on antibiotics for such a long time wreaks
havoc on one's digestive
system. It took six months of eating yogurt to be able to have milk and
I still have problems with certain fruits (peaches, strawberries,
grapes). Since then I have been using Coralife's gloves, but they tend
to leak. I am looking into gloves from a vet. I saw some high gloves
that were used to help remove a calf during birth. I am trying to find
a source for these now.
Hope all is well,
Steven Pro
<Yes my friend. Do read through the article, FAQs especially having to do
with this phenomena: http://www.wetwebmedia.com/Wound.htm
Bob Fenner> |
Atypical Mycobacterium and Aquariums (5/11/04)
I have been diagnosed as having a rare infection, caused by "atypical
Mycobacteria". <Sorry to hear.> (There is a photo posted in the FAQ's
- http://wetwebmedia.com/woundfaq.htm
- but my case is not as serious as the poor guy shown there). <Thank goodness.> My doctor is giving me special
antibiotics, called Minocycline. <Should help, but treatment of this infection may take a long time.>
My question for you is: Is it possible that my infection came from my aquarium (freshwater, 150 liter, tetras). <There are many types of "atypical"--as in non-TB--Mycobacteria, some from birds and some from fish. Perhaps the doctor can tell you what species.>
How can I treat my aquarium? <I would consult a veterinarian with expertise in fish. Perhaps they could culture the tank. This infection is very difficult to eradicate. It usually requires a complete takedown and disinfection of the tank and its contents. The fish need o be treated with antibiotics effective against Mycobacteria, sometimes by injection. I also recommend never putting your hands in your tank without wearing gloves. Shoulder-length aquarium gloves are available online or at many local retailers. Steve Allen.>
Zebra Danios With TB 12/05/2005
Hi, We have 10 gallon tank and have started the tank 4 months from now. We bought 3
Danios to start with, and they did very well for first 2.5-3
months. We used to do weekly water change. Our local pet store suggested to not to change water for first month to have fully cycled tank. We stopped
the water change. I am not sure if this is the cause or something else, but we lost our smallest fish during this time.
Rest two fishes has lived fine for some time and they started slowing down. They used to eat a lot and swim around in whole tank that is filled with
natural plants. They stopped eating with that eagerness. They stopped playing. We noticed that their spine is also got curved.
First we were thinking that they are getting old. After reading FAQ section in your
website, we are scared about fish TB.
I have been touching the water to clean up the tank. Though I don't have any wounds, but still I am scared and wanted to know what measure we can take to
diagnose if we got infected or not.
About the fishes, now they both are dull and during the night they lie down on the bottom of tank. Actually till light is off mostly they lie down on
the bottom. If light is on, they try to swim. We can see they have hard time swimming. They most stand still at one place. I have also read on internet
somewhere that when they are at the end of their life cycle, then also they develop curve in their spine. So how do I know if my fishes have TB or they
are just old.
In summary these are questions I have.
1) What measures can we take to find out if we have infected ourselves with the fish TB?
< Fish TB is very very rare. If people were getting infected and it was a problem I think you would see warnings all over the place. As a precaution I just wash up after having my hands in an aquarium.>
<Rare in people, yes.... but I have seen many, many cases in fish
lately - many of which were Betta splendens.... -SCF>
2) how do I find out if my fish's spine is getting curved because they are old or they have fish TB?
< More than likely your fish are getting old. Usually these little guys don't last more than a couple of years tops and the
contouring of the spine is one of the signs of a fish getting older.>
3) In case of fish TB, how do I sterilize the whole tank? Do we have to start from scratch for the new fishes?
< I think you fish may have gotten ill due to poor water quality. Check the nitrates. The lower the better. These little guys like clean well oxygenated water.-Chuck>
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