Copyright 1998 Stuart News Company
The Stuart News/Port St. Lucie News (Stuart,FL)
May 2, 1998, Saturday
SECTION: A Section; Pg. A1
LENGTH: 938 words
HEADLINE: 16 REPORT ILLNESSES RELATED TO SICK FISH
BYLINE: Debi Pelletier of the News staff
BODY:
Troubled Waters
Doctors are trying to determine whether the reported illnesses
are caused by exposure to sick fish.
STUART - As of Friday, 16 people have contacted the Martin
County Health Department to complain of illnesses that might be
related to exposure to area waters or sick fish.
But Valerie Gryniuk, the department administrator, said she
doesn't know whether the sicknesses are related to the area's
recent water problems.
"I can't say if they're related to each other," she
said.
Over the past two months, anglers and residents have noticed
thousands of fish in the St. Lucie and Indian rivers with unexplained
lesions or growths on their bodies. Some point to the discharge
of fresh water from rain-swollen Lake Okeechobee as the originator
of the murky water and ailing animals found in the rivers.
In the meantime, a Stuart eye doctor and a family physician
have joined forces with a Maryland doctor to examine people who
think they've suffered >from exposure to the fish or water
in the St. Lucie Estuary.
"The eye is the window to the body," said Dr. Ronald
Frenkel, in explaining his involvement. "The back of the
eye is part of the central nervous system."
He and a physician who doesn't want to be identified until
he's had a >chance to catch up on the research are cooperating
with Dr. Ritchie Shoemaker of Pocomoke City, Md., who has treated
dozens of patients for exposure to Pfiesteria piscicida.
The toxic microalgae is blamed for killing millions of fish
in Maryland and North Carolina estuaries. Also found was Cryptoperidiniopsis,
which has been found in the St. Lucie Estuary and is blamed for
the recent outbreak of fish lesions here.
Health officials are careful to point out that Pfiesteria has
not been >found in Florida. But Crypto is a concern because
it is almost identical to >Pfiesteria in shape and structure.
It appears to have the same toxic effect on fish. A total of 28
species of fish have been documented with red or white lesions
on their bodies.
What's not known is whether Crypto's toxin has the same effect
on people.
"That's the million-dollar question," Gryniuk said.
"You can't take the symptoms from one situation and try to
make the second one fit. A lot more research has to be done on
this."
Since one of the common symptoms of Pfiesteria exposure is
memory loss, Shoemaker said he wants to team up with a specialist
who can do neurocognitive tests. However, he's devised some simple
methods to determine whether those tests are needed. So far, he
has heard from four Martin County residents >and has referred
them to the Stuart doctor for follow-up.
Other commonly reported symptoms include the rapid onset of
eye irritation and redness, something that often occurs after
exposure to red tide, a more common microalgae.
"I think ophthalmology-wise, it's new territory," Frenkel said. "But if you
have a central nervous system problem, it's worth looking at the
eyes."
One of the limitations faced by the health department is its
lack of >funding. "We can do blood work, take cultures
and do the basic physical exam. But if >this is an infectious
disease problem, we'll need funding to get an infectious disease
specialist," Gryniuk said.
That is something Frenkel is working on. "We need a team
to work on >this," he said, pointing out that although
he can examine eyes, a microbiologist >might be needed if cultures
are taken.
Human health effects from Pfiesteria have been reported as
far back as >1991, with the first documented research linking
the fish kills to health effects published in 1994.
But that report dealt with three laboratory workers who were
exposed to concentrated levels of the Pfiesteria toxin in a closed,
poorly ventilated environment. It was unclear whether the same
effects would be found in >people on or near the waterways.
Then in 1997, researchers from Johns Hopkins University and
the >University of Maryland provided the first "objective
medical evidence" that Pfiesteria, "or one of its cousins,
has sickened five people on the Pocomoke River," stated a
report from North Carolina's department of natural resources.
At about the same time, Maryland officially recognized the
human health implications of Pfiesteria and Shoemaker thought
he was vindicated. He had evaluated those first patients and about
50 others that he decided were suffering from Pfiesteria illness
syndrome.
As a result, the Centers for Disease Control and Prevention
decided further study was needed and divided $ 3.2 million among
Florida, Delaware, Maryland, North Carolina, South Carolina and
Virginia. Although the focus was on Pfiesteria, the investigation
has been expanded to include the human health effects of all toxic
microalgae, including Cryptoperidiniopsis and red tide.
Scientists in Maryland have isolated two of Pfiesteria's toxins
and sent >them to the CDC for further analysis. Chemist Peter
Moeller of the National Oceans Service in Maryland said he has
found "a minimum of three distinct suites of toxins,"
in the microalgae, which apparently produce the toxin when fish
excrement is detected. It is hoped this will lead to a method
of detecting the toxins in the body fluids of fish, animals and
humans.
Although there is evidence to suggest the microalgae have made
people sick, Dr. Steve Wiersma, an epidemiologist with the state
health department in Tallahassee, said that is yet not proved.
Anyone who catches or sees a lesioned fish should not eat it
and is >asked to call the DEP's hot line at (800) 636-0511.
Matt Grimison of the Vero Beach Press Journal contributed to
this report.
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