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Toxins #6 – Fish Handler’s Disease

Fish Handler’s Disease:
 
This is an infectious disease caused by the bacteria Erysipelothrix rhusiopathiae, commonly found on fish, oysters, clams, and other crustaceans. 
During the process of handling and cleaning the catch of the day, small cuts and scratches can occur on the hands which allows the Erysipelothrix bacteria to breach the skin and cause a cellulitis.

Symptoms of Fish Handler’s Disease:

• Onset of symptoms is usually 2 – 7 days after exposure from handling and cleaning fish, oysters, clams, or other crustaceans.
• Most commonly occurs on the hands, typically in the web space and dorsum of the hand between the thumb and 2nd finger. 
• A well demarcated area of erythema, with burning, itching, pain, and swelling. 
• The area of erythema will expand approximately 2 – 3cm per day. 
• As the cellulitis progresses, the patient can develop fever, joint stiffness, lymphangina and lymphadenopathy.

Treatment:

• Clean the area of the wound well with soap and water.
• Soak in non-scalding hot water with Epsom Salts, 3 – 4 times per day.
• Oral antibiotic: 
  penicillin VK 500mg po qid x 7 days,
  or cephalexin (Keflex) 500mg po qid x 7 days,
  or Ciprofloxacin (Cipro) 500mg po id x 7 days.
• Make sure they are up-to-date for tetanus prophylaxis.

For more details on this an other ocean-related toxins see the July/August 2006 edition of the Wilderness Medicine Newsletter.

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