Red tide, flesh

By Dr. Raymond James, DO, Boca Grande Health Clinic

That is a good question after the storm of the century. And when might it be safe?

City Water

Everyone who was in Boca after the storm remembers how we all incorporated the new routine of the five-gallon bucket shuffle. We brought water from a brown pool or the beach to get our toilet bowls to flush. But this only works if there is room in the sewer lines. How happy we were to get water back. But E. coli bacteria and other bacteria from your gut can be in the water, so it must be boiled for one to two minutes to kill any invisible bacteria for a day or two until the water department tests the water for bacteria and confirms that the water is safe to drink. Until then, we are in a "boil water" notice for a day or two. Washing hands with soap or showering and washing clothes is usually not a problem, and most folks would not get sick from drinking a bit, but it is not worth the risk.

Flood Water

I saw a fellow wading into waist-high water to help someone in a stranded car at an intersection in North Port –with an "uh-oh" look on his face as he realized a porta-potty was floating by. When heavy rains and flooding occur, those waters are often contaminated by unfriendly bacteria and sewage exposure that you are not aware of. Thirteen million gallons of sewage from the treatment plant in Bradenton spilled into the Manatee River this past August due to heavy rains. That overflow contributed to high bacteria counts along the southern beaches that month, including here in Boca Grande.

Where does all that rainwater and contaminated flood water go from central Florida? South my friends. The Myakka and Peace Rivers gather man-made sewage with agricultural sewage sources, along with fertilizer runoff rich with nitrogen and phosphate that feed algae and bacteria and flow into Charlotte Harbor. Flooding has caused increased volume flow rates 16 times normal due to Ian, and that caused the Myakka River to rise above its banks, even flooding I-75. Surprisingly, the bacteria counts in Boca have been acceptable so far.

Beaches

The state routinely measures the water along Florida's beaches every two weeks and measures Enterococcus bacteria that are from human feces. They report water conditions as good, moderate or poor. When conditions are poor and the risk of getting an infection in an open wound is increased, the state will issue a beach warning. You can follow these testing results yourself at flordiahealth.gov, or google Florida Healthy Beaches Program. Red tide current information, including actual sampling data and location, can be found at myfwc.maps.arcgis.com, or you can google Red Tide Current Status. Currently we have moderate to high amounts in samples 3 to 5 miles off the Coast west of Stump Pass and south along Little Gasparilla. After Charlie, it took Peace River water quality four months to recover, so we can hope that early next year we can stabilize.

Flesh-eating bacteria

You may also have heard the warning about flesh-eating bacteria in Lee County. Vibrio vulnificus is a bacterium that grows in salty warm water along the sea floor and currently is thriving, causing a spike in infections. The state of Florida normally sees an average of 20 to 30 cases of Vibrio illness a year, with 5 to 10 deaths. Since Ian, Lee County has had 28 cases and 6 deaths. Like all bacteria that can cause cellulitis (an infection of the skin that enters through a wound or cut), it can take advantage of humans with a weakened immune system and begin to grow deeper under the skin and spread into your bloodstream.

People over 65 or with diabetes, obesity or on immunosuppressive drugs are more likely to be a target for bacterial infections. Deep infections under the skin can spread fast, because bacteria can double every 5 to 20 minutes. Some patients can go from a tender red wound to serious or even life- and limb-threatening infection in 8 to 12 hours. If a cut or wound, especially on a foot or leg, starts to become more red and painful, you should be seen immediately by your doctor and consider antibiotics if infection is developing.

Vibrio has been around for a long time, and we know it also can sometimes cause illness in humans who eat raw or undercooked shellfish such as oysters. For most, it is a mild illness if ingested, but if someone has an open wound and weakened immune system, I recommend staying out of the warm water of the Bay and Gulf right now and instead wear shoes and enjoy a walk on the beach. The pool is much safer, as long as it has been checked for roofing nails!

How to bathe after the storm of the century

Three days after Ian none of us had bathed, and some of us (me) were smelling a bit "ripe," so a few took advantage of the deserted beach to bathe as the sun set. It looked quite inviting until my mind began to process the risk/benefit ratio, and my wife said, "Don't even think about it."

I decided instead to bathe in my hot tub that I had been prepping for such a purpose. The day after Ian passed, I had pulled part of the roof out and scooped up the leaves and debris and dumped all the pool shock I possessed into it. After three days it was kind of blueish green, with a haze of cloudy debris and probably dead bacteria and algae forming a murky layer along the bottom. Not until I eased into the cold water naked that next morning at 5 a.m. in the dark did I let out a shriek as I stepped on a roofing nail hidden in the murky bottom layer. I pulled hundreds of nails, screws and staples out of the pool and hot tub over the next few weeks. Another unforeseen danger. Thus began the next chapter – recovery.

Note in the photo above from NASA, the brown water from Charlotte Harbor blooming out from Charlotte Harbor as it is ejected through Boca Grande pass. The brown water is high in tannin from decaying vegetation. In contrast, some of the Gulf is lighter green than normal due to sediment stirred by Ian from the bottom reflecting light. Go to "Watercolor Seas in the Wake of Hurricane Ian" to slide back and forth between satellite views of the Florida Gulf Coast September 22 and then October 1.