Diving and serious infections

[lulubelle]

Hello,

I have been reading about serious infections seen in divers.

I take a medication which makes me somewhat immunosuppressed and in fact had a very serious issue last fall (sepsis) which was thought to be unrelated to diving. So i am trying to be better informed about this risk.

So what is the incidence of serious infections such as Vibrio in divers? While I am sure that they are more likely in immunocompromised divers, are they seen more often in immunocompromised divers? Or are these incidences very rare?

Secondly, is the risk particularly to diving, or are these infections just as likely when swimming from shore, walking in knee deep ocean water, or sitting on a beach. I had read articles recently about some of the lovely things which are being cultured off of beaches.

I am trying to decide if diving is really any worse of a risk to me than being on a beach, walking in the surf, being on a airplane, etc. One must go on living even if these risks are present.

My decision for now is to give up diving in a shorty to minimize coral scrapes, cuts from wrecks, etc.and to wear gloves when diving in areas where it is permitted. I won't dive with fresh cuts as most of the Vibrio reports I read appeared to be related to a cut gone wild.

Thanks for weighing in.

 

[TSandM]

Lulubelle, I spent some time searching this morning, and as I expected, I came up with little hard information to offer you.

The intersection of the set of chronically immunosuppressed patients and scuba divers is going to be a small set. Many conditions that require immunosuppression are going to leave the patient unwilling or unable to engage in strenuous activity. Until recently, we didn't have a lot of immunosuppressive agents to choose from, and the majority were fairly toxic. Transplant patients would probably be the people living closest to a normal life under immunosuppression, and I doubt anyone has studied transplant patients who dive.

It is clear from the literature that there are potentially pathogenic bacteria in both salt and fresh water. It appears it is worse in areas you'd expect to be bad -- polluted rivers, the vicinity of fish farms, near sewage outfalls, and the like. It also appears that long term exposure to water (as saturation divers have) encourages the growth of water-loving organisms like pseudomonas (one which is notoriously difficult to treat).

But for a normal scuba diver, diving away from heavy pollution and not staying in the water long enough to develop skin breakdown, I suspect the risks are not that high. Otitis externa definitely tops the list of dive-related infectious processes, as it is rather common. I would strongly recommend an immunosuppressed patient exercise diligence in prophylaxis of ear infections.

Otherwise, I think you have to recognize that you are at some unknown degree of increased risk for infection when exposed to marine organisms. But remember, your gut is a cesspool, and you are probably far more likely to get into trouble with your own native flora than with the low bacterial counts in open water, the only exception being open wounds.

 

[lulubelle]

Thanks for your answer Lynne.

That is the way I was thinking about it. It seems to me that swimming from shore or walking on the beach would be higher risk activites than diving offshore or in remote areas. From what I have read about Vibrio infections, they generally took advantage of an open cut or wound from a coral, etc. So I'm thinking that giving up the shorty and protecting my legs with a full length suit or skin, and my hands with gloves where they can be worn should probably help me reduce my risk from this particular one.

Also good tip about the ear prophylaxis, that's easy. I never do that, and have not had an infection, but that does seem to be a risk that would be higher in divers and an easy one to reduce.