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water near shore at the dive facility. Again, the water used
to fill the rinse tanks was found to be safe. But this time the
bacteria that developed throughout the day were identified,
confirming that some likely originated from the ocean and
others from the divers themselves.
None of the identified bacteria would be considered overt
human pathogens, but some are considered opportunistic
pathogens: They could infect individuals with compromised
immune systems or may infect open wounds. Bacteria
identified in the communal rinse tanks are generally
associated with unsanitary conditions. Where these bacteria
are present, other pathogenic bacteria may occasionally
occur. The scope of the study did not include checking for
viruses usually found along with bacteria that may cause
serious diseases.
In the eye of the infected
In March 2006, a group of 27 health-care providers attended
a conference at a dive resort in the South Pacific. On the
second day of diving, two divers reported eye problems, and
over the next few days 13 divers (roughly half of the group)
were diagnosed with conjunctivitis, an inflammation of the
eye. It is characterized by the sensation of a foreign body
in the eye, redness of the mucosa and possible discharge.
Conjunctivitis of viral or bacterial origin spreads easily
from person to person through close contact. There was an
outbreak of conjunctivitis among the local population, but
the divers did not have much contact with them.
Two physicians from the group investigated the spread
of the conjunctivitis among the divers. They concluded the
conjunctivitis originated from a divemaster who had an
eye infection prior to the diver outbreak. The divemaster
placed his mask in a communal container of diving
masks, which apparently became the means by which
conjunctivitis was spread among the divers. Only divers
who used this tank were infected. Those who did not use
the tank were not infected despite close contact with those
who were.
To prevent further spread of infection, divers used bleach
and detergent for mask cleaning. Affected divers received
antibiotic drops and ointments and were healed in the next
several days. One diver manifested symptoms after returning
home. This case study demonstrated that disease can be
spread among divers using communal rinse and storage
containers. Conjunctivitis is a disease with short delay from
infection to symptom manifestation, which made it possible
to identify the source of infection. Other infections may
have been transmitted by the same means, but due to longer
periods of incubation as well as occurrences after the divers
returned home, the link to communal tank was missed.
Based on the lack of reports, the risk of infection by means
of communal rinse tanks appears negligible, however, it’s
possible divers incorrectly attribute such infections to other
sources. Miller’s findings and the report of the conjunctivitis
Beach Bacteria
Waterborne disease outbreaks (WBDO) have been
reported in people bathing in pools and rivers but not
among seaside beachgoers. However, due to presence
of the diarrhea-causing microbes on seaside beaches,
epidemiologists assume that cases of gastroenteritis
resulting from exposure to marine pathogens must be
common, too. The summertime increase in occurences of
gastroenteritis in coastal states indicates a possible role of
beaches in disease transmission.
In 2009 and 2010, scientists discovered methicilin-
resistant staphylococcus aureus (MRSA) in the sand of
many beaches on both the West and East coasts. MRSA
causes intrahospital infections with a high mortality rate
due to its resistance to many antibiotics. MRSA also
occurs outside of hospitals, but the source of infection
is not known. Seasonal increases in MRSA infections
coinciding with times of increased beach use may indicate
beaches are a possible means of MRSA transmission.
“If equipment is not properly
cleaned, dried and stored after
use, colonies can grow and
microbes can reach sufficient
numbers to infect users.”
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