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Under the Boardwalk: Impact of warming sea waters

By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

In 1964, the Drifters released the popular song Under the Boardwalk written by Kenny Young and Arthur Resnick. The song has been covered by numerous artists and actors including Bette Midler, the Rolling Stones, Bruce Willis, Sam & Dave, and the Beach Boys. Rolling Stones magazine ranked this song in the top 500 best of all time. Over 40 individual performers have drifted in and out of the Drifters over the years. There is a long history for the group. 

If you are considering a vacation to the beach and boardwalk, the Centers for Disease Control and Prevention (CDC) issued a health warning on September 1, 2023 for the Eastern Seaboard and the Gulf Coast. The advisory relates to an increase in infection caused by the bacteria Vibrio vulnificus in the United States.

Vibrio vulnificus thrives in warm seawater and poses two significant health risks to people. The bacterium requires saltwater or brackish water to survive. Brackish water is less salty than seawater, but has more salt than freshwater. 

The first risk is direct contact to an open wound, cut, scape, or sore on the surface of exposed skin. The organism will infect the skin through these wounds and can result in serious damage to the tissue in the area. Once the Vibrio vulnificus has invaded the skin, it can then enter the blood resulting in a more serious infection. The organism is considered a flesh-eating bacteria and results in death of the surrounding skin and tissue. The damage can be extensive to skin and often requires intensive treatment in the hospital. 

In previous years, the Vibrio vulnificus infections were most often reported between May and October and within the Gulf Coast states. The pattern is changing due to the warmer summers including recent heat waves. The higher temperatures have resulted in warmer waters off the coastal beaches. Cases of serious infections have now been reported from the East Coast states including North Carolina, New York, and Connecticut. Unfortunately, some of these cases have resulted in deaths. 

In Florida where cases are more common, there has not been a documented increase in the number of infections reported. The state confirmed 33 cases with seven deaths this year, which is similar to the 2020 and 2021 numbers. The Florida Department of Health reported fewer cases in 2022 believed to be due to the impact of hurricane Ian. 

The infection has its more devastating effects on those individuals with preexisting health conditions. Public health experts and healthcare professionals are warning the public to avoid saltwater areas for swimming especially if they have open cuts, scrapes, or wounds. If contact with saltwater results in a skin lesion or ulcer, go see your primary care provider immediately. 

The second concern is with eating raw seafood, especially oysters. Since oysters feed by filtering water through their shells, the Vibrio vulnificus organism survives in the oyster. Cases of the infection have been reported with oysters harvested from colder water climates as well. If eaten raw, the oysters will infect the gastrointestinal tract of humans resulting in sickness. This illness can be mild to life-threatening. The CDC estimates approximately 80,000 people are infected each year from eating oysters with around 100 deaths. 

The Vibrio vulnificus infection is not limited to just oysters, but applies to other raw seafood. Since the bacteria does not cause a change in the look, smell, or even taste of the seafood, it can be hard to detect until someone becomes ill. If eating seafood, it is recommended to make sure it is cooked properly to kill any bacteria. 

Seafood can be imported into the United States from countries with warmer saltwater conditions reporting cases of Vibrio vulnificus infections. Knowing the country of origin for seafood can be helpful, but not foolproof. The best advice is to cook the seafood and avoid raw seafood, especially oysters based on the warnings from the CDC report. 

So, you can sit under the boardwalk, just don’t expose yourself to warm saltwater if you have a cut. If you are going to picnic under the boardwalk, make sure it is cooked seafood!

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