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Saturday, July 27, 2002

Outlook improves for DeLand boy with waterborne infection

By DINAH VOYLES PULVER | News-Journal Environment Writer

DAYTONA BEACH — Doctors battling rare waterborne illnesses that struck two Central Florida boys this week lost their struggle to keep a 12-year-old boy alive Friday but say the outlook for the second boy, a DeLand teen, is improving.

Volusia County health officials are warning swimmers to stay out of freshwater lakes. But other experts question whether the extraordinarily rare bacteria should keep everyone from beating the heat in Central Florida's many lakes.

"It's frightening when a tiny little bug can cause such devastation to a child," said Dr. Steven Wiersma, state epidemiologist for the Florida Department of Health. "But let's put it in perspective; this shouldn't keep us out of the water."

Floridians should be more concerned about preventable water-related injuries and accidental drownings, he said.

"These tragedies are of tremendous personal magnitude for these boys and their families," Wiersma said, adding they probably couldn't have been prevented.

The microorganisms that caused the infections are naturally occurring and thrive in the soil and water of warm tropical and subtropical lakes.

The DeLand boy, whose name is not being released, is suffering from an infection caused by bacteria known as chromobacterium violaceum. He remains in critical condition at Florida Hospital-Orlando. Doctors believe the bacteria entered his body through a cut on his leg while he was swimming in Lake Talmadge, east of DeLand, on Saturday.

Dr. Jaime Carrizosa, the infectious disease specialist for the hospital, said the DeLand boy is fortunate blood cultures showed the bacteria so quickly.

Treating the infection as early as possible is essential, Carrizosa said. In the DeLand boy's case, Carrizosa said he thinks doctors were able to start the treatment in time. "This kid is coming through."

Treatment didn't come early enough for the Oviedo boy. Experts say the chance of surviving an amoeba attack is less than 5 percent because the microbes multiply so rapidly in the body.

Doctors say both diseases are highly unusual, especially when compared to the number of people who probably are exposed every year.

Only 150 cases of the amoeba infection have been reported in history worldwide, Wiersma said. Only 50 cases of the chromobacterium infection have been recorded.

Those numbers are less than minuscule when compared to the millions of people who swim in lakes and rivers worldwide each year, Wiersma said.

The annual drowning rate in the United States — more than 4,000 people each year — is more than 20 times higher than all the cases of chromobacterium and amoeba combined, according to the Centers for Disease Control and Prevention. In 1999, another 734 people died in recreational boating accidents.

But the two microbes pose the greatest risk during the hottest months of the year, when warm water encourages their growth.

That's why Volusia officials recommend swimmers stay out of the lakes in July and August. They list only two approved freshwater swimming areas — DeLeon Springs and Blue Spring.

Carrizosa also subscribes to that theory and won't let his children swim in area lakes.

"I took one of my kids out for a school science project and we sampled 10 lakes," he said. "We found the amoebas in seven of those 10 lakes."

But health officials know others will continue to swim and ski in the lakes.

The experts agree a few safety precautions will go a long way toward protection from the microbes in the water:

— Never swim in a lake that is stagnant or contains very warm water.

— Always wear nose clips and stay out of the muck.

— People with immune deficiencies should not swim in lake water and it's risky to go in with an open wound or cut.

"We're blessed with beautiful lakes," Wiersma said. "We can enjoy them if we use common sense and observe water safety rules."

HICI Special Report — Freshwater Swimming: Fun or Folly?

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