NYC health advisory: Chinatown seafood markets linked to Mycobacterium marinum skin infections

The New York City Health Department announced Wednesday that it has identified an outbreak of a rare skin infection in persons who handled live or raw fish or seafood that was purchased in markets in Manhattan, Brooklyn, and Queens Chinatowns.

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The outbreak bacterium, Mycobacterium marinum, enters the skin through a cut or other injury while handling live or raw fish or seafood.

Health officials advise the public to wear waterproof gloves in their home when preparing live or raw fish or seafood that came from a market in Chinatown, especially if they have cuts or abrasions.

Employees of both these seafood markets and restaurants that purchase food from these markets also are urged to wear waterproof gloves when handling live or raw fish or seafood.

There is no risk associated with consuming the food from these markets.

Human infection with Mycobacterium marinum was first recognized a pathogen of aquarium fish about nine decades ago.

It survives in both fresh and salt water in most parts of the world. It was once responsible for outbreaks of skin infection in swimming pools prior to the stricter pool disinfection we have now. M. marinum doesn’t survive in a well chlorinated swimming pool.

Today, exposure to aquariums is by far the most common risk factor for acquiring this infection. Certain other recreational activities are rarely implicated such as skin diving and boating activities. Occupational exposure is seen in oyster workers and marine animal handlers.

Human infection is typically associated with trauma, like cuts and abrasions from fish spines or crustaceans. The injury may be quite trivial and typically is confined to the arms and hands.

Mycobacterium marinum is a bacterium that doesn’t grow well at body temperature. This may explain why infections are localized to the extremities where body temperature is cooler.

The infection makes take a few months to manifest. The lesions may appear as groups of small papules or a nodule (granuloma). About half of those infected feel pain and it rarely goes systemic. It is more common in adults than children.

Dissemination in immunosuppressed people have been reported, again usually acquired from home aquariums.

How can you prevent infection with Mycobacterium marinum?

• Use rubber or plastic gloves when handling fish or cleaning aquariums.
• Stay out of fresh or salt water when you have open cuts or sores.
• If you are cleaning fish, wear heavy leather gloves to avoid cuts from sharp spines.
• Make sure your swimming pool is properly chlorinated and maintained.
• Special care should be taken if you have a depressed immune system.

Health authorities say if you show any symptoms or believe you are at risk, please see a dermatologist or infectious disease physician and explain that you think you may have a skin infection (M. marinum) that occurs after contact with live or raw fish or seafood. It is important to begin antibiotic treatment early.

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