Coral boilers disease

[Michael Gochfeld]

Dear Dr. Ramos:

Your message of Oct 21st to the coral-list eventually reached me.  I
presume that by now you have reached a diagnosis and hopefully a healthy
resolution.

Diseases of this sort are of great interest to us in Environmental and
Occupational Medicine.  I would be very interested in hearing more about
this case and it sounds like it would be publishable as
well----depending on what you were able to find.

As my daughter pointed out in forwarding the message, coral have
short-chain brominated compounds and it is possible that heating coral
might drive off bromine which could account for some of the symptoms.
Although the symptoms you describe are also consistent with a metal fume
fever, I wouldn't expect any of the metals to be present in sufficient
quantity, nor in the correct form (solid fume) to produce that illness.

You mentioned "we have already begun testing...." and I wonder whether
you were testing the patients, or the coral, or the water in which they
were boiled.

Were the coral commercially obtained (hence presumably dried) or were
they brought back fresh from a tropical trip.

Did the symptoms begin while they were boiling the coral or afterwards.

How soon after the boiling event did the symptoms begin and was this
done indoors in a small room or kitchen or laboratory???

Were the seven patients the only ones exposed and were all exposed for
about the same duration.

Was the water fresh (our of the tap) or might it have been water that
had stood around for a while (hence your interest in Legionella).

Were there Xray findings.

Is it possible that the seven had another exposure and the coral-boiling
was a red herring.

In your contact with the Coral list did you encounter other similar
cases.

I look forward to learning more about this fascinating episode.

Michael Gochfeld

Michael Gochfeld, MD, PhD
Professor of Environmental and Community Medicine
UMDNJ-Robert Wood Johnson Medical School
Piscataway, NJ 08854


>Date: Sun, 21 Oct 2001 20:34:53 -0500
>From: Shiloh Ramos <shilohjramos at hotmail.com>
>To: coral-list at coral.aoml.noaa.gov
>Subject: Recent illness after boiling coral
>Sender: owner-coral-list at coral.aoml.noaa.gov
>
>I am a resident physician in Appleton, WI, currently working at
Appleton
>Medical Center.  I have an inquiry regarding coral.  Recently, we
admitted
>7 patients with similar symptoms after boiling coral for a saltwater
fish
>tank.  Their primary symptoms/signs include: shortness of breath,
fever,
>headache, dry cough, and an elevated white count.  All 7 patients
>developed these symptoms within several hours after boiling the coral.
>We have already begun testing for chromium, copper, zinc, manganese,
>carbon monoxide, cyanide, and legionella.  We were wondering if you
might
>have any advice as to other substances that might be contained in coral
or
>used in its processing for sale.  As well, any advice regarding
possible
>infectious agents (such as Vibrio parahaemolyticus), would be
appreciated.
>
>Please send any email to shilohjramos at hotmail.com.  If you have a more
>immediate response, you can phone (920) 831-5042, and they should be
able
>to easily locate me.
>
>Thanks again,
>Shiloh J. Ramos

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