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Wilderness: Fish-Handler's Disease

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Fish-Handler's Disease Overview

Fish-handler's disease occurs when cuts or scrapes in the skin become infected with the bacteria Erysipelothrix rhusiopathiae. Handling and preparing fish and shellfish can create small cuts and scrapes in the skin where bacteria may enter. Developing fish-handler's disease requires deliberate contact with fish, particularly lobster and other shellfish. Fish-handler's disease occurs worldwide wherever fish and shellfish are handled.

Fish-Handler's Disease Symptoms

  • The disease generally develops 2-7 days after injury to the skin and subsequent bacterial infection.
  • A sharply defined, red-purple circular area appears and surrounds the puncture.
  • The area of injury increases in diameter by about one-half inch per day.
  • Pain, burning, itching, and swelling at the infection site; joint stiffness; and lymph node swelling accompany the infection.

Fish-Handler's Disease Treatment

All wounds require immediate cleansing with fresh tap water. Gently scrub the wound with soap and water to remove any foreign material.

After cleansing, a topical antibiotic ointment (for example, bacitracin) should be applied 3-4 times per day.

Oral antibiotics are often prescribed to treat the infection. Prior to starting an antibiotic, be sure to tell the doctor about any drug allergies. Continue antibiotics for at least 5 days after all signs of infection have cleared. Use sunscreen and wear protective clothing, such as a long-sleeved shirt, pants, and a wide-brimmed hat, while taking these antibiotics because certain antibiotics may cause sensitivity to the sun. 

Pain may be relieved with 1-2 tablets of acetaminophen (Tylenol) every 4 hours or 1-2 tablets of ibuprofen (Advil, Motrin) every 6-8 hours.

When to Seek Medical Care

Consult a doctor about treatment with available medications.

Synonyms and Keywords

fish-handler's disease, fish handler's disease,fish handler disease, fish, lobster, bacterial infection, fish poisoning, fish hand

WebMD Medical Reference from eMedicineHealth

Reviewed by David T. Derrer, MD on May 06, 2014

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