May 4, 2001 - Before heading to the local salon for a manicure or pedicure, be forewarned! You could wind up with more than a new shade of polish. As 110 unlucky folks in Santa Cruz, Calif., recently learned, you might also take home a nasty infection.
That particularly severe bacterial outbreak wasn't typical, but it's a reminder that even simple cosmetic procedures carry health risks.
In late September 2000, a dermatologist in Santa Cruz contacted the county board of health after several patients began showing up at her office with similar, treatment-resistant skin abscesses or boils on their lower legs. She told officials that all five people had recently had a pedicure in one of the whirlpool foot bath chairs at a single salon. These recliner-type chairs have an integral footbath with recirculating water that reaches to just below the patron's knees.
The county called in Kevin L. Winthrop, MD, a CDC medical epidemiologist with the State of California Department of Health Services, to investigate. "We visited the salon, reviewed and watched the procedure, and took cultures of the [sick] women's legs and the foot bath filter screens," he tells WebMD. The screens had never been removed for cleaning, and tremendous amounts of hair, skin, and organic debris had built up.
Laboratory tests revealed massive amounts of the same unusual microbe Mycobacterium fortuitum in both the filter screens and patients' sores. It is a common bug normally found in quantities too small to be problematic.
"That sealed it and told us the source of the infection," says Winthrop. The salon owners closed the shop voluntarily in early October.
Winthrop's team eventually identified 110 people who'd been infected. "No one died and no one was hospitalized, but there are still some people being treated now," he says. "We anticipate that many will require plastic surgery, because these boils can be very disfiguring."
Winthrop calls the situation "very unusual." The vast amount of organic debris in the poorly maintained spa chairs provided "a breeding ground for microorganisms." Even occasional cleaning would have prevented the outbreak. But with no specific laws and only vague manufacturer's guidelines for maintaining the chairs, the salon owners had never anticipated a problem.