What are the common symptoms of coral scrapes and cuts. How can divers prevent injuries from coral. What is the proper first aid treatment for coral-related wounds. Can coral scrapes lead to serious complications.

Understanding Coral Injuries: A Diver’s Guide

Coral scrapes and cuts are among the most frequent injuries encountered by divers and snorkelers. The Divers Alert Network (DAN) receives approximately one inquiry per week regarding coral-related injuries. These wounds can be particularly troublesome, often characterized by a burning sensation, pain, and itching. In some cases, a rash may also develop. What sets coral injuries apart is their potential for latent evolution, sometimes taking weeks or even months to heal completely.

Why are coral injuries unique?

Coral injuries differ from typical scrapes due to the complex nature of coral structures. The soft living tissues covering corals, especially stony corals, can easily tear when contacted. This allows the coral’s rigid, abrasive structure underneath to cause deeper cuts and introduce foreign material into the wound. The presence of various antigens and substances from the coral can trigger an acute inflammatory process and infection, prolonging the healing process.

Mechanisms of Coral-Related Injuries

Understanding how coral injuries occur is crucial for divers to appreciate the risks and take appropriate precautions. The mechanism of injury involves several factors:

• Abrasive coral structures
• Soft tissue tearing
• Introduction of foreign material
• Presence of marine organisms on surfaces

Why do coral cuts take longer to heal than typical scrapes? The marine environment introduces unique challenges. Cuts and scrapes from sharp-edged coral and barnacles often fester and may require weeks or even months to heal completely. In some cases, granulomas can form if debris from the original wound remains in the tissue, as the body attempts to eliminate it.

Common Manifestations of Coral Injuries

The severity and nature of coral injury symptoms can vary depending on several factors. These include the presence and amount of toxins, the size and location of the abrasion, and the pre-existing sensitivity of the injured person. Common manifestations include:

1. Burning sensation
2. Pain
3. Itching
4. Rash (particularly with hydroid coral contact)

Fire Coral: A Special Case

Fire corals, belonging to the class Hydrozoa, deserve special attention. These organisms contain nematocysts, which can cause envenomation even with a simple touch. How does fire coral affect the skin? Typically, blistering occurs a few hours after contact. While these blisters often resolve within days, it’s common for injuries to relapse after a week or two of apparent healing progress. This delayed reaction is characteristic of fire coral envenomations.

Preventing Coral Injuries: Essential Tips for Divers

Prevention is always better than cure, especially when it comes to coral injuries. Here are some essential tips for divers to minimize the risk of coral-related wounds:

• Maintain proper buoyancy control
• Wear protective gear like wetsuits or dive skins
• Be aware of currents that may push you into coral
• Avoid touching or coming into contact with any marine life
• Carry a marine animal first aid kit during ocean dives

How can divers enhance their knowledge about marine life injuries? Consider taking courses in marine life identification and first aid. Additionally, various books and publications are available for those who want to deepen their understanding of potential underwater hazards.

First Aid for Coral Scrapes and Cuts

Proper first aid is crucial for preventing complications and promoting faster healing of coral injuries. Follow these steps if you or a fellow diver experiences a coral scrape or cut:

1. Thoroughly clean the wound with soap and water
2. Flush the area with large amounts of clean water
3. Apply a half-strength solution of hydrogen peroxide and water
4. Rinse again with clean water
5. Apply a thin layer of antiseptic ointment
6. Cover the wound with a dry, sterile, non-adherent dressing
7. Clean and re-dress the wound twice daily

Wet-to-Dry Dressing Technique

For wounds that develop a crust, a wet-to-dry dressing change can be effective. How does this technique work?

1. Place a dry sterile gauze pad over the wound
2. Soak it with saline or a diluted antiseptic solution
3. Allow it to dry, then remove the bandage
4. Dead and dying tissue should adhere to the gauze and lift free
5. Repeat this process once or twice daily for a few days

Once the dressings become non-adherent, resume regular wound dressing as described earlier.

Recognizing and Addressing Complications

While proper first aid can prevent many issues, it’s essential to monitor coral injuries for potential complications. What signs should divers watch for?

• Extreme redness around the wound
• Red streaks on the affected extremity
• Increased pain
• Fever
• Presence of pus
• Swollen lymph glands

If any of these symptoms occur, it’s crucial to consult a qualified health professional. They may recommend starting an antibiotic treatment, especially if a Vibrio bacteria infection is suspected. Why is Vibrio infection a concern? This type of infection can cause severe illness and even death in individuals with compromised immune systems, such as those with AIDS, diabetes, or chronic liver disease.

Coral Poisoning: A Rare but Serious Complication

In some cases, particularly with extensive abrasions or cuts from highly toxic coral species, coral poisoning may occur. What are the symptoms of coral poisoning?

• Poor wound healing
• Continuous pus drainage
• Swelling around the cut
• Swollen lymph glands
• Fever
• Chills
• Fatigue

If you experience these symptoms following a coral injury, it’s essential to seek medical attention promptly.

Long-Term Management of Coral Injuries

The healing process for coral injuries can be prolonged and may require ongoing care. How can divers ensure proper long-term management of their wounds?

• Continue regular cleaning and dressing changes
• Monitor for signs of infection or delayed healing
• Protect the wound from further irritation or contamination
• Consider follow-up with a healthcare provider for persistent issues
• Be patient, as complete healing may take several weeks or months

In some cases, professional medical intervention may be necessary for optimal healing. This could include debridement of non-healing tissue, prescription antibiotics, or advanced wound care techniques.

Enhancing Diver Education on Marine Life Hazards

Prevention and proper response to coral injuries rely heavily on diver education. How can the diving community improve awareness and preparedness for these types of incidents?

• Integrate coral injury prevention into basic diving courses
• Offer specialized workshops on marine life hazards
• Develop comprehensive first aid training for dive professionals
• Create easily accessible resources for divers to reference before and during trips
• Encourage the sharing of experiences and lessons learned among divers

By fostering a culture of awareness and preparedness, the diving community can significantly reduce the incidence and severity of coral-related injuries.

The Role of Dive Operators and Resorts

Dive operators and resorts play a crucial role in preventing and managing coral injuries. What steps can these organizations take to protect their clients?

• Provide thorough briefings on local marine hazards
• Offer or require protective gear for divers
• Maintain well-stocked first aid kits with coral injury-specific supplies
• Train staff in proper wound care and recognition of complications
• Establish relationships with local medical facilities for severe cases

By implementing these measures, dive operators can create a safer environment for their guests and be better prepared to handle incidents when they occur.

Advancements in Coral Injury Treatment

As medical knowledge and technology progress, new approaches to treating coral injuries are emerging. What are some of the latest advancements in this field?

• Development of specialized antimicrobial agents for marine-related wounds
• Use of advanced wound dressings that promote faster healing
• Application of regenerative medicine techniques to address tissue damage
• Implementation of telemedicine for remote consultation on dive-related injuries
• Research into the specific toxins present in various coral species to develop targeted treatments

These advancements offer hope for more effective and efficient treatment of coral injuries in the future, potentially reducing healing times and complications.

The Importance of Reporting and Data Collection

Improving our understanding and management of coral injuries relies on accurate reporting and data collection. How can divers contribute to this effort?

• Report all coral-related injuries to dive operators or local authorities
• Participate in surveys or research studies on marine injuries
• Document personal experiences with coral injuries and treatments
• Share information with diving communities and forums
• Support organizations dedicated to diver safety and marine conservation

By actively participating in these efforts, divers can help build a more comprehensive knowledge base that benefits the entire diving community.

Balancing Conservation and Diver Safety

While preventing coral injuries is crucial for diver safety, it’s equally important to consider the impact on coral reefs themselves. How can divers balance their safety needs with coral conservation efforts?

• Practice responsible diving techniques to minimize contact with marine life
• Choose eco-friendly protective gear and sunscreens
• Support dive operators who prioritize both diver safety and reef conservation
• Participate in coral restoration and clean-up projects
• Educate fellow divers about the importance of protecting coral ecosystems

By adopting a holistic approach that considers both human and environmental health, divers can enjoy safer experiences while also contributing to the preservation of vital marine habitats.

The Future of Coral-Safe Diving

As awareness of coral conservation grows, what might the future of diving look like in terms of preventing coral injuries?

• Development of new diving techniques that further reduce the risk of coral contact
• Innovation in dive gear design to enhance protection without harming marine life
• Implementation of virtual reality training to improve diver skills before entering the water
• Increased use of guided tours and restricted access to sensitive reef areas
• Integration of real-time marine life monitoring systems to alert divers of potential hazards

These potential developments could revolutionize the way divers interact with coral environments, leading to safer and more sustainable diving practices.

Coral Scrapes and Cuts – Divers Alert Network

Cuts and scrapes are the most common injuries incurred by divers and snorkelers. DAN receives about one inquiry a week related to someone who has come into contact with coral. A burning sensation, pain and itching are common and may also be accompanied by a rash. These injuries can have a latent evolution and take weeks or months to heal, confusing both patients and clinicians.

Mechanisms of Injury

Soft living tissues cover the surface of corals. In the case of stony corals, the rigid (abrasive) structure underneath makes the coral’s soft tissue easy to tear and get into the scrape or cut. Foreign material can prolong the wound-healing process since the different antigens and substances cause an acute inflammatory process and infection. Cuts and scrapes from sharp-edged coral and barnacles tend to fester and may take weeks or even months to heal. Granulomas can form if debris from the original wound remains in the tissue. The body attempts to remove it, resulting in an itchy rash or papule (small, raised, tender bump) that lasts for some time before the body eliminates it.

While most “raspberries” generally heal quickly, skin abrasions from a marine environment can sometimes be more challenging to treat than those we get from outdoor activities such as baseball or bicycling. Whether it is a coral, a rock or a wreck, they all share a common factor: They are covered by living marine organisms, which makes coral cuts and scrapes unique.

Manifestations

The extent of the reaction depends on the presence and amount of toxins, the size and location of the abrasion and the pre-existing sensitivity of the injured person. The most common manifestations are a burning sensation, pain and itching. A rash may accompany the injury if the coral is a hydroid, such as fire coral.

Most animals of class Hydrozoa become hydroids as a life stage. They are predominantly colonial, and while most of them are marine creatures, you can find a few species in freshwater environments.

Fire corals are cnidarians, so they contain nematocysts. Touching them with a simple rub can cause mechanical activation and envenomation. The manifestation is usually blistering, which typically appears a few hours after contact. They typically resolve in a few days, but it is quite common for these injuries to relapse within a week or two after what seemed to be healing progress. This delayed reaction is typical of these types of envenomations.

Prevention

When underwater, try to avoid contact with coral or any other living creature. Whenever possible, wear a wetsuit or dive skin to protect yourself if you are accidentally pushed into coral by another diver or a current. Ocean divers should consider a marine animal first aid kit for their travels. Ready supplies will speed up the time to properly administer first aid for injuries. Additionally, for divers who want to learn more about the various marine life injuries, there are courses in marine life identification, first aid courses and a variety of books and publications available.

First Aid

• Scrub the cut vigorously with soap and water, and then flush the wound with large amounts of water.
• Flush the wound with a half-strength solution of hydrogen peroxide in water. Rinse again with water.
• Apply a thin layer of antiseptic ointment, and cover the wound with a dry, sterile and non-adherent dressing. If you have no ointment or dressing, you can leave the wound open.
• Clean and re-dress the wound twice a day.
• If the wound develops a crust, use wet-to-dry dressing changes. Put a dry sterile gauze pad over the wound and soak it with saline or a diluted antiseptic solution (such as 1% to 5% povidone-iodine in disinfected water). Allow it to dry then rip the bandage off the wound. The dead and dying tissue should adhere to the gauze and lift free. The tissue underneath should be pink and may bleed slightly but should be healing. Change the dressings once or twice a day. Use wet-to-dry dressings for a few days or until they become non-adherent. Then resume the regular wound dressing described above.
• Look for any signs of infection: extreme redness, red streaks on the extremity, pain, fever, pus or swollen lymph glands. If you have any, consult a qualified health professional about starting an antibiotic. A possible Vibrio bacteria infection can cause illness and even death in someone with an impaired immune system (e.g., from AIDS, diabetes or chronic liver disease).
• Watch for coral poisoning, which can occur if abrasions or cuts are extensive or from a particularly toxic species. Symptoms include a wound that heals poorly or continues to drain pus, swelling around the cut, swollen lymph glands, fever, chills and fatigue. If you have these symptoms, see a physician.

Complications

The most frequent complications from non-stinging coral scrapes are inflammation (which leads to poor healing) and less commonly a secondary infection. Proper wound cleaning is crucial. If fire coral is the culprit, then a diluted acetic acid solution, such as household white vinegar, is a reasonable topical decontaminant and should be used as a soak to reduce the pain. Immersion in hot water can reduce the symptoms. Hot water is ideal, but you can use instant hot packs, cold packs or ice packs. Provide symptomatic treatment for the inflammatory response. Steroid creams are rarely helpful, and they can prolong a skin infection. If the inflammation is severe, you may administer systemic steroids in a moderate, tapering dose under the supervision of a trained medical provider. Oral antihistamines can sometimes help reduce the itching or burning sensation. 

Possible Complications of an Old Problematic Wound

It is not uncommon for divers to contact DAN concerned about a minor skin abrasion on their hands, knees or elbows that happened months ago and has not healed despite proper care. These chronic wounds often have a red and bumpy appearance, occasionally develop a crust and are usually painless. If common antibiotic ointments do not help, divers wonder if the cause may be a marine-specific pathogen.

Divers with an open wound, even a small cut or scrape, are at risk for skin infections. When an old problematic wound fits the descriptions above, it might have become infected with an opportunistic pathogen known as Mycobacterium marinum. Despite the name there are no marine-specific pathogens that affect humans. Some infections are more common in aquatic environments. M. marinum is responsible for a condition commonly known as fish tank granuloma, or aquarium granuloma.

The red and bumpy nodules, no larger than a centimeter, are granulomas — inflammatory immune cells trying to wall off the pathogen. Granulomas are usually isolated but can sometimes appear in small clusters. They are not necessarily painful. There may or may not be discharge from the wound.

Characteristics of

M. marinum That Affect Healing

• The pathogen is opportunistic. It causes infection only in the right conditions (environmental and patient-related), so it is often not considered as a potential culprit.
• It likes cooler temperatures, which is why these wounds tend to flourish in areas with lower body temperatures such as hands, knuckles, elbows and knees.
• Only specific antibiotics work, so the typical antibiotic treatments are usually unsuccessful.
• The life cycle is slow, which means treatments last a long time. Sometimes patients will abandon what could have been a successful treatment or doctors may look for other potential explanations for the symptoms.
• It requires specific culture media that a doctor would not ask for unless they suspected this pathogen. Standard culture results are often negative, which delays the diagnosis.

Allow your doctor to examine the wound and follow their standard procedures. The doctor will probably ask you how it happened or when it started. Tell them about the superficial abrasion in a marine environment. You may want to ask specifically if M. marinum could be the cause. Your doctor does not need dive-specific medical knowledge for this type of issue.

Fitness to Dive

Always take care of wounds and clean them thoroughly no matter the severity. The skin is our most effective and efficient means of immunological defense. A compromised wound can get seriously infected.

As a rule, treat wounds properly and let them heal before diving. This is particularly important before traveling to a remote location or one with limited local medical care capabilities. A skin lesion with the potential for infection might warrant a more conservative decision to stay ashore if you have such a trip planned.

Chronic skin lesions require specific consultation with your physician team before diving. Your doctor may prescribe treatment or a protective covering to prevent skin breakdown.

A Case of Cellulitis Associated with Coral Injury

Ann Dermatol. 2008 Dec; 20(4): 212–215.

, M.D.,, M.D.,, M.D.,, M.D., and , M.D.

So Young Na

Department of Dermatology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

Hye Young Lee

Department of Dermatology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

Jin Ok Baek

Department of Dermatology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

Joo Young Roh

Department of Dermatology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

Jong Rok Lee

Department of Dermatology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

Department of Dermatology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

Corresponding author.Reprint request to: Jong Rok Lee, M.D., Department of Dermatology, Gil Medical Center, Gachon University of Medicine and Science, 1198, Guwol-dong, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-2000, Fax: 82-32-460-2001, moc.latipsohlig@1jjmd

Received 2007 Dec 11; Accepted 2008 May 7.

Copyright © 2008 The Korean Dermatological Association and The Korean Society for Investigative DermatologyThis article has been cited by other articles in PMC.

Abstract

Corals are the marine organism that belongs to the phylum Cnidaria, and are one of the common causes of superficial injury in the marine environment. In addition to acute reactions such as burning or stinging pain and erythema, coral injuries may present with complications such as foreign body reactions, bacterial infections, and/or localized eczematous reactions. A 23-year-old male presented with an erythematous edematous tender patch with centrally grouped vesicles on the left ankle; the injury had occurred during skin-scuba diving 2 days before. A biopsy of the lesion treated with hematoxylin-eosin stain showed epidermal necrosis with subepidermal blisters and neutrophilic panniculitis. Herein we report a case of cellulitis caused by the nematocyst stings of corals.

Keywords: Cellulitis, Coral

INTRODUCTION

One of the most common injuries in the marine environment is the stings caused by Cnidarians including jellyfish, the Portuguese man of war, hydroids, sea anemones, and coral^1,2. Corals are a member of the class Anthozoa, which is composed of many calcified polyps that containing tentacles with nematocysts, venom-filled cells that are responsible for stings and lacerations^1,3. Coral injuries present with acute reactions such as pain, erythema, and swelling and may also be complicated by foreign-body reactions, secondary bacterial infections, and/or localized eczematous reactions¹.

Herein we report a case of cellulitis associated with coral injury of the ankle of 23-year-old man who had been wounded during skin-scuba diving in island of Hainan, China 2 days before his presentation to our clinic.

CASE REPORT

A 23-year-old man presented with an erythematous edematous patch with centrally grouped vesicles on the left ankle (). The skin lesion occurred following a coral injury while he was skin-scuba diving at the island of Hinan, China 2 days prior to his presentation. This was associated with stinging pain and mild itching. He stated that the accident had occurred near the coral reef and at the time, he had felt stinging pain on his left ankle which was not covered by the diving suit. On physical examination, there were no remarkable findings including a normal body temperature except for the skin lesion. His past medical history was not significant. Histopathologic findings revealed the extensive epidermal necrosis with subepidemal blisters and neutrophils in the blister cavity () and interstitial, perivascular and periadnexal inflammatory cell infiltration throughout the dermis (). There was also panniculitis predominantly infiltrated with neutrophils and some eosinophils and lymphohistiocytes without the evidence of foreign body granulomas (). Radiological examination of his left ankle showed non-specific findings and no foreign body materials, and laboratory testing showed only leukocytosis including neutrophilia with a mildly elevated ESR. We did not perform a bacterial culture and sensitivity test.

Erythematous edematous patch with central grouped vesicles on the left ankle.

(A) Histopathologic findings show extensive epidermal necrosis with subepidermal blisters (H&E, ×10). (B) There are some neutrophils within the blister cavity (H&E, ×20)

Mild to moderate interstitial, perivascular, and periadnexal inflammatory cell infiltrate of neurophils in the dermis (H&E, ×10).

Panniculitis mainly infiltrated with neutrophils, some eosinophils, and lymphohistiocytes (H&E, ×10).

Because his vaccination history was uncertain, we gave him an anti-tetanus immunoglobulin injection and treated him with systemic steroids in combination with antibiotics (a 1st generation cephalosporin for 1 week and a 3rd generation cephalo sporin for the following 2 weeks). For local therapy, we applied mupirocin ointment and a topical steroid cream. After 3 days of treatment, the pain and erythema were both improved but the swelling on the left lower leg was still present. So we changed the antibiotic regimen to levofloxacin for 7 days; afterwards, his symptoms began to resolve slowly. We have observed him for 5 months and his skin lesion is almost completely resolved without any signs of delayed hypersensitivity reactions.

DISCUSSION

Coral is an aquatic organism that belongs to the phylum Cnidaria^1,2. It is composed of many calcified polyps that contain tentacles with venom-filled cells called nematocysts^1,3. There are two types of coral injuries: stings and lacerations. Of the two, stings are caused injected nematocysts which contain toxins like calcium carbonate and are generated from hard coral reef structures². The coral injuries occur most commonly on forearms, elbows, knees, and other areas unprotected by gloves or the diving suits which are used for sports diving and other marine-related activities. The initial responses of coral injuries including stinging pain, erythema, and swelling occur immediately to within several hours around the wound⁴. These symptoms result from coral poisoning. Systemic symptoms such as low grade fever also may be present but do not necessarily indicate an infection⁴.

Coral injuries can be complicated with foreign body reactions, localized eczematous reactions, and/or secondary bacterial infections¹. Foreign body reactions, which result in granuloma formation, may occur because of retained bits of calcareous material and proteins from injected nematocysts⁵. A delayed and persistent contact dermatitis has also been reported to occur following coral stings which occur off the eastern coastline of the Red Sea. In that report, the shiny and lichenoid coalescent papules with severe itching developed 3 weeks later after injuries which occurred to people who had a history of seafood allergy, atopic dermatitis, or previous contact with coelenterates^6,7. The delayed reactions to cnidarians stings are not uncommon and may occur 2~14 days after the occurrence of a sting injury^2,8. It usually presents as a erythematous papular or papulonodular eruption with severe itching at the same site of the stings². It takes several weeks to heal and may respond to topical or systemic steroids in combination with antihistamines^2,8. Injuries that occur in the marine environment can be also infected with marine organisms such as Streptococcus species, Escherichia coli, Pseudomonas aeruginosa, Mycobacterium marinum, Staphylococcus aureus, Vibrio cholerae, Vibrio vulnificus, or Vibrio parahaemolyticus which are the most common pathogens isolated from seawater and marine wounds³. Therefore, coral injury accompanied with a secondary bacterial infection may lead to cellulitis with ulceration and tissue necrosis. As all the factors mentioned above are responsible for the slow healing of a coral injury, we need to deal with the appropriate management for each of them.

In our case, no foreign body materials of his left ankle were found on physical and radiological examination. However, there were clinical and laboratory findings of cellulitis including redness, swelling, local heating, tenderness, and leukocytosis with neutrophilia and an elevated ESR. In addition, the histopathologic findings showed epidermal necrosis with diffuse infiltrate, composed mainly of neutrophils that extended throughout the dermis and into the subcutaneous fat. An initial outpatient therapy for secondary bacterial infection in the marine environment should be targeted against Vibrio species, which includes ciprofloxacin or trimethoprim-sulfamethoxazole. In the case of inpatients, parenteral antibiotics appropriate for initial therapy include cefotaxime, ceftazidime, chloramphenicol, gentamicin, and tobramicin. In our case, we treated him with cephalosporin in combination with systemic corticosteroids for 3 weeks. Although the erythema and pain were getting better, the swelling on the leg was not. We then replaced cephalosporin with levofloxacin, a quinolone derivative. As for local therapy, mupirocin ointment and topical corticosteroids were applied along with aspiration and saline wet dressing of vesicles.

According to previous reports, the complete healing period varies from 1 week to 15 weeks^1,4,8. It may be more delayed if a secondary infection or delayed hypersensitivity reaction occurred. In our case, the acute reaction accompanied with cellulitis began to subside slowly and we considered the possibility of a delayed reaction; we arranged for follow up observation. We report a case of cellulitis caused by a coral injury which revealed extensive epidermal necrosis with subepidermal blisters and neutrophilic panniculitis on histopathologic examination.

References

1. Scharf MJ, Daly JS. Bites and stings of terrestrial and aquatic life. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick’s dermatology in general medicine. 6th ed. New York: McGraw-Hill; 2003. pp. 2270–2271. [Google Scholar]2. Burke WA. Cnidarians and human skin. Dermatol Ther. 2002;15:18–25. [Google Scholar]3. Zoltan TB, Taylor KS, Achar SA. Health issues for surfers. Am Fam Physician. 2005;71:2313–2317. [PubMed] [Google Scholar]5. Habif TP. Dermatitis associated with swimming. In: Habif TP, editor. Clinical dermatology: a color guide to diagnosis and therapy. 4th ed. Chile: Mosby; 2004. pp. 539–543. [Google Scholar]6. Miracco C, Lalinga AV, Sbano P, Rubegni P, Romano C. Delayed skin reaction to Red Sea coral injury showing superficial granulomas and atypical CD30+ lymphocytes: report of a case. Br J Der matol. 2001;145:849–851. [PubMed] [Google Scholar]7. Addy JH. Red sea coral contact dermatitis. Int J Dermatol. 1991;30:271–273. [PubMed] [Google Scholar]8. Dagregorio G, Guillet G. Delayed dermal hypersensitivity reaction to coral. J Am Acad Dermatol. 2005;52:534–535. [PubMed] [Google Scholar]

Saltwater nectotizing fasciitis following coral reef laceration possibly exacerbated by a long-haul flight: a case report | Cases Journal

The rapidly progressive and destructive course of necrotizing fasciitis is thought to be polymicrobial rather than monomicrobial [4]. The diagnosis of primary or idiopathic necrotizing fasciitis may be challenging because it occurs in the absence of a known causative factor or portal of entry for bacteria [5]. The three main secondary necrotizing fasciitis syndromes recognized are type I, or polymicrobial; type II, or group A streptococcal; and type III gas gangrene, or clostridial myonecrosis. The organisms most closely linked to the condition are group A beta-haemolytic streptococci and this was the causative organism identified in our patient. In recent years there has been an emergence of virulent toxic shock strains of group A beta-haemolytic streptococci leading to necrotizing fasciitis with multi-organ dysfunction. Most cases are caused by M types 1 and 3 which produce exotoxin A and streptolysin O[5] The M proteins with their exotoxins act as superantigens, liberating cytokines and resulting in a toxic shock syndrome.

Another type I variant is saltwater necrotizing fasciitis, in which an apparently minor skin wound is contaminated with saltwater containing a Vibrio species. While our patient’s coral reef injury was sustained swimming in salt water, microbiological analysis did not reveal contamination with any marine organisms. Vibrio alginolyticus necrotizing fasciitis has been reported in a patient following a stingray injury in the Pacific Ocean near Hong Kong [6], and in an immunocompromised patient injured on a coral reef while bathing in the Colombian coastal waters of the Caribbean Sea [7].

In assessing mortality risk in patients with necrotizing infections, Elliot et al [3], found that most patients who develop necrotising fasciitis have pre-existing conditions that render them susceptible to infection. Conditions that result in immunosuppression, such as advanced age, chronic renal failure, peripheral vascular disease, diabetes mellitus, and drug misuse appear to be risk factors. Specific conditions making patients susceptible to Vibrio infections include alcoholism and cirrhosis, oral steroid therapy, polycystic kidney disease and leukopenia, hemochromatosis, and multiple myeloma [5]. It has also been found that the condition occurs slightly more often in male patients [3]. Our patient was healthy with no associated comorbidities prior to this event, which, along with prompt diagnosis and aggressive treatment, may account for lack of critical multi-organ decompensation with this virulent and destructive infection. However, the condition may have been exacerbated by the long-haul flight and related physiological changes on the day following his coral reef injury. Mittermayr et al[8] demonstrated that long-haul flights induce significant fluid accumulation in the lower extremity and the increase in tissue oedema was maintained for some days after flight. They went on to report that lower leg volumes were significantly increased after 4 h sitting (+109 ml) reaching its maximum after 10 h (+145 ml). These changes were accompanied by an increased body weight, total body water, extracellular water and tissue thickness anterior to the tibia[8] These physiological fluid shifts may have contributed to the severity of our patient’s necrotizing condition following his long-haul flight from Thailand.

Early recognition and aggressive treatment with extensive debridement and broad spectrum antibiotics is paramount to avoid the fulminant course of necrotizing fasciitis with very significant morbidity and mortality rates [3]. A further adjunct to extensive surgical debridement and dressings has been added with the use of vacuum-assisted wound closure (VAC). Huang et al [9]. compared VAC dressings with wet dressings in the management of open necrotizing limb wounds following debridement. While the VAC dressings were seven times more expensive than conventional dressings, they reported significant decreases in wound size, with treatment time reduced 3.7 fold in the VAC group. In our case, VAC dressings also provided coverage to the unbreached pretibial periosteum between surgical debridements, and, following split-skin grafting over the defect, encouraged granulation and capillary growth into the graft. Further new techniques are being examined such as hyperbaric oxygen therapy (HBO) treatment to increase tissue oxygenation in both healthy tissue and in the vicinity of infected tissue [10].

Snorkel First Aid: How to Treat Coral Cuts

If you make it a point not to disturb coral to the best of your ability, following the snorkeling etiquette rules, then you should avoid most injuries from coral.  However, every once in a while the surf or water have its own plan.  If you’re close to coral, checking out a fish or particular growth, then the surf can push you towards it.  If you push yourself away or brace yourself then you can get cut.  I have been in situations where the surf has actually pushed over the coral and my belly and legs were scraped.  Not good.

Coral cuts and scrapes are not run of the mill, though.  Certain care has to be given to them to make sure that they are not infected and that they heal well.

An Overview

Marine polyps secrete a hard calcareous exoskeleton that is coral.  These exoskeletons are often formed into sharp, rock-like pieces that are colorful.  There are many different types of corals and coral reefs will often have many different species within it.  These occur in tropical and subtropical waters and climates.  Because of the way coral is formed they can cause injury (coral cuts and abrasions) that may seem harmless at first but can soon develop blisters and infections to the wounded area and the rest of the body.  Precise care is always needed for coral cuts.

Symptoms of Coral Cuts and Abrasions

• Coral cuts can get itchy, red and inflamed.  If not treated properly then they can fester.

• Redness may spread from the wound to the surrounding skin. This may be a spreading infection known as cellulits.
• Cellulitis is an infection of the skin and the soft tissue surrounding the skin that results from bacteria from the coral to invade the area.
• Red streaks that move up and down an extremity (finger, toe, hand, foot, arm, leg).  May from a blister or the wound may drain pus.

Treating a Coral Cut or Abrasion from Snorkeling

• Clean vigorously (scrub as hard as the pain permits) and then flush with fresh water as soon as possible after the coral cut.
• If it is stinging then you can rinse it with a from of acetic acid.  Most people turn to vinegar.  Or you can clean it with isopropyl alcohol.   This helps to reduce the effect of irritable toxins from the coral.
• Flush with 1/2 fresh water and 1/2 hydrogen peroxide
• Rinse daily and then apply an antibiotic such as bacatracin.
• If it eases you, you may take oral antibiotics to prevent or fight an infection.  See a doctor for a prescription of anti-biotics.
• If you don’t notice signs and symptoms of an infection than over-the-counter (OTC) steroid ointment will help with redness, itching and stinging.
• Treat pain with acetaminophen (Tylenol) and swelling with ibuprofen (Motrin or Advil) a couple times per day.  You may also use naproxen, found in Aleve.

Note:  Patients that are alcoholics have a tendency to develop bacterial infections by Vibrio spp that can be very aggressive and dangerous (life-threatening) in a short time-span. Any redness of skin that progresses rapidly with blisters moving up an extremity (arms or legs) toward the body should be considered a medical emergency, and will require IV antibiotics.

When to Seek Medical Care, Call an Ambulance or 911

Severe, deep cuts or if infection is present and the wound is not healing.

If you plan on using antibiotics a doctor should always be consulted.

Rapid occurrence of redness, blistering, especially in an alcoholic.

We Recommend this First Aid Kit in a Waterproof Dry Box:

How To Prevent and Treat Coral Scrapes

Scuba diving is traditionally a look, don’t touch kind of sport. But even careful divers can inadvertently run into trouble. By far the most common diving injury is the common scrape, usually from coral.

Irritations often occur as a result of a brush with coral or sponges. Coral scrapes can be painful and sometimes difficult to heal because the living organisms in the coral can get into the wound and cause infections. Contact with a sponge can leave irritating fibers in the skin, producing an itching rash that can range from mild to severe, possibly with pain and blistering.

READ MORE: 10 Tips for Avoiding Dive Emergencies

Even if you’re careful, it’s likely you’ll come into contact with coral someday. If and when, here’s what to do:

1. An ounce of prevention is worth a pound of cure. Makes sure your body is covered, even if just by a dive skin, and wear gloves where allowed.

2. Regularly irrigate a scrape with copious amounts of vinegar over a period of about 30 minutes.

3. Apply triple-antibiotic to the wound twice a day for a couple of days.

4. Scrapes can become infected even with proper initial care. Watch for hotness to the touch, redness or red streaks around the site, swelling, discharge of pus, or fever. If you see them, contact a doctor.

5. Fragments of coral sometimes become lodged beneath the skin and the body mounts a prolonged allergic reaction to them. In some cases, debridement is required to resolve the reaction.

Even in the absence of embedded coral remnants, it is not unusual for a marked hypersensitivity response to a coral injury to continue for three to four weeks before significantly improving. Sometimes the lesion will resolve, then return.

If a scrape doesn’t substantially resolve within a month, or gets worse, you should consult a dermatologist.

Editor’s Note: Even innocent injuries can turn deadly if you have an allergic or severe reaction. After any accident, watch for severe swelling, dizziness, blurred vision, breathing difficulties, weakness, muscle pain, cold sweat and a rapid heartbeat. If any occur, call 911 (or DAN’s emergency hotline 919-684-4DAN if no emergency services are available) immediately. Injectible epinephrine can help calm allergic reactions. CPR may be necessary until help arrives.

Coral Diseases – South Florida Aquatic Environments

Tolerating a very narrow range of environmental conditions including temperature, salinity, and solar radiation, reefs are very sensitive to damage from environmental changes.

Corals, in particular, are susceptible to a number of diseases including black band disease, white band disease, and coral bleaching.

Black Band Disease

Black band disease. Photo courtesy Paige Gill, Florida Keys National Marine Sanctuary

Symptoms:

• Black band moving across the surface of coral colonies, leaving behind exposed white skeleton
• Entire colonies may be killed within months

Cause:

• Black band disease is primarily caused by a bacteria called Phormidium corallyticum

Brain coral infected by black band disease. Photo courtesy U.S. Geological Survey

Black band disease was first described in the early 1970s as a black band moving on the surface of star corals (Monstastrea spp.) and brain corals (Diploria spp.). It destroys live tissue as it moves over the surface of the colonies, leaving behind bare white skeleton. This disease may kill entire colonies within a matter of a few months, however tissue loss from a colony can be only partial with recovery after the black band disappears. This black band consists primarily of the filamentous cyanobacterium Phormidium corallyticum along with other microorganisms. Research has shown that the death of coral tissue is caused by lack of oxygen as well as exposure to hydrogen sulfide in the tissue adjacent to this black bacterial band.

Black band disease occurs when corals are stressed by environmental factors including sedimentation, nutrient levels, pollution, and high water temperatures. These stressors primarily exist during the summer months in the Florida Keys. Black band disease has been observed throughout the world’s reef systems with recent outbreaks in the Caribbean and the Florida Keys.

White Band Disease

Symptoms:

• Tissue peels from colonies of elkhorn and staghorn corals, leaving behind exposed white skeleton
• Bare skeleton is quickly colonized by filamentous algae

Cause:

• Scientists are unsure of the cause, however algae overgrowth may be the culprit

White band disease. Photo courtesy NASA

White band disease was discovered when biologists observed the peeling of tissue from colonies of elkhorn and staghorn (Acropora spp.) corals in waters of the U.S. Virgin Islands. This tissue loss resulted in a distinct line of bare white skeleton, after which this disease is named. Although scientists are unsure about the cause of this disease, it is suspected that algal overgrowth of the coral maybe the primary cause. White band disease progresses from the base of the colony up towards the tips of the branches. Bare, white coral skeleton is left behind, colonized by filamentous algae.

White band disease has had a devastating impact on the corals in the Caribbean, with the infection of approximately half of the shallow water elkhorn corals within the first five years after this disease was first observed. White band disease also devastated reefs in the Florida Keys, killing 95% of all Acropora corals. Even today, the presence of this disease is still evident on many reefs throughout the Caribbean.

Coral Bleaching

Coral bleaching. Photo courtesy OAR/National Undersea Research ProgramCoral bleaching in Florida waters. Photo courtesy Florida Keys National Marine Sanctuary

Symptoms:

• Loss of symbiotic algae leaves translucent coral tissue
• Colonies appear white from the underlying skeleton

Cause:

• Bleaching is believed to be caused by stressful environmental conditions

Coral bleaching occurs through the loss of the symbiotic algae found in living coral tissue. These zooxanthellae are responsible for giving healthy coral a brownish or greenish coloration. When these algae are lost, the white coloration of the underlying skeleton is visible through the translucent coral tissue. Partial bleaching may occur, resulting in only partial loss of zooxanthellae from the colony, as well as total bleaching when the entire coral colony appears bleach white.

This coral disease was first reported in the late 1800’s, however since 1980 extensive outbreaks affecting numerous species have been documented. The affects of bleaching vary greatly among species of corals as well as between individuals within the same species. Bleaching is believed to be a response to stressful environmental conditions. It is attributed to increases in ultraviolet radiation, extreme temperatures and salinities, and high levels of turbidity and sedimentation. Loss of zooxanthellae affects growth rates and overall health of the coral host.

Glossary terms on page

• salinity: concentration of total salts dissolved in water, usually measured in parts per thousand.
• zoanthid: generally small anemone; may be colonial or solitary, and both symbiotic and free-living.
• turbidity: measurement of water clarity, turbidity increases when more light is scattered by particles suspended in the water.

Coral Diseases: Corals Tutorial

Coral diseases generally occur in response to biological stresses, such as bacteria, fungi and viruses, and nonbiological stresses, such as increased sea surface temperatures, ultraviolet radiation and pollutants. One type of stress may exacerbate the other.

The frequency of coral diseases has increased significantly over the last 10 years, causing widespread mortality among reef-building corals. Many scientists believe the increase is related to deteriorating water quality associated with human-made pollutants and increased sea surface temperatures. These factors may allow for the proliferation and colonization of microbes. However, exact causes for coral diseases remain elusive. The onset of most diseases likely is a response to multiple factors.

While the pathologies, or mechanisms by which many diseases act upon the coral polyp are not well known, the effects that these diseases have on corals has been well documented. Black-band disease, discolored spots, red-band disease, and yellow-blotch/band disease appear as discolored bands, spots or lesions on the surface of the coral. Over time, these progress across or expand over the coral’s surface consuming the living tissue and leaving the stark white coral skeleton in their wake. Other diseases, such as rapid wasting, white-band, white-plague, white-pox, and stony coral tissue loss disease, often cause large patches of living coral tissue to slough off, exposing the skeleton beneath. Once exposed, the coral’s limestone skeleton can be a fertile breeding ground for algae and encrusting invertebrates. The colonization and overgrowth of the exposed coral skeleton by foreign organisms often results in the health of the entire colony taking a downward spiral from which it seldom recovers.

Yellow-band disease can rapidly spread over a coral, destroying the delicate underlying tissues. On the left is a massive coral in the early stages of attack by yellow band disease. On the right is the same coral several weeks later. Note how rapidly the area of destroyed tissue has expanded. Learn more and view a larger image.

90,000 Applications: The latest news from Russia and the world – Kommersant Style (131803)

Brazilian sea explorer Luis Rocha received a special award this year – the Rolex Awards for Enterprise.

The Swiss watchmaker established the award in 1976 to celebrate the 50th anniversary of the birth of its famous Rolex Oyster.

This model is the progenitor of all modern watches. Rolex creator Hans Wilsdorf has developed a waterproofing system using rubber seals and a screw-down crown.After protecting the watch from water, he christened it “oyster” so that the name reminds of the sea and a strong shell that protects the pearl.

The

Rolex Awards for Enterprise is aimed at researchers, scientists, artists, technologists, physicians who need funds to pursue projects that benefit humanity. During the existence of the program, 155 people aged from 24 to 74 years out of 35 thousand who declared their right and desire to use the help and support of Rolex received grants for their work.And of course, a present from the company – a Rolex watch.

Luis Rocha deals with the problems of saving coral reefs. He explains that only a small fraction of them, like the Great Coral Reef, are known and studied. Professor, PhD, working at the University of Florida and the California Academy of Sciences, he is currently conducting research in one of the most famous “coral” states on the planet, consisting of 26 atolls and more than a thousand coral islets – in the Maldives. Its task is to study corals in the “twilight zone”, at great depths from 30 to 150 meters, which are hardly accessible to humans.Luis Rocha agreed to answer the questions of the “Style. Watch”.

– You were born in Brazil, a paradise for zoologists, biologists, anthropologists. Why did you choose the ocean and not, say, the jungle of the Amazon?

– At the beginning of my work as an ichthyologist, I had to study the freshwater fish of the Amazon, but I was always drawn to the ocean.

– Is it true that as a child you spent hours in front of aquarium display cases?

– When I lived in São Paulo, I walked to school.For about ten minutes, the school was nearby. But almost every day I spent two or three hours on the road, because I tried to walk past all the windows with aquarium fish. They fascinated me.

– Did you discover the underwater world through the films and books of Jacques-Yves Cousteau?

– Of course, in my childhood it was not so easy to find something to read or see about the ocean. I lived in a small town, then my parents moved to Sao Paulo. So I was delighted to be able to watch the adventures of the Cousteau team on TV.It’s amazing how primitive devices and how brave they worked. Today it is still not a walk, but at least less dangerous than 50 years ago.

– Coral reefs are a symbol of the diversity of the sea. But everyone knows only the upper floors. What happens below, at the limit of scuba diving accessibility?

– This is exactly what I am trying to figure out. Almost everything we know about coral reefs comes from shallow areas of up to 30 meters, but the reefs extend to a depth of 120-150 meters.When we descend to this depth, even the simplest questions, such as who inhabits the reefs, have no answers. This is due to the fact that researching such depths requires serious equipment: bathyscaphes, robots, professional divers. All this requires money, and many scientists cannot.

– How has the pandemic affected your work? Did you have to postpone any expeditions?

– I have planned two expeditions this year to the Maldives to explore their deep reefs with the staff of the Maldives Institute of Marine Research.We had to postpone both expeditions until 2022. Hope we can have the first one in February.

– The Maldives for foreigners has long turned into a recreation reserve with artificial beaches and palm trees. What do you want to find there?

– The Maldives has impressive coral reefs, many of which are still in good condition, and the local authorities want to keep them that way. Much of the world’s deep reef research has been done in the Atlantic and Pacific Oceans, and we know very little about this ecosystem in the Indian Ocean.

– Does Maldives Tourism Help Conserve Marine Coral Reefs? Or hinders?

– Tourism really mostly helps because tourists wouldn’t go there if the reefs were dead. So most of the income from tourism depends on the health of the reefs. For example, artificial beaches built next to resorts would be instantly washed away by the ocean if not for the protection provided by the reefs.

– How big is your team?

– It has five divers: four scientists and one diving safety specialist.We also always travel with a journalist and a photographer: since these underwater massifs are little known, they are just as important to cover them in the media as it is to study them. Several Maldivian scientists are also part of our team and will work with us to analyze and publish scientific data. In addition to our long term partnerships and work in the Maldives, we have projects in Brazil, Chile, Cape Verde and New Zealand. All this for better understanding and effective protection of deep reefs.

– How did you meet the Rolex team? Rolex Awards for Enterprise – your first meeting with the brand or have you known each other for a long time?

– This is the first and immediately very happy meeting. I have always admired Rolex’s willingness to support research and conservation projects, but before receiving the award, I never spoke to them. I applied for this grant precisely because I thought my project would fit well with Rolex’s spirit of research and the philosophy of their Perpetual Planet program.

– Do you wear your watch on land and under water?

– Yes, the Rolex Submariner never leaves my wrist! On land it is a wonderful watch, and under water it is also a reliable tool that I use as a backup for my electronic devices, which sometimes fail.

Interviewed by Alexey Tarkhanov

90,000 New microbiome-altering coral disease discovered

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Microbiome-Changing Coral Disease Discovered

19 December 2019

Scientists conducting research on the reefs of the Pacific and Indian oceans have discovered a high growth of bacteria causing a new, previously unknown coral disease.The causative agents of this disease are cyanobacteria, which form a layer of thin gray biofilm on living coral tissue. Testing the material, scientists have revealed the resistance of the biofilm to the effects of various chemicals, which means that it may well carry drugs or poisons with special chemical formulas. Coral disease has been called gray spot disease and has already been identified in 12 Porites and 6 other coral species. In general, the disease affected almost 22% of the colonies surveyed by scientists.

The largest number of diseased corals is observed in the region of Micronesia, and more specifically in the Luminao reef (Guam). Gray spot disease is quite contagious to living uninfected neighboring corals, but for some reason it progresses slowly. In addition, in some cases, infected tissues continue to grow above the microfilm that covers them, which indicates the natural immunity of corals. Using sampling devices, the scientists collected samples of various types of corals, both infected and healthy, and examined them for the presence in tissues and on the surface of various microorganisms that inhibit the protective functions of these inhabitants of the oceans.After a thorough analysis of the results of the study, it was found that a large number of pathogens are involved in the degradation of the protective forces of corals, which make living creatures more susceptible to the effects of cyanobacteria. Moreover, the presence of certain pathogens is very significant for the causative agents of gray spots disease: it was those corals that had similar microbiome profiles that were affected by the new disease. This obviously means one thing – the organization of the microbiome is controlled.

An interesting fact is that healthy corals in their tissues contained certain infectious clusters, and the affected ones – so-called survival clusters. The former may well have appeared before the onset of symptoms of a new disease, while the latter – the corals kept them as probiotics to fight the infection developing in their tissues.

Coronavirus | Health and longevity

Coronavirus: types, symptoms and prevention

All viral infections known to mankind came to us from animals.Flu from birds, whooping cough from pigs, and HIV from monkeys. Now science is faced with a new type of coronavirus that previously only affected animals. This was the difficulty in treating such infections. Pathogens that come from animals are difficult to tolerate by humans. The virus does not have time to evolve in a new biological form, therefore it has such a lethal effect. So what is coronavirus and how dangerous is it for humans?

Animal coronavirus

The population of the planet had heard practically nothing about coronaviruses until this year’s situation.But in veterinary therapy, they have been known for a long time. This virus infects the gastrointestinal tract and upper respiratory tract of domestic and farm animals.

Cats and dogs are very often exposed to infections caused by the coronavirus. Antibodies to the virus are found in 54% of pets. Even if the animal does not go outside and does not come into contact with others, this does not mean that it cannot become infected. Often times, the infection is brought into the house with shoes.

If the animal has strong immunity, then it easily copes with the disease within a few days.But with weakened immunity, the first symptoms of the disease appear: decreased appetite, diarrhea. The disease is often fatal. Usually, the animal is prescribed a course of antibiotics, as well as a specific diet.

Human coronavirus

The virus got this name thanks to its shape. The surface of the virus particle has protein protrusions that resemble a corona under a microscope. This group of viruses causes intestinal and respiratory infections. Previously, 6 varieties of coronavirus were known, most of which did not pose a danger to humans.But in 2003, there was an outbreak of SARS in China that lasted six months. Then more than 8,000 people were infected, the death toll was 774.

At the end of 2019, China was again overtaken by an epidemic caused by a new type of coronavirus. In just one month, the number of infected people exceeded 5,000. The spread of the virus began in the large city of Wuhan. Analysis showed that this virus is related to the one that caused the epidemic in 2003. The researchers believe that the cause of the virus was the wholesale markets where seafood, snakes, and bats were sold.

Wuhan has now been quarantined. You can get into the city, but you cannot leave. The fact is that the coronavirus was already recorded outside China: Thailand, Vietnam, Singapore. Isolated cases of infection were noted in Europe, America and even in Russia. The people of Wuhan wear masks, the roads are treated with a special solution. People are constantly admitted to hospitals who complain of discomfort.

The problem with the new 2019-nCoV virus is that its incubation period is longer than that of the previous one.It is approximately 3 to 14 days. During this period of time, no symptoms appear, but the virus is transmitted to another person.

Types of human coronavirus:

• Human coronavirus 229E is one of the viruses that cause the common cold.
• The human coronavirus OS43 causes colds and pneumonia in immunocompromised people (babies, the elderly).
• SARS-CoV caused a Chinese epidemic in 2003.
• HCoV NL63 – Causes moderate respiratory tract infections.
• Human coronavirus HKU1 – has isolated human cases.
• MERS-CoV is more commonly referred to as Middle East Respiratory Syndrome.
• The 2019-nCoV human coronavirus is the cause of the epidemic at the end of 2019.

Symptoms

In most cases, the coronavirus provokes a respiratory infection. Rarely intestinal, most often found in children.Usually, under the influence of the virus, a cold (ARVI) occurs, which ends with a full recovery. However, it can sometimes cause SARS and severe acute respiratory syndrome. In this case, there is a high probability of death.

Primary symptoms similar to those of a seasonal cold or flu:

• fever;
• shortness of breath;
• cough;
• diarrhea;
• vomiting.

Coronavirus is detected by PCR. To test for the presence of 2019-nCoV, sputum and nasopharyngeal swabs are taken.

Prevention measures

To avoid contracting the infection, you need to limit travel to China until the epidemic subsides. It is also worth handling food of animal origin more carefully. Many suppliers have given up on Chinese products, but not all. Now at the border of Russia and other countries, the check of arriving people is intensified. Passengers with suspected ARVI are compulsorily isolated for further examination.

States are taking a sufficient number of measures to prevent the disease, but each person can independently minimize the risks of infection.Take care of your body hygiene. This includes not only hand washing, but also the internal state. Viruses are unable to survive in the alkaline environment that is characteristic of the human body. If the pH is kept at an optimal level, viruses will pass by. The Coral Club also offers safe antiviral drugs for the whole family.

viruses

The shadow of COVID: a dangerous syndrome affects four organ systems of those who have recovered | Articles

Those who have recovered from the coronavirus and have suffered from it in a mild form, can expect a new problem.Those who have recovered more and more often reveal multisystem inflammatory syndrome – a serious complication of COVID-19 , which occurs some time after the infection itself. At first it was believed that it was characteristic only for children, however, scientists began to record similar symptoms in adults, and recently this pathology was isolated as a separate disease. Scientists from the United States published a study in which they showed that in adults the syndrome affects more body systems than was described in children: at the same time the kidneys, lungs, gastrointestinal tract, cardiovascular system, other organs and tissues are affected .As explained to Izvestia in the Central Research Institute of Epidemiology of Rospotrebnadzor, the reasons for the development of the disease are still unclear, and the syndrome is still rare for both children and adults.

Painful Quartet

Multisystem inflammatory syndrome, which was previously thought to develop after coronavirus infection only in children (MIS-C – Multisystem Inflammatory Syndrome in Children) , also affects adults. Scientists from the Department of Cardiovascular Medicine at the Vanderbilt University School of Medicine in Tennessee have found that in those over 18 years of age, the disease develops more severely and affects four organ systems at once.

Information about the first isolated cases of the development of a dangerous postcoid ailment similar to Kawasaki’s disease began to appear last year, and in the spring it was given its own name by analogy with the “children’s version”: MIS-A – Multisystem Inflammatory Syndrome in adult. As stated on the website of the US regulator CDC, “As in children, adults infected with the virus that causes COVID-19 may develop MIS-A symptoms several days or weeks after illness.MIS-A is a condition in which problems can occur in various organs such as the heart, gastrointestinal tract, skin or brain . ”

Photo: Getty Images / MediaNews Group / Orange County Register / Paul Bersebach

Experts from Tennessee have also confirmed the fact of multiple injuries in the body of adults on the basis of data from 7.2 thousand patients with signs of coronavirus infection. Of these, 839 (11.7%) were hospitalized with a positive SARS-CoV-2 test result during the study period.Of these, 156 patients (18.6%) were attributed to the MIS-A risk group, and 683 (81.4%) were classified as carriers of acute infection. As a result, only 15 patients from the risk group met the criteria for multisystem inflammatory syndrome, the rest were excluded from the analysis.

It turned out that syndrome affected more body systems simultaneously than previously described . “The average number of organ systems involved was four. The gastrointestinal tract, hematological and renal systems were most often affected. , ”the article concludes.Some patients required mechanical ventilation. Experts conclude that the syndrome is so far rarely recorded and further study is needed to work out treatment regimens.

Other problems

The first reports of the development of multi-inflammation in adults began to appear in September last year, Deputy Director for Research of the Central Research Institute of Epidemiology of Rospotrebnadzor, Corresponding Member of the Russian Academy of Sciences Alexander Gorelov told Izvestia. According to him, symptom complex in both children and adults is practically the same. He manifests itself in the form of persistent fever for more than five days, hypotension (a decrease in blood pressure by more than 20% from the initial one), multiple organ disorders – pathologies of the cardiovascular system, gastrointestinal tract, kidneys, hematological, dermatological, neurological symptoms.

Photo: RIA Novosti / Ilya Pitalev

– Children tolerate coronavirus more easily, therefore, such formidable symptoms that appear in multi-inflammatory syndrome immediately attracted attention, said Alexander Gorelov.- In adults, there were a lot of other problems, and the postcovid is quite pronounced. Therefore, they paid attention to him a little later. In adults, an exacerbation of chronic diseases can be added to this syndrome, because the coronavirus itself can serve as both a cause and a trigger, a trigger for exacerbation of diseases.

Therefore, the syndrome itself was described and separated into a separate group later, but it can also be attributed to the postcoid syndrome, said the Central Research Institute of Epidemiology of Rospotrebnadzor.

In search of the causes

Multisystem inflammatory syndrome is a rather rare phenomenon in both children and adults, said Albert Rizvanov, director of the Scientific and Clinical Center for Precision and Regenerative Medicine of Kazan Federal University, in a conversation with Izvestia. However, the reasons for its development are still not established.

– There are several hypotheses in this regard. For example, the fact that antibodies that are produced against COVID-19 somehow disrupt the body’s .Moreover, with coronavirus, the immune system is under enormous stress. The body fights infection by triggering various immune responses. An example of this can be a cytokine storm, when not the virus itself kills a person, but the immune response to it. COVID causes problems with blood clotting, which leads to cardiovascular disorders. Multi-inflammatory syndrome is another example, the expert said.

As Albert Rizvanov explained, genetics should play an important role here, which determines the immune response to the pathogen.It must also be remembered that patients who have contracted a new coronavirus infection at any age often develop autoimmune reactions , Professor Irina Shestakova, the chief infectious disease specialist at Medsi Group, told Izvestia. Therefore, even if a person has been ill easily, the consequences of the postponed coronavirus infection can be serious.

Photo: RIA Novosti / Denis Abramov

– It is clear that there is a direct cytopathic effect of the virus, which lies in its ability to enter cells through the ACE-2 receptor.And this enzyme is present on almost all epithelial and endothelial cells of the body. At the same time, pathologies of both the lungs and other tissues and organs are caused not only by the direct damaging effect of the virus, but also by an autoimmune reaction, – said Irina Shestakova.

As Izvestia wrote earlier, Rospotrebnadzor experts found that MIS-C occurs more often in overweight children who did not receive antiviral therapy at the onset of the disease.

No1 ProBiotic (No.1 Probiotic) – capsules for stomach health and digestion improvement

Our company works directly with the manufacturer, which allows us to guarantee the quality of the product at an affordable price!

To buy ProBiotic capsules No1 in our online store or just get a consultation, find out which program is right for you *, just fill out the form on the website.We will contact you within a few minutes.

Our managers are not just operators, but the best specialists in the field. They will be happy to answer all your questions!

We are confident in the quality of the products, so you make all payments upon receipt of the parcel (cash on delivery). No ADVANCE PAYMENTS!

Delivery is carried out by the “New Mail” company.

* we cannot give a 100% guarantee of the result. The effectiveness of the product is individual and may depend on the characteristics of the human body.

No1 ProBiotic is designed to restore and strengthen the health of the stomach. It has an effective effect with minor deterioration in the state of the mucous membrane or microflora, various types of gastritis (acute, chronic) and complications (atrophic gastritis, peptic ulcers, neoplasms). A feature of this product is the ability to use it at any age. Efficiency is combined with safety and absence of side effects.

Release form: capsules for oral administration.

Kind: nutraceuticals

Taste: no taste

Volume: 30 pcs.

Action

In prophylaxis, the active ingredients destroy bacteria and infections affecting the walls of the digestive system, the condition of the gastric mucosa improves and the production of acid along with enzymes is regulated. Discomfort, digestive problems are removed.

With an effective effect, it removes the inflammatory process caused by infection, the irritated and damaged tissues of the stomach and mucous membranes are restored, metabolic processes and the state of the local microflora are restored.

Additional properties

In addition to the main effect – the fight against stomach problems, the active ingredients help cleanse the body of toxins and excess cholesterol, remove the main symptoms of diseases (sharp and cutting pain).

Overdose

Cases of overdose have not been registered so far.

Side effects

The occurrence of allergic reactions and the manifestation of increased individual sensitivity to the constituent components is possible.

Pregnancy and lactation

The safety of use in pregnant women and during lactation has not been studied. If it is necessary to take the product during this period, the benefit-risk ratio should be taken into account and a doctor should be consulted.

Method of administration and dosage

Take orally 3 times a day, 1 piece, regardless of food intake, drink plenty of water. Before use, it is advisable to drink a glass of clean non-carbonated water.

The duration of the course of admission depends on the present reasons for the loss of sexual arousal in men.

· The minimum course for prophylactic reception or strengthening of sexual activity – from 40 days.

· An effective course of administration in the fight against more obvious disorders in the state of intimate health – from 2 months.

· The maximum course is designed to combat hormonal imbalance, symptoms of prostatitis and psychological causes of loss of arousal – 2.5 months.

To consolidate the result, it is recommended to take a second course – not earlier than 3 months after the end of the main course, but not later than 6 months of a break.

Additional information

The price set on ProBiotic capsules No1 in our store is a promotional price from the manufacturer. The validity period of the promotional offer and the number of promotional goods, check with the managers.

Terms of exchange / return

You can return or exchange goods within 14 days in accordance with applicable law.

* The product is not a medicinal product.

All results are purely individual and depend on the characteristics of the organism.

Capsules No. 1 Probiotic can be ordered all over the world.

* The promotional price is valid when ordering the minimum course.

Details of the action from managers

* Getting acquainted with the samples of products presented on the site, it is necessary to take into account some points related to the accuracy of color reproduction and the appearance of products. The manufacturer reserves the right to unilaterally, without notifying the consumer, make changes to the color finish and packaging design, as well as change the form of release.Checking for compliance with the ordered product is carried out at the post office, subsequently exchange or return will not be accepted.

90,000 warts treatment at the coral club

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Treatment of papillomavirus 16 type

tar soap for warts and papillomas Who authorized the treatment of warts? not only did not help, but also hurt. Disadvantages: My daughter, 36 years old.CoralMine, Coral water, coral calcium – throw one sachet into a glass closed vessel with a capacity of 1.5 – 2 liters, drink 1520 minutes before meals and 1 – 1.5 hours after meals. Drink during the day. Coral warts club Remedy from taken cups, Supply sector papilloma treatment Where to wear warts in the transition. Coral Mine, Coral Water, Coral Calcium – one gastroenteritis. Virus treatment. Antiviral program. Below are two types of Coral Club antiviral programs – treatment of acute and chronic viral diseases.I take from the Coral Club, write your city, I will find the address of a warehouse in your city. I had erosion before B. I was told not to treat her before giving birth, if there is no HPP. At first there was no HPP, then I picked it up somewhere. International Coral Club is a leader in production and promotion. CoralMine coral water CoralMine. 20% Become a member of the club Discount. Aloemannan It is used for any skin diseases (warts, bites, etc.), improves the skin; Ultimate Licorice and Bearberry leaf improve. Warts Encyclopedia of Alternative Treatment.Health Encyclopedia of Health. The use of medicinal products of the company Dr. Nona (Doctor Nona) Articles and programs for the use of products Coral Club (Coral Club) Traditional methods of treatment and prevention of diseases. Treatment. Friends at the Coral Club. The nose is a hole through which toxins of the bronchopulmonary system are released. And many, not understanding this, treat the nose, if snot suddenly appeared. We see, as always, at the root, now you understand that it is not the nose that needs to be treated, but the bronchi should be cleaned. Now the scheme itself: Making tea.A very good effect is observed in the treatment of prostatitis., In the treatment of inflammatory diseases of the female genital area, such as adnexitis, ovarian cysts, endometriosis, bacterial vaginitis, because in the development of genitourinary infection, as a rule, plays a huge role, as a rule, plays. The advantage of Coral Club antifungal products is that they are natural and safe, unlike most fungicidal preparations, which are very toxic and can cause disturbances in the liver, kidneys, lymph, and endocrine system.What Coral Club preparations are good for the skin? The Coral Club offers a program for skin regeneration and thousands of people have already recovered their skin and are gratefully using this product. The results of using the products of the Coral Club company. Kolesnik Olga, 43 years old, Odessa In order to lose weight I bought CoralMain. And my treatment turned out to be coral calcium, diluted with the recommended amount of water (1.5 liters). Samofal Alexey Anatolyevich, 27 years old, Odessa During the illness. All of a sudden, my friend started to have warts on her arm.And so she decided to try to pick out a capsule of Garlic from the coral club and lubricate the warts with this liquid and so that you think they disappeared. folk remedies for papillomas in the intimate places of papillomas in a cow on milking how to treat papillomas application

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Papillomas attacked me relatively recently.Mostly in the armpits, which made me uncomfortable. The skin in those places is constantly rubbed with clothing. In addition, I do sports intensively, which means I also sweat intensively during training. Papilight helped to cope with a sore in the form of papillomas, for which many thanks to its creators. I recommend to those who got papillomas. It is impossible to detect infection immediately. The disease is diagnosed after the first symptoms appear. Papillomas are not only an aesthetic problem, but also a medical one.Warts often bruise, bleed, become inflamed, and can cause cancer. To increase immunity and overcome an unpleasant disease, it is recommended to use special drugs, which include Papilight Comfort. The papillomavirus is very insidious, it takes a lot of time and effort to fight it. Papilight Comfort is one of the most effective drugs that can affect not only the wart itself, but also the virus that caused it. If the papilloma suddenly becomes inflamed, you do not need to immediately panic.This phenomenon can be explained by completely harmless factors. To find out exactly the cause of the violation, you will have to contact a dermatologist. Inflammation of the papilloma. If the papilloma is inflamed, the question arises, what. Inflammation of the papilloma is a reaction to its damage when the growth is rubbed. If the papilloma becomes inflamed and enlarged after a piece of the growth came off, you need to treat the site of inflammation. What to do if the papilloma is inflamed and reddened: the danger and methods of treatment. Papilloma is a benign skin growth caused by HPV.in infants, moles can turn red and increase in size with the natural development of education, such age spots. 4 Inflamed papilloma under the arm. You should consult a doctor in any case, especially if the papilloma has increased in size and hurts. How to treat papillomatosis? In many cases, the growths can be removed. The doctor can prescribe such a procedure using folk remedies. So, if the papilloma turns red, becomes inflamed and begins to increase, then. It is also possible that the papilloma became inflamed and reddened after celandine or others.It is possible to treat the human papillomavirus for a very long time, counting on achieving a long-term remission. Achieve this result. If the papilloma is inflamed, blackened, covered with a dense crust, itching. Papillomas are treated by a dermatologist. First of all, diagnostic tests are prescribed. If the papilloma began to become inflamed and enlarged after a piece of education came off, then you need to proceed as follows. What to do if the papilloma is inflamed, reddened and sore? Papillomas are benign neoplasms that, with a certain chance, can turn into a cancerous tumor.To avoid oncology, you must always monitor the condition of the growths. Even the most harmless of them are capable of. What to do if papilloma is inflamed – how to treat it, which doctor to go to. First aid for damage to growths: treatment with antiseptics, stopping blood and preventing infection. Why does papilloma get inflamed? The most common cause of papilloma inflammation is it. In this case, first of all, remission of the underlying disease is achieved, and then, if it is still required, papilloma is treated; Hormonal changes in the female body.They arise when.

Treatment of warts at Coral Club

papilloma treatment

It is impossible to detect the infection immediately. The disease is diagnosed after the first symptoms appear. Papillomas are not only an aesthetic problem, but also a medical one. Warts often bruise, bleed, become inflamed, and can cause cancer. To increase immunity and overcome an unpleasant disease, it is recommended to use special drugs, which include Papilight Comfort.Even new flat warts have appeared. Can you tell me another treatment or a doctor? I myself am from Moscow. Girls, I never wrote reviews, but then I decided) these bastards flat warts prevailed all over my face, I did not know what to do. I have had flat warts on my face for several years, but they did not bother me acutely until the failure in the body after the transferred one. The doctor immediately warned that the treatment was relatively long for 12 months. The first week of use did not bode well. (I didn’t think of taking a photo before). I smeared it as prescribed.Methods for removing flat warts on the face and treatment reviews. Flat warts are benign lesions that rise slightly above the skin. 445 reviews (Means for removing warts). New review: Plantar wart removal: third. When I removed flat warts on my arm, I still got burns, because the product spread and burned healthy skin. Means for removing warts Super celandine. Warts are viral formations, and since drugs against viruses are, to put it mildly, conditional, I would not say that we can treat warts.In September, I felt discomfort, it seemed to me that I had pricked my leg in the country. As time went on, the injection site became more disturbing. I’m already in October. I don’t remember who wrote it. Was it interesting for warts? We have the same one now. I had warts on my thumb 6 pcs. I smeared them with varnish for a month. no way! and what is such a serious treatment? In childhood, we used to do all sorts of crap, God forgive me, we smeared and took out the same, and new ones did not appear. to my sister. Plane warts are flat formations that match the color of the skin, so they are.Lactic acid and salicylic acid can be used to treat warts, but they are most effective. treatment of warts at the coral club . papillomas in a cow on milking how to treat. Reviews, instructions for use, composition and properties. Tell us how and by what means you remove papillomas at home, such as are on the face, neck, armpits, under the breast, these malignant processes! Tell us, did the superpurity preparations, cryopharma, verrukacid help you? Removal of papillomas with folk remedies. Method number 1.Celandine in the fight against papillomas, warts. Reviews Removal of papillomas at home. Anna Merzlyakova said: I vote for the second method, with garlic. What remedy can be used to remove papillomas at home? The external manifestations of HPV can give the patient physical and psychological discomfort, therefore, for many, the removal of papillomas at home remains relevant. Moreover, it is not necessary to deal with the removal of papillomas. Removal of papillomas at home is carried out with folk remedies or pharmaceuticals.The main thing is to follow the instructions and recommendations for their use. Methods for removing papillomas with folk remedies are very diverse. Removal of papillomas with folk remedies: is the treatment effective? Papillomas are cutaneous formations that are referred to as benign tumors. They develop due to ingestion. Removal of papillomas at home is carried out with folk remedies or pharmaceuticals. The main thing is to follow the instructions and recommendations for their use.Friends, tell me how you can remove papillomas at home? I’ll tell you right away that I was at the doctor’s office. In response to: the doctor gave the go-ahead for home removal of all my papillomas. As for the remedy for papillomas, I was convinced from my own experience of the effectiveness of verrukacid. You just need to apply it. This is an excellent remedy for removing papillomas and warts, though not all. I decided to try the felt-tip pen. The review today will be dedicated to the Lekker Supercleaner felt-tip pen. This is an excellent remedy for removing papillomas and warts, though not all.I decided to try the felt-tip pen. Removing papillomas with home remedies – celandine juice. This treatment is the most popular among lovers of natural remedies. Based on the destruction of warts using celandine juice, which destroys their protein structure. If the method of treatment is effective, then it is pathological.

Medicines for worms up to a year

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Principle of action Gelmiforte remedy for parasites and helminths

Gelmiforte remedy for parasites and helminths Destroys all known types of parasites Helps cleanse organs and tissues, neutralizes intoxication due to parasitic infection Regenerates mucous membranes, cleanses blood, lymph, intercellular fluids Normalizes redox balance, threatening the formation of cancer cells Increases the body’s immune status and resistance normalizes the functions of oppressed organs, puts in order the hormonal background Heals mechanical damage resulting from the vital activity of worms Eliminates ulcers, pains, smooth muscle spasms

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Official website Gelmiforte remedy for parasites and helminths

Composition of Gelmiforte remedy for parasites and helminths

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Expert opinion

SPECIALISTS RECOMMEND Gelmiforte a remedy for parasites and helminths, TO QUICKLY RID OF GLISTS AND OTHER PARASITES Human infection with parasites is a very frequent and widespread phenomenon.But patients do not take the disease seriously, and even after the discovery of the parasites, many do not receive treatment as it should be or do not complete the treatment. This is hazardous to health! Therefore, if you have any suspicions, be sure to undergo an examination and, if necessary, take a course of Gelmiforte, a remedy for parasites and worms. Now in our clinic this is the first choice drug, which we prescribe even for prophylaxis. Klimenko Boris Semenovich parasitologist, Ph.D.

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Method of application Gelmiforte remedy for parasites and helminths

How to use Gelmiforte remedy for parasites and helminths Adults and children from 14 years old 1 capsule twice a day 30 minutes before meals.Drink capsules with plenty of water. Take no more than 3 capsules daily. The recommended course of admission is 4 weeks.

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How to order Gelmiforte remedy for parasites and helminths?

Fill out the form for consultation and order Gelmiforte remedy for parasites and helminths.The operator will clarify all the details with you and we will send your order. In 1-10 days you will receive the parcel and pay for it upon receipt

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Official website Gelmiforte remedy for parasites and helminths

You can buy Gelmiforte a remedy for parasites and helminths in such countries as:

Russia, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Uzbekistan, Ukraine, Estonia, Latvia, Lithuania, Bulgaria, Hungary, Germany, Greece, Spain, Italy, Cyprus, Portugal, Romania, France, Croatia, Czech Republic, Switzerland, Azerbaijan, Armenia, Turkey, Austria, Serbia, Slovakia, Slovenia, Poland

Took Gelmiforte remedy for parasites and helminths.The effect is amazing. I felt young and healthy. Immunity has noticeably improved, for the 8 months that have passed since I took the course, I never got sick. Previously, I could only dream about it. Recomend for everybody.

Recently I watched a program about human parasites. There they talked about this remedy, boasted that we had created the best remedy in the world against parasites. In my opinion, there was even a minister.