Applying plenty of sunscreen and water safety are the primary health considerations most people think about at the beach. But it’s also possible to encounter various types of infectious organisms while wading in the ocean or walking barefoot on sand.
One that’s been in the news lately is Vibrio vulnificus, a bacterium that can be found in coastal salt or brackish waters and causes an infection called vibriosis. If you eat contaminated seafood (such as oysters) or swallow vibrio while swimming, it can cause stomach cramps, diarrhea, vomiting and nausea.
It can also enter your body through a break in the skin, said William Schaffner, a professor of infectious diseases at the Vanderbilt University Medical Center, “and cause this ‘flesh-eating’ bacterial sort of illness.”
That said, your risk of contracting Vibrio while swimming is low — the Centers for Disease Control and Prevention estimates that contaminated seafood is behind 65 percent of cases — and healthy people without underlying illnesses often have mild symptoms.
Here’s everything you need to know about avoiding Vibrio, plus a few other organisms you might encounter at the beach.
Vibrio vulnificus
Vibrio thrives in warmer waters and is becoming more common due to climate change. “It was confined to the Gulf area for the longest time, but with climate warming, we’re seeing it move up the Eastern Seaboard,” said Schaffner.
In addition to staying out of the water if you have a skin injury, take precautions to avoid getting one. An easy way to do that is to wear shoes when walking on sharp rocks or shells. If you develop a cut at the beach, clean it immediately and monitor for signs of infection, said Norman Beatty, an associate professor of medicine in the Division of Infectious Diseases & Global Medicine at the University of Florida College of Medicine.
Taking a shower after a swim is smart, said Schaffner, since vibrio or other bacteria on the skin will “wash right down the drain, literally.”
It’s especially important to seek medical attention if you suspect an infection and are immunocompromised, have a liver disease, cancer, diabetes or are taking medications that affect your immune system, as these all put you at a higher risk of a more severe infection, said Beatty.
Seabather’s eruption
It’s often referred to as sea lice, but seabather’s eruption is “not even vaguely related to lice,” said Stephen Tyring, an adjunct professor of dermatology and infectious disease at the University of Texas Health Sciences Center, Houston. Instead, the bumpy rash with blisters is caused by contact with tiny jellyfish or sea anemone larvae that become trapped under your bathing suit and release toxins.
You may be more likely to get this rash in tropical and subtropical waters, but seabather’s eruption has been reported along the East Coast of the U.S., including in the Mid-Atlantic and New York.
To reduce your chances of developing seabather’s eruption, remove your swimsuit shortly after getting out of the water and, if the fabric allows, dry it on high heat, added Schaffner, which can “kill those larvae that may be still attached to your swimsuit.”
The rash can last for two to 14 days, and may also come with a low-grade fever, Tyring said, but it usually resolves within a week or so. In the meantime, you can take over-the-counter antihistamines or apply topical corticosteroids to ease the itch.
Cutaneous larva migrans
Cutaneous larva migrans is a parasitic skin infection caused by different types of animal hookworm larvae. These can be found on beaches, often as a result of fecal contamination from cats or dogs, said Beatty. Stepping on the larvae barefoot “can trigger skin irritation and this kind of lacy rash on the feet,” he explained, which may look red, creeping or snakelike.
The risk of getting this infection is rare at most beaches in the United States, but it is more common on the East Coast than the West Coast and in tropical regions.
Luckily, the parasite doesn’t tend to spread to other parts of the body, said Beatty. Since humans are not the natural host for these hookworms, cases usually resolve on their own, but your practitioner may recommend a topical antiparasitic cream or ointment to help the rash heal.
Staphylococcus aureus
More common than Vibrio vulnificus is a bacterium called Staphylococcus aureus, said Schaffner, often just referred to as staph. Around 30 percent of people have staph in their noses or on their skin, and while the germ usually isn’t harmful, it can spread and cause infections.
It’s not uncommon to find staph at the beach. In a 2012 study of three California beaches, the germ was identified in 59 percent of seawater samples and in 53 percent of sand samples.
Like Vibrio, staph can enter the skin through open wounds or cuts, said Schaffner. Staph, though, tends to be “a more superficial infection” than vibrio, he added, since the latter tends to get deeper into skin tissues.
Most staph infections are easily treated with antibiotics. Let your doctor know if you notice redness, swelling or tenderness at the site of a wound after spending time at the beach, since these could be signs of staph.
Norovirus
Norovirus infections are frequently spread through contaminated food, but people can also become ill after ingesting contaminated water, including at beaches. This pathogen spreads easily: “It takes very, very few viral particles to make one sick,” said Schaffner. You’re less likely to catch norovirus from a sick person standing or swimming nearby and more likely to get it from sewage-contaminated ocean water — which, even when diluted, can initiate infection, he said.
Norovirus can cause gastrointestinal symptoms such as diarrhea, vomiting and stomach pain. Some people experience headaches or fever. Typically, “you’re ill with a diarrheal illness for two or three days,” said Schaffner.
At the beach, the best way to protect yourself from norovirus is to try not to ingest water when swimming, said Beatty. “The group I’d be most concerned about would be children,” he said, since kids may not realize they’re swallowing water while playing in the surf.
E. coli
E. coli (Escherichia coli) is found naturally in the intestines and can make you sick if you ingest it. This bacterium “can sometimes contaminate the beach,” said Beatty. Environmental specialists monitor waterways for E. coli and enterococci, another pathogen found in the intestines, as possible indicators that a beach might be contaminated with fecal matter, he explained, which can occur after heavy rain.
An E. coli infection typically causes stomach pain and diarrhea, but some people experience more severe complications, such as dehydration or hemolytic uremic syndrome, which happens when the infection damages small blood vessels and can be fatal. Young children, people with weakened immune systems, and those 65 and older are more at risk for serious illness.
As unpleasant as they can be, infectious organisms that you encounter at the beach shouldn’t prevent you from enjoying your summer. “But with a few careful precautions,” Schaffner said, “you can minimize your picking up something at the beach that you don’t want.”
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