Bay Journal

The night I feared I’d lose my leg

A true Chesapeake Bay infection story

  • By Rona Kobell on August 28, 2014
Capt. Tim Marshall looks for artifacts on Martin National Wildlife refuge, near where Bay Journal writer Rona Kobell contracted her bacterial infection

For years, I’ve been writing about swimmers and watermen getting serious bacteria infections from contact with the Chesapeake Bay. But I’ve also been telling people when they ask that it’s generally safe to swim in the Bay and its tributaries. Just make sure you don’t have any open cuts, I say, and you’ll be OK.

At least that’s what I used to say — until I got an infection of my own. Until I endured all of the symptoms of the terrible flesh-eating bacteria — fever, nausea, vomiting, chills, swelling. Until I lay awake in a hotel room far away from home, wondering if that night was the night I would lose my leg.

It happened three weeks ago. I was on Smith Island, which is about 10 miles off the coast of Crisfield in the middle of the Chesapeake Bay. I had been planning a two-day trip to cover a meeting on the island’s post-Sandy recovery for the Chesapeake Bay Journal and a travel story for our sister publication, Bay Journeys. When I heard that some biologists from the Department of Natural Resources would be out there around the same time to measure sea grasses at the Martin National Wildlife Refuge, I decided to stay an extra day.

I checked into the Smith Island Inn on Ewell and met a few other guests. They warned me not to go in the water. Recently, they said, a woman had lost her leg from an infection, and two other people had been in the news in the Washington area for contracting dangerous bacteria.

I explained to the guests that I wrote about cases like those, and that it’s rare for such things to happen. The Washington men were older than 60, I said, and they were in a much more polluted part of the Bay. Smith Island is pristine, I said. Just look around! Then I biked off through the golden marsh to cover my stories.

I decided to hire a local captain, Tim Marshall, to take me to the Martin Refuge. Marshall, a lifelong islander, has a large collection of arrowheads and other Indian artifacts. He takes out many tourists, and also has a keen eye for wildlife. I thought going with him would serve two purposes: I could gather information for the travel story, and I wouldn’t have to stay out with the biologists for several hours while they measured grasses. I only needed about a half an hour with them; we had an interview scheduled for later in the afternoon.

I wore a long-sleeved shirt, waterproof pants I had just bought, and water sandals. I was slathered in bug spray and sunscreen. Capt. Tim nosed the boat to a mudflat and helped me out. I pulled up my pant leg for about 30 seconds to climb out of the boat. When I got onto the mudflat, something bit me. I didn’t see what it was, but it hurt more than the typical mosquito bite, and there was a drop of blood on my leg.

“I think a spider bit me,” I told Capt. Tim.

He responded that the bugs hadn’t been that bad this year — which was true. I’d been on Tangier Island two months before and was nearly eaten alive.

I took my photos and then we moved on to look for arrowheads and sea grass. I kept my leg covered. Capt. Tim took me to the pelican rookery. Then he glided through the Sound to show me stingrays. After about three hours, I had gotten what I needed and asked to go back. I ate lunch, wrote one story, and then biked a few miles to the town of Rhodes Point and back for some more photos. Then I met with the biologists, interviewed them, and introduced them to Capt. Tim, who invited all of us over later to tour his artifact museum.

The bite on my leg was starting to swell a bit as our group went to the home of John and Pam DelDuco, island residents who’d invited us for dinner. Toward the end of a lovely night, the subject of infections came up, and I mentioned my leg was bothering me a bit.

DelDuco reminded me that I knew the symptoms. Just watch out for them, he said, but it was probably nothing.

I took the group to Capt. Tim’s and then walked home. I was a little worried, but I figured it was nothing more than an allergic reaction to a bug bite.

I packed up and went to bed, eager to take the 7:30 a.m. ferry back to Crisfield. I hadn’t gotten much of a chance to talk to my husband or children while on the island, and I missed them. Email access was sparse, and so was cell service. It had been three days since we'd really talked.

At 3 a.m. I woke up sweating. Goosebumps everywhere. I could tell I had a fever. I touched my leg. It was burning hot, and swollen, as though I had a ridiculously fit calf muscle. I couldn’t move it. I saw the area around the bite was red, and in the middle, there was a bulls-eye. I managed to make it to the bathroom, where I promptly vomited. And there I stayed, unable to move my leg to get back to the bed.

I thought immediately of Mauro Lanzisera, a Broomes Island waterman who had tripped on his boat rope and then gone into the water to get the vessel as it got away from him. Lanzisera washed his cut, applied peroxide, and showered. He still nearly lost his leg. He endured one month at Shock Trauma, six surgeries and intense physical therapy before he could walk again. That was five years ago, when no one wanted to acknowledge the Chesapeake had a flesh-eating bacteria problem.

Lanzisera was able to get to the hospital right away. I did not have that option. Smith Island is about a 45-minute boat ride from Crisfield. I could see the clock. 4:05 a.m. The boat would be leaving in three and a half hours.

I could call 911 and they could dispatch a medevac helicopter to fly me to Crisfield. Would that be much faster? I had a pit in my stomach thinking about the cost, and the nagging feeling that it could still be just an allergic reaction to a bug bite. I sat there, immobile, not sure what to do.

I ran down in my head what I knew about vibrio vulnificus, the bacteria that infected Lanzisera and so many others. I was one of the first reporters to write about vibrio in the Chesapeake Bay region, back in 2004, when researchers first warned that warmer water temperatures meant we could see more cases here. That is bearing out; the number of vibrio cases is growing all across Maryland and Virginia. Centers for Disease Control statistics show a sharp increase. In Calvert County, where Lanzisera lives, there were five cases this summer; the year I covered his case, health officials would barely acknowledge there was a problem. Now, they were putting out advisories, and Anne Arundel County was even doing shows on vibrio survivors on their public access channel.

For vibrio to thrive, the water temperature has to be above 80 degrees. I didn’t have a thermometer with me, but I was guessing it wasn’t that warm. Please, please, let it be giardia, I said to myself. Please, please, not vibrio.

This leg and I, we’d had a good run. Last year, we ran the Baltimore Marathon relay, a 7.5 mile stretch that ended with a tendon injury. With lots of physical therapy and rest, I’d nursed it back to health. It finally felt back to normal. And now I could lose it. I imagined my routine — playground, school bus, Starbucks — without my left leg. I couldn’t bear it. I cried. Then, somehow, I made it back to bed and slept for three hours until it was time to go.

When DelDuco picked me up, he asked how I slept. I said not well. He told me he felt terrible about worrying me over nothing.

I stuck out my leg.

“Turns out it wasn’t nothing,” I said.

His face changed a whole color.

We agreed I’d go to the Crisfield Clinic as soon as the boat landed.

“Look, it’s probably nothing, but go get it checked,” DelDuco said, in a tone that convinced neither of us.

There were three of us on the boat. Capt. Terry Laird, known as Big Terry, drove. His son, Terry Jr., took a nap — he’d been up since before dawn tending to soft crabs. I sat in a plastic chair on the back deck and checked my e-mail. When Terry Jr. woke up, I asked for directions to the clinic. He asked if I felt all right. I stuck out my leg and explained I thought I’d gotten a spider bite — because it sounded better than telling him thought I had a flesh-eating bacteria.

“Yep. Somethin’ got ya!” Terry Jr. said, adding that Smith Island didn’t have too many spiders. “Probably a mosquito.”

The clinic wasn’t open yet, so I sat outside. A man with a large coffee mug stepped out of a late-model American car. I noticed he had an earring. He looked young.

“Are you the doctor?” I said.

“I am,” he replied.

I was in his office after about 15 minutes of paperwork.

“I’m Steve,” he said.

“Dr. Steve?” I replied.

He smiled, and I showed him my leg. Then I started to cry.

“I don’t want to lose my leg. I know what happens to people when they get infections from the water. Please tell me I’m going to be OK.”

“Well, I’m not going to have to take out the saw just yet,” Dr. Steve replied.

It wasn’t vibrio. It was cellulitis, another bacterial infection caused by streptococcus and staphylococcus. Cellulitis is a cousin of the deadly MRSA. And, if left untreated, it can kill you. But the silver lining is that it doesn’t lead to losing one’s limb. And with strong antibiotics, you can usually get rid of it in about a week. What probably happened, Dr. Steve said, was that something bit me. With my skin exposed to the Bay, bacteria living in the water entered my skin through the pin-head-sized opening. 

Dr. Steve urged me to fill the prescription in Crisfield and get on the antibiotics right away. Within 24–48 hours, he said, I’d start to see a difference, but I needed to take the whole course.

On my way back to Baltimore, I stopped in Salisbury to see my friend Tom Horton. In close to a half century of chronicling the Chesapeake, Horton’s spent more time in the water than some rockfish. But he’s never gotten an infection.

I showed him my leg.

“Yes, that’s pretty swollen,” he said, only slightly more helpful than Terry Jr.

When I got home, I showed my husband my leg. He had the same look on his face that DelDuco had.

Then I called DelDuco. It had only been five hours since I began taking the medication, but the leg was still swollen. No change. Of course, driving 190 miles probably didn’t help matters. I was beginning to worry I’d gotten a misdiagnosis, like Lanzisera had. The first time, doctors took a look at his leg, gave him meds, and sent him home. It was only after a physician moonlighting in the emergency room for extra cash happened to see him that Lanzisera was rushed to Shock Trauma in Baltimore. The doctor recognized the infection as something he’d treated in Iraq.

“Is it true that there was a woman who came to Smith Island and went in the water and lost her leg?” I asked.

DelDuco was quiet.

“Yes,” he finally answered.

But, he said, she was in her 60s. She didn’t get treatment right away.

“You’re going to be fine,” he said.

I woke up again at 3 a.m. But this time, when I asked my husband to touch my leg, he looked relieved.

“It’s much, much better,” he told me.

By the next morning, I could tell it was about 50 percent better. It still was hot, but not burning, and I could flex it a bit.

Over the next week, the cellulitis slowly went away. Within 8 days, my leg was feeling well enough to ride a horse two hours up a mountain. Within 10 days, I could ride a bike again. And finally, three weeks later, the tell-tale red dot has disappeared. And I am fine.

But now, when people ask me if it’s safe to get into the water, I am not sure what to tell them. I didn’t have any open cuts. I was wearing bug spray. I had long pants on. I was in a pristine part of the Chesapeake, the cradle of the crab habitat, where pelicans outnumber people by a large margin.

There are things I wish I’d done differently. I wish I’d been wearing wader boots instead of sandals, even though waders are uncomfortable for lots of walking. I should have cleaned the bite with peroxide immediately and covered it with a band-aid. Would that have helped? I’m not sure.

I’ll still go in the water from time to time. It’s my job. And I’m grateful to have the opportunity to visit the most wonderful people in the most beautiful places. Maybe I was just unlucky. Or lucky. But 10 days with streptococcus and staphylococcus will go down as a terrible chapter in what was a rather eventful summer. I am glad to see it end.

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About Rona Kobell

Rona Kobell is a former writer for the Baltimore Sun. .(JavaScript must be enabled to view this email address).

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