Posted on 09/10/2005 6:44:00 AM PDT by wjersey
Actually there aren't that many. But what they do have are ships with extensive medical and berthing facilities. One is the USS Bataan, about the size of a WW-II aircraft carrier, and designed to carry and support a Marine Expeditionary force. It operates helicopters and Harrier jump jets, and the V-22 Osprey can also be deployed on it. One is the Iwo Jima, of the same class, , while the third is a command ship, IIRC, but still with considerable medical facilities.
Since there are only 10-20,000 people left in New Orleans, they clearly no longer have as much need as the Mississippi and Alabama coasts.
That's our call, not yours.
I can post pictures of patients with vibrio vulnificus infections if you would like.
Let's see...it's 3 pm...your lunch is probably out of the fundus of your stomach by now so it should be ok.
TAW
Pictures? A total of 65 cases documented among the general population would statistically equate to 1:5,000,000; how many such horrible cases have you personally seen, treated?
As in all bacterial diseases, antibiotics are effective except in those who are immuno-deficient.
My fundus is a firmament unto itself, I do not vomit.
Good grief all we've seen is The New Orleans Plantation of the Gulf Coast.
TAW
Yes, but the treatment is well within the scope of what we used to call a general practitioner.
Trent did himself proud this time.
It's racism against whites by CNN! We should have congressional hearings.
Where's Jesse Jackson?
Yes, a mild case of gastroenteritis caused by ingesting undercooked shellfish could be treated by a general practitioner. However, the necrosis associated with a wound infection caused by any of the bacteria in the genus Vibrio should be treated by an ID specialist and a dermatologist. Furthermore these infections carry a 100% mortality rate if not treated properly.
Would you let your GP debride a wound?
One last point if I may. Because of their asymptomatic progression, most of the two percent of the U.S. population that has chronic liver disease caused by Hepatitis B and C don't even know that they have it. The percentage of the population with CLD due to other etiologic factors escapes me at the moment. I make this point because when a person with CLD becomes symptomatic from a Vibrio infection it's usually too late to provide curative therapy.
If you were dying with necrotizing skin lesions, you would probably want someone who specializes in the skin to be treating you.
Hope the following helps.
CLINICAL PRESENTATION
Q. INFECTION, VIBRIO
1. ETIOLOGY: Cellulitis and necrotizing soft-tissue infections can be caused by marine Vibrios. Infection with V parahaemolyticus, V vulnificus, and V alginolyticus are most frequent, but all Vibrio species have caused infections (Kumamoto, 1998; Kaye, 1990; Plotkin, 1990; Park, 1991; Levine,1993; Howard, 1993; Shin, 1996; Hlady, 1996).
2. EPIDEMIOLOGY (Hlady, 1996; Howard, 1985; Pessa, 1985; Jenkins, 1986; Klontz, 1988; Kaye, 1990; Park, 1991; Warnock, 1993; Howard, 1993; Levine, 1993):
a. In US, most marine Vibrio infections occur along the Atlantic and the Gulf seaboards; most cases occur in summer months.
b. High risk of rapid spread of infection in patients with underlying illness, especially cirrhosis and alcoholic hepatic disease. Higher incidence in patients with liver disease may reflect a preference of Vibrios for an environment rich in saturated transferrin, either from an excess of iron or a relative lack of transferrin (Hlady, 1996).
3. PREDISPOSING FACTORS:
a. Infection results from contact of a wound with saltwater harboring a marine Vibrio or from a puncture wound or small laceration acquired by handling shellfish harvested from such environments. Primary sepsis is caused by ingestion of contaminated raw shellfish (usually oysters) (Howard, 1985; Pessa, 1985; Jenkins, 1986; Klontz, 1988; Kaye, 1990; Plotkin, 1990).
b. Has been reported following catfish spine puncture wounds (Midani, 1994), shark attacks (Klontz, 1993), and injury inflicted by a stingray (Ho, 1998).
4. CHARACTERISTICS (Kumamoto, 1998; Howard, 1985; Pessa, 1985; Jenkins, 1986; Klontz, 1988; Kaye, 1990):
a. Tend to present within 24 hours of marine contact; manifested by fulminant signs and symptoms.
b. The site of infection (usually on an extremity) is initially erythematous and extremely edematous or ecchymotic, then rapidly progresses to vesicles and bullae and finally to necrosis involving skin and subcutaneous fat.
c. Vibrio infections also can cause gastroenteritis and primary septicemia. Primary septic form is virulent, with symptoms appearing within 24 hr of consuming raw seafood. Secondary skin lesions, including vesicles or bullae, gangrene, purpura macules, papules or wheals are concurrent with septemic symptoms. Requires early empiric therapy, without awaiting confirmation of the diagnosis (Warnock, 1993; Shin, 1996).
5. LABORATORY:
a. Cultures from a single wound may reveal single or multiple Vibrio species and single or multiple strains of those species (Plotkin, 1990).
b. Most common species isolated in primary septic form is V vulnificus (Kumamoto, 1998; Parks, 1991).
6. MORTALITY:
a. Primary wound infection in otherwise healthy patients has good prognosis with minimal mortality if treated promptly. In patients with underlying disease, mortality is 25% if the wound is debrided, 60% to 100% if not debrided (Halow, 1996).
b. Primary septic form has mortality of nearly 100% despite aggressive treatment (Kumamoto, 1998; Warnock, 1993).
So you are saying that it requires a dermatologist to properly debride the necrotic tissue in order to effect the recovery of the patient?
Yes.
I think the tens of thousands came from a democrat and he was refering to registered voters, not necessarily live people with one name on election day....
Then I am convinced; it just struck me as odd, but I was thinking in terms of treating the sailors on board rather than the whole patient load a hospital ship might have.
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