Dermatitis associated with exposure to a marine cyanobacterium during recreational water exposure

Records from the Fraser Island National Parks First aid station were examined. Information on cyanobacterial blooms at Fraser Island were obtained from Queensland National Parks rangers.Examination of first aid records from Fraser Island revealed an outbreak of symptoms predominantly in January and February 1998.During a bloom of L. majuscula there were numerous reports of symptoms that could be attributed to dermotoxins found in L. majuscula. The other four years examined had no L. majuscula blooms and the number of L. majuscula symptoms was much reduced. These cases comprised a high percentage of the cases treated at the first aid station.Lyngbya majuscula is a cyanobacterium that has been found to contain highly toxic chemicals including lyngbyatoxin A and debromoaplysiatoxin that cause irritant contact dermatitis [1]. It is common across the globe and large blooms have been reported both in the tropics and subtropics [2]. These may be increasing in frequency as well as an increasing risk of exposure due to increases in the numbers of holiday makers and recreational water users in areas known to have blooms. These have occurred in warmer climates in locations as disparate as Queensland, Australia, Florida, USA and Hawaii, USA. Exposure in humans has been most commonly reported via the dermal route. More rarely exposure via the gastrointestinal tract has been reported [3], including an associated fatality [4]. High rates of severe dermatitis have not been found amongst recreational water users bathing in areas known to be experiencing cyanobacterial blooms [5]. However, periodic outbreaks of dermatitis have been reported in the literature every 10 years or so since the early 1950s [6-10].Dermatitis caused by L. majuscula was recorded in swimmers with symptoms similar to a burn, usually appearing in the genital, perineum and perianal areas. Initial symptoms of erythema and burning sensations, appearing a few hours after exposure gave way to blister formation and de