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Germ load of the Baltic sea

Question
Dear expert team,
many pulic institutions warn about dangerous germs in the Baltic sea (Vibrio vulnificus). Patients with immunosupression and patients with underlying diseases should not bath in the Baltic sea. Is there a danger for children with CF (not-transplanted) and would you dehort from taking a bath in the Baltic sea?
Many thanks for your advice,
J. B.
Answer
Dear Mrs. B.,
Vibrions are wide-spread gram-negative bacteria, that live naturally in the water. Vibrions are in contrast to many other species very salt-tolerant and are therefore not only found in freshwater but also in saltwater. Infections caused by these so-called non-cholera vibrions, e.g. Vibrio vulnificus and other species, are known for a long time and altogether very rare. Mostly elderly people and/or patients with immunosupression are infected. Furthermore, wound infections, gastro-enteritis (as the germs can also be transmitted via fish or seafood that is not properly cooked) and very rare also infections of the blood (sepsis) are described. Pneumonias are caused by these germs if at all only in very rare cases. Infections of the lung in case of CF patients are therefore not known. Non-cholera vibrions seem obviously not be capable to adapt to the airways as their habitat. In so far, the recent warning because of non-cholera vibrions in the Baltic sea does not seem to be a special risk for CF patients in my opinion. The high and persisting temperatures resp. water temperatures support of course the growing of bacteria, e.g. also in lakes. Even if the water in public swimming pools should be free of Pseudomonas aerugionsa, contamination with this germ cannot be excluded. Therefore one should get information about the water quality before going to public swimming pools in case of CF.
Best regards,
M. Hogardt
01.10.2018