Sick Striper? Mycobacteriosis? What you should know.

By Dr. George DeFranca

Why should New England fisherman be aware of the recent attention that has been paid
to the increasing numbers of sickly looking striped bass (Morone saxatilis) being caught
in the Chesapeake Bay area? Because this fishery is the major breeding and launching
ground for most of the stripers that migrate annually along the northeastern Atlantic coast
as far as Maine and the Canadian maritimes. The Hudson bay striper population usually
stays local to Long Island waters for the most part. A recent report found 76% of striped
bass caught in the bay to have mycobacteriosis.(1) Reports of increasing numbers of
striped bass caught with bleeding sores, bulging eyes, loose scales, and emaciation
(wasting away) have been reported in our New England waters, as is even evident by our
own forum posts. What is the problem? How is it identified? Is it harmful to humans?
What should we do whennot if, we come into contact with a diseased fish (its only a
matter of time)? These are some of the concerns I want to make my fellow
kayakfishermen aware of in this article.

WHAT IS THE PROBLEM?

The problem is called Mycobacteriosis (MB for short) and is caused by naturally
occurring bacteria in the genus Mycobacterium, a family that hales such notable cousins
as m. tuberculosis and m. leprae, organisms causing tuberculosis and leprosy respectively
in humans. MB is also called fish tuberculosis. Mycobacteria as a group are hardy
animals, being able to withstand up to 10,000 ppm chorine exposure and alcohol
preparations up to 60%. After being engulfed by white blood cells, they even have the
reputation of surviving and living inside of their attackers. The bacteria that is most
associated with mycobacteriosis in striped bass is m. shottsii and was discovered in 2001.
(2) Its role in causing human disease is not fully known. However, a closely related bug
is m. marinum, a bacteria that is also known to cause MB in stripers and, more
importantly, disease in humans. Because m. shottsii and m. marinum are closely related,
there is the possibility that m. shottsii can also cause disease in people. Fortunately, these
bacteria are non-tuberculous, meaning they do not cause tuberculosis in people.
Striped bass, like people, become infected when their immune system is suppressed.
Stress in the form of physical injury, excessive handling, pollution, and poor nutrition sets
the fish up for disease. Anything that pierces a fishs slime layer or skin will open the
door to microbial infection. Usually a healthy fishs immune system is strong enough to
defend against infection but if it is weakened, the fish will succumb to disease
Increasing numbers of striped bass are competing for decrease numbers of Chesapeake
Bay menhaden, a staple in their diet. Although the Atlantic menhaden population is
considered healthy, and this is a contentious subject, a decline in younger fish returning to
the Chesapeake Bay has been observed. These are the preferential food source for young,
growing stripers in the bay area before they migrate up the coast. Without vast numbers
of nutritious and protein-rich menhaden to support the growing, competing population of
stripers, the nutritional status of stripers is put at risk.

In addition, pollution from acid rain and other sources is creating a domino effect with
serious and far reaching consequences. Acid rain, both dry particulate matter and
precipitation laden with chemicals, can alter the pH or acidity of surface water. Fish are
most susceptible to acid rains effects on the ecosystem. More insidiously, the imbalance
caused by this pollution favors the growth of mycobacteria. Increasing numbers of this
organism have been documented every year for the past 20 years. Between 1998-1999
skin lesions found on striped bass due to this particular infection were found in nearly
50% of fish caught in the estuaries of the Chesapeake bay. In 2001, estimates reached
70%.(3) Infection rates rise each year and progressively climb as the fish get older.
Mycobacteriosis is an illness that festers over time, taking years to eventually kill, unless
this fish dies of some other event. The rates of infection favor males more than females.
Why this disease mostly affects striped bass is a mystery. Hopefully future research will
shed some light on the problem. This problem looks like it is here to stay and the future
of the striped bass may be threatened again since its record low levels in the 1980s.

HOW IS IT IDENTIFIED?
Mycobacteriosis many times goes unrecognized by anglers because it is mostly a
disease of the internal organs. The spleen, kidney, and liver are prime targets. Many
anglers that keep their catch fillet them and discard the rest without opening the body
cavity. Later stage disease can manifest as external sores and lesions. However, not all
external lesions are MB. They can be from other microorganisms, parasites, or physical
trauma.
A hallmark of the disease is that the fish becomes emaciated. The back along the
dorsal fin will look smaller, even skinny. Sores develop on the surface and open to the

outside oozing tissue fluid or blood (Figure 1).

This is also called Ulcerative Dermatitis Syndrome. Inside small granulomas can be seen
on the spleen and kidneys (Figure 2). These are small, round whitish-gray nodules or
specks. They are accumulations of white blood cells, bacteria, and scar tissue. The fish
can swell inside from accumulated body fluids, their eyes can protrude, and spinal
deformity is not uncommon in later stages. Look for a fish that appears under-weight, has
red sores, possibly open sores that bleed, loose scales, and bulging eyeballs.

The typical appearance is of a fish that looks unhealthy and is

literally wasting away (Figure 3).

This is usual of
myobacteria infections, but other parasites can be involved. The only accurate way to
identify the offending organism is via autopsy and the culture of lesions.

IS IT HARMFUL TO HUMANS?
Even though it is uncommon for this disease to be transferred from fish to people,
there are certain circumstances under which humans are more susceptible. Anglers need
to be aware of them in order to prevent transmission. Mycobacteria are also found in fish
aquariums and pools and have been known to cause skin lesions in people working with
them, ie., fish tank granuloma. Striped bass infected with mycobacteria have the
potential of passing it on to humans, thus the name Fish Handlers Disease. This is
especially true in people with breaks in the skin, cuts, open sores, or suppressed immune
systems that are handling fish with mycobacteriosis. However the infection is usually
mild and contained to the skin, unless the person has suppressed immunity.
The lesions develop on the extremities in areas where the skin is cool and the
circulation is not great. Therefore, it is usually seen on the hands, arms, or legs. This is
most likely because m. shottsii cannot survive in temperatures above 86. However, it
can affect the joints, bones, and regional lymph nodes. The characteristic lesion is red,

painful with swelling (Figure 4).

A persistent nodule or
firm bump under the skin and a rash on the exposed body parts may appear. It may itch
and break open. Pustules can form and ooze a thick whitish-yellow fluid. If you are
healthy, chances are the disease will self-limit. However, if bacteria are seeded deeply
into the tissues by puncture wounds, a more serious infection can develop locally.

Immunologically suppressed individuals can also suffer more serious and systemic
disease. Fortunately, this illness responds to antibiotics. Since this may appear like a mild
cellulitis, it may be initially treated with antibiotics to target a staph or strep infection by
mistake. When there is no response, a tissue biopsy and culture will reveal the offending
mycobacteria and the appropriate antibiotic will then be administered. (4)

WHAT SHOULD WE DO?

If you catch a fish that appears ill, has sores on it, especially if they are open and oozing
blood or fluid, care should be taken in handling. This is a good argument for the use of
gloves. Do not keep the fish. Supposedly you cannot get sick by eating a fish with MB.
To date, I dont think there is enough research done on the subject. However, there is an
ancient dietary rule most of us inherently follow: if it doesnt look or smell good, dont
eat it. My sense is that this common sense axiom applies in this situation. I release all of
my fish anyway. Clean off any equipment or kayak surface that has come in contact with
the fish, especially blood or body fluids. A simple rinse with fresh salt water when out in
the kayak will do, or better yet, use an alcohol wipe that you can dispose of in a ziplock
baggy. A definite risk of infection is involved if you handle these fish and have open
sores, cuts, or even scratches on yourself. You must not touch infected fish in this
situation without wearing protective gloves. Bandage any cuts or scrapes before going
out and wear gloves. Wipe the gloves down with alcohol wipe if exposed. When you can,
wash your hands with soap and water like you normally would after fishing. Most
importantly, if you do get symptoms of mycobacteriosis infection, call your doctor and be
sure to tell him or her of your suspicions.
Most kayak fishermen and woman I know are conscious and decent people that care
about our environment and its resources. As such we must endeavor to not weaken a
fishs vital force by fighting them long and hard. Also, excessive handling of the fish
should be avoided, returning them quickly to the water being the goal. This can limit the
stress we put on their immune system. Finally, we can all do our small part to protect our
waters and environment from pollution.
In summary, MB is more of a problem for stripers than it is for us. The infection in
humans is usually mild and highly treatable with antibiotics. However, common sense
should prevail when coming in contact fish that are infected with MB.

References
1. Rhodes M.W., Kator , I, Kaattari, et al. 2004. Isolation and characterization of
mycobacteria from striped bass Morone saxitills from the Chesapeake Bay. Diseases
of Aquatic Organisms 61(1-2): 41-51.
2. Rhodes, M.W., Kator, H, Kotob, P., et al. 2001. A unique Mycobacterium species
isolated from an epizootic of striped bass (Morone saxatillis). Emerging Infectious
Diseases 7:896-899.
3. Fact Sheet FHB 2002-01, August 2002. Dept. of the Interior. USGS.

http//www.lsc.usgs.gov.
4. Debra Poutsiaka, PhD, MD, New England Medical Center, Infectious Disease Dept.,
personal communication, 3/18/06.
Figures
Figure 1. Young striper with red bleeding lesion on side. (Courtesy of Ridler and Mark
of NEKF)
Figure2.Granulomas/nodulesonspleen.Notewhitishrayspecks.JohnJacobs1,Mark
Matsche,SteveJordan,etal.2003.StripedBassHealth.Universityof
Maryland,CenterforEnvironmentalScience,HornPointLaboratory1MD
DepartmentofNaturalResources,FisheriesService2.
Figure 3. Severely emaciated striper. JohnJacobs1,MarkMatsche,SteveJordan,etal.
2003.StripedBassHealth.UniversityofMaryland,CenterforEnvironmental
Science,HornPointLaboratory1MDDepartmentofNaturalResources,
FisheriesService2.
Figure 4. Mycobacterium (marinum) hand lesion. (Courtesty of A.D.A.M.
www.adam.com)