ST. PETERSBURG — In late June, Bill Sanders dozed in a lounge chair behind his home in Tropical Shores, about 30 feet from Tampa Bay. The stench of dead fish kept his wife inside.
He began coughing after about 15 minutes, so hard that it woke him up, and he developed a sore throat. Days later, he almost passed out while reading at the breakfast table. Too disoriented to walk or stand, he crawled to their bedroom to find his wife, who took him to St. Anthony’s Hospital.
The emergency room doctor ruled out a stroke or heart attack and sent him home.
The next day, Sanders lost all hearing in his right ear.
The 68-year-old was diagnosed with vestibular neuritis, which can remain dormant in the body for years. Red Tide was the most likely trigger, an ear, nose and throat specialist told him.
The algal bloom is caused by tiny marine organisms called Karenia brevis. They produce neurotoxins that can cause respiratory and neurological symptoms and skin irritation.
Red Tide has killed more than 1,711 tons of sea life in the Tampa Bay region, but the harmful effects to humans and pets are lesser known.
“We’ve had Red Tide in our waters for hundreds of years,” said Barbara Kirkpatrick, executive director of the Gulf of Mexico Coastal Ocean Observation System, “but as we populate our coastline, more people are being impacted.”
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Scientists know this much about Red Tide: It causes sneezing, coughing and watery eyes in humans. Those with respiratory problems like asthma should stay away.
Kirkpatrick helped lead a 2014 study that examined a link between Red Tide and emergency room visits in six Florida counties. Researchers found an increase in hospital visits for respiratory and digestive illnesses, particularly among people 55 and older.
That echoed a study Kirkpatrick led a decade earlier, which found a 54 percent increase in the rate of admission for respiratory illnesses — asthma, bronchitis, upper airway disease or airway obstruction and pneumonia — at Sarasota Memorial Hospital during the 2002 bloom.
Researchers expected an uptick in asthma and bronchitis, but the rise in pneumonia surprised them.
Kirkpatrick said it made them wonder if the toxin was impeding the immune system.
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She also helped lead a study that followed 125 asthma patients for seven years, finding that exposure to intermittent Red Tide did not worsen their illness over time. But she said knowledge of the bloom’s long-term effects on other patient populations is limited.
“There’s a lot we still don’t know,” she said.
Kirkpatrick recommends local residents to err on the side of caution when it comes to Red Tide. People who live near the coast should wear cloth or paper masks when walking outside, even if they’re just going from their house to their car, Kirkpatrick said.
Those who work near the water, such as lifeguards, beach waiters and particularly city employees cleaning up dead fish, should wear more robust N-95 masks, she said.
“We know it’s a potent toxin,” Kirkpatrick said. “Look at the number of fish killed.”
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Audrey Henson went five weeks without her daily morning beach runs because of Red Tide. Then on July 15, the 31-year-old drove to the beach, hoping the stench of dead fish had dissipated enough to slip in a run.
She stepped out of her car, and her nose and eyes started running. Her throat swelled up. Health officials would have told Henson to leave the shore to alleviate her symptoms — but she lives a 5-minute drive from Gulfport Beach Park.
She said that she can smell the dead fish while standing outside her house. She keeps her windows closed and air conditioner running, per the official recommendations, but running errands or walking her dog often mean coming home with a severe headache.
A 2005 study that Kirkpatrick helped lead showed a 24 percent increase in headaches among lifeguards during Red Tide blooms.
Another study led by Kirkpatrick reported an association between the Red Tide blooms of 2005 to 2009 and an increase in emergency room visits for headaches among patients ages 55 and older. The denser the bloom, the more headaches were reported.
That might explain the symptoms Henson’s brother experienced after working along the Pinellas coast.
The siblings own a demolition business called By the Bay Bobcats. She said her brother spends most of his days working outside. During two recent jobs near Gulfport and Pass-a-Grille beaches, Henson said, Red Tide triggered debilitating migraines that forced her brother to leave work, go home and lay down.
Kirkpatrick is working on an extensive study with the Roskamp Institute, a nonprofit Sarasota lab that studies neurological disorders, that she hopes will reveal the long-term neurological impact of Red Tide. But it will take five years before the data and results are ready to share.
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Brian Harris, 30, was fishing three miles from John’s Pass in Madeira Beach in early July when his fish trap got stuck in his propeller. He had to jump in the water and free the rope. He was back in the boat within minutes.
The next day, he noticed red rashes on his back. Then on his legs, arms and shoulders. A dermatologist conducted a biopsy. Harris, a bait fisherman, kept working as rashes spread and worsened.
“I felt like my skin was on fire,” he said. “Like poison ivy, but hot.”
When the biopsy report came in, it showed Harris had hives set off by an environmental irritant — most likely Red Tide, his dermatologist told him.
Harris started working for his brother’s landscaping company in St. Petersburg a week ago to avoid the toxic algae. The hives disappeared within 48 hours of being out of the water, he said.
Little research has been done on skin irritation caused by Red Tide, Kirkpatrick said. She’s trying to secure funding for such a study. But she’s received reports of people suffering from rashes after swimming in Red Tide and warns people to be careful.
Her advice to anyone who starts to get a rash or itchy skin: “Rinse off as quickly as you can in freshwater and minimize exposure.”
There are also concerns about live fish caught in a Red Tide bloom.
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The Florida Poison Information Center in Tampa has received 27 calls about illnesses linked to Red Tide this year, said medical director Dr. Justin Arnold.
He knows that is an undercount.
“Not everyone calls us when they’re exposed to Red Tide,” Arnold said.
The most immediate and severe reaction to Red Tide exposure tends to come from eating shellfish that feed on infected toxic algae. The result is neurotoxic shellfish poisoning, Arnold said, which can cause symptoms ranging from vomiting and diarrhea to seizures.
A handful of the calls received by the center this year were from people who didn’t know eating recreationally harvested shellfish during a Red Tide bloom is dangerous, Arnold said.
Seafood in restaurants and grocery stores is safe because it is caught offshore in the Gulf of Mexico, and the state rigorously monitors and shuts down commercial shellfish beds at the first sign of Red Tide.
People should not fish in Red Tide bloom patches or areas where the water is significantly discolored, Kirkpatrick said. When fishing in other areas, only eat the fish that vigorously fight on the line, because that means they aren’t loaded with neurotoxins.
Toxin accumulates in the gut of the fish, she said, so throw out the guts and only eat the filleted meat.
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Henson’s 9-year-old beagle, Cooper, has been suffering from Red Tide, too. The vet told Henson that Cooper’s teary eyes and sneezing are an allergic reaction.
Cooper’s twice daily one-mile walks have been reduced to five minutes.
“He sits by the door and cries,” Henson said. “He wants to be outside.”
St. Petersburg Animal Hospital and Urgent Care has seen nearly 10 dogs for illnesses relating to Red Tide in the last month, said Dr. Brett Zager.
That’s a high number, the veterinarian said.
Owners have brought dogs in after taking their pets to the beach and seeing symptoms such as vomiting, diarrhea and fever, Zager said. The common diagnosis is gastroenteritis, or inflammation of the gastrointestinal tract.
If a dog comes into urgent care within two hours of eating a dead fish, Zager said, the vet would induce vomiting. Depending on the symptoms, dogs also may be given antibiotics or a few hours of IV fluids to rehydrate.
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Sanders, the Tropical Shores resident who lost his hearing, recently began physical therapy to recover his balance and ability to walk in the dark, or while multitasking.
The doctor told him his hearing loss is likely permanent.
He fears his days as an audiophile are over.
When the nurse called him in the waiting room last week, he turned in the wrong direction. He couldn’t tell where her voice was coming from.
Worst of all, he said, is the fear of losing connection to the people around him.
“I worry that constantly having to ask family and friends to repeat themselves will cause them to share less often,” he said.
He wishes there was more research on the impact of Red Tide on human health. He hadn’t realized it was anything more than a neighborhood stink bomb.
Editor’s note: The tonnage of sea life killed by Red Tide was updated on Aug.3.
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Red Tide coverage
Tampa Bay has Red Tide questions. Here are some answers.
Is it safe to eat seafood? Here’s how Red Tide affects what you eat.
Can I go fishing? The state is limiting saltwater fishing.
Piney Point: The environmental disaster may be fueling Red Tide.
Red Tide resources
• The Florida Fish and Wildlife Conservation Commission has a website that tracks where Red Tide is detected.
• Florida Poison Control Centers have a toll-free 24/7 hotline to report illnesses, including from exposure to Red Tide: 1-800-222-1222
• To report dead fish for clean-up in Tampa Bay, call the Florida Fish and Wildlife Conservation Commission at 1-800-636-0511 or file a fish kill report online.
• In St. Petersburg, call the Mayor’s Action Center at 727-893-7111 or use St. Petersburg’s seeclickfix website.
• Visit St. Pete/Clearwater, the county’s tourism wing, runs an online beach dashboard at www.beachesupdate.com.
How to stay safe near the water
• Do not swim around dead fish.
• Those with chronic respiratory problems should be careful and stay away from places with a Red Tide bloom. Leave if you think Red Tide is affecting you.
• Do not harvest or eat mollusks or distressed and dead fish from the area. Fillets of healthy fish should be rised with clean water, and the guts thrown out.
• Pet owners should keep their animals away from the water and from dead fish.
• Residents living near the beach should close their windows and run air conditioners with proper filters.
• Beachgoers can protect themselves by wearing masks.
Source: Florida Department of Health in Pinellas County