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My family have been fish mongers (handlers) for generations. I'm the first one to develop a serious hand infection that has required surgery. They are all convinced I'm doing something wrong but I don't know what it could be. Can you shed any light on this for me?

Every job has its ups and downs. Men and women who handle fish (fresh or frozen) with their bare hands are at risk for hand infections. Fish, shrimp, and other seafood products have sharp fins or claws that can cause small cuts in the fingers or palms of the hand. The tiny opening is big enough for bacteria to enter and cause damage to the tendons and tendon sheaths (covering around tendons). Usually, the type of bacteria present is mycobacterium marinum. Exposure to this type of bacteria (leading to hand infection) is common with exposure to fish. A less common (rare) bacterium among fish handlers that can also cause infection and even death of the affected soft tissues has been reported. Symptoms of hand infection due to mycobacterium abscessus are very similar to symptoms caused by the more common mycobacterium marinum. Symptoms include pain, swelling, and redness of the skin over the area affected. Fish handlers often ignore the symptoms. They may keep on working for months before seeking medical help. They may not be able to identify a single traumatic event that could have caused the problem. And they are in good health otherwise. You may not have done anything different from other fish handlers. If your immune system was compromised (weakened) for any reason, you could have been at increased risk for hand infection. Previous trauma to the affected area may put you at risk for infection. Use of contaminated needles (e.g., to inject drugs) is another risk factor for this type of infection. But, there may not be a known cause in some fish handlers.

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