Man catches ‘incredibly rare FISH tuberculosis’ after biting his nails until he bled

AN AQUARIUM cleaner was struck down with an “incredibly rare” form of fish tuberculosis because he bit his nails, an employment tribunal has heard.

Joshua Hodges ground his nails “very low” — to the extent that his fingers were “regularly bleeding” — and did not wear gloves when his hands were in the water.

GoogleJoshua Hodges, who worked for Aquatechniques (pictured) in Redhill, Surrey, was struck down with an “incredibly rare” form of fish tuberculosis because he bit his nails[/caption]

The hearing in Croydon, south London, was told Mr Hodges started working for Aquatechniques in Redhill, Surrey, in September 2019.

According to the tribunal, Mr Hodges’ work involved “cleaning and maintaining fish tanks” and he often travelled to clients’ homes as part of that role.

In mid-May 2022, Mr Hodges went to see his doctor about an infected finger.

He was referred to an infectious diseases specialist at St George’s Hospital, London, who diagnosed him with a Mycobacterium Marinum infection.

The tribunal heard: “In fish, this causes a tuberculosis-type illness.

“In humans infection can occur when injured skin is exposed to water contaminated with the bacteria, and it presents as a skin infection.

“An infection of this kind is apparently incredibly rare in humans.”

Tuberculosis in humans is normally a lung infection that is caused by bacteria and can be serious if not treated.

Mycobacterium Marinum does not cause this in humans — although it does in fish.

Instead, the rare infection normally affects the skin around where the bacteria entered and can lead to chronic lesions.

The illness meant Mr Hodges was prescribed “high dose antibiotics” — with side effects including “unpleasant nausea” — for up to a year.

This resulted in him being too unwell to work in the mornings and often in the afternoons.

WORK PROBLEMS

Business owners Emma and Simon Flood were warned by a lawyer that if Mr Hodges suffered a “return of his condition” he could easily sue them if he were to become reinfected.

To avoid this, they reassigned him to work in the pond construction team as there was “no, or very low, exposure to water with fish in it as part of that role”.

Mr Hodges was “not enthusiastic” about this change in role – particularly as he had learned he was being paid less than others – and he met with his employers to tell them this.

“Mr and Mrs Flood remained resolute that he was not to return to his Fish Tank Maintenance role,” the tribunal heard.

Mr Hodges tried to sue his former employers for unfair dismissal, breach of contract for failing to pay him notice, and unlawful deduction from wages but this was not upheld.

Employment Judge Kathryn Ramsden, said: “Mr Hodges described feeling like he was stuck between a rock and a hard place.

“The Floods were unwilling for him to return to the fish tank maintenance role, and he did not want to continue in the Pond Construction team without a pay rise.

“This was, from Mr Hodges perspective, a choice between two evils, and he chose the lesser, but he was not forced to end his employment – that was still at his discretion, even though he did not like the terms on which his employment could otherwise continue.

“The Tribunal finds that Mr Hodges employment was terminated by mutual agreement, and should rightly be seen as such. Therefore his claims for unfair and wrongful dismissal fail.”

What is mycobacterium marinum and how do infections affect humans?

The infection by Mycobacterium marinum in humans is relatively uncommon.

When it occurs, it mainly affects the skin.

Chronic skin lesions, especially on the extremities, are often a diagnostic challenge. 

The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis.

Since this infection is a contact zoonosis, it is important for clinicians to be aware of its diagnosis and properly guide professionals that are in risk groups.

This infection can be prevented by the use of waterproof gloves.

Source: Journal of Venomous Animals and Toxins including Tropical Diseases

   

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