Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: In the summers of 2003 and 2004,
2 microalgal blooms of potentially toxic dinoflagellates (genus Ostreopsis, usually distributed in tropical waters) occurred along
the coasts of Bari, south Italy. Our findings suggest an association between
this phenomenon and concomitant symptoms in people exposed to marine aerosols.
During mid-August 2003 and early September 2004, symptoms of rhinorrhea,
cough, wheezing, and fever were observed during periods of 7 and 5 days, respectively,
in people exposed to marine aerosols by recreational activities on the beach
(swimming or sunbathing) or working activities (swimming attendants involved
in entertainment activities in the water and on the beach, assistance to the
swimmers, and cleaning the beach and swimming pools). Although a mild macroalgal
mucilage was floating on the surface, the water appeared clear. Some people
described a metallic taste of the water. Three days after the onset of symptoms
during both summers, marine waters to which patients had been exposed were
analyzed for temperature, salinity, pH, nitrogen and phosphorus contents,
and phytoplankton presence/abundance. Follow-up testing was conducted 3 to
4 days after the last patient was identified. The study was approved by the
Institutional Review Board and the patients gave written informed consent.
Gallitelli M, Ungaro N, Addante LM, Procacci V, Silver NG, Sabbà C. Respiratory Illness as a Reaction to Tropical Algal Blooms Occurring in a Temperate Climate. JAMA. 2005;293(21):2595-2600. doi:10.1001/jama.293.21.2599-c