Freudenthal A R, Joseph P R
Office of Marine Ecology, Nassau County Department of Health, Mineola, N.Y.
N Engl J Med. 1993 Aug 19;329(8):542-4. doi: 10.1056/NEJM199308193290805.
Seabather's eruption is an annoying pruritic dermatitis that appears on the areas covered by the bathing suit as an erythematous macular or papular dermatitis, with or without urticaria. It occurs sporadically in Florida, the Caribbean, and as far north as Bermuda. The cause is not known.
We collected information in Nassau County, Long Island, New York, about cases of all types of water-related dermatitis reported by beach personnel, health providers, and affected swimmers from 1970 through 1991. Concurrently, we surveyed all Nassau County swimming waters, especially during the summer season (June through September), for the presence of organisms capable of causing dermatitis. In 1980 a sudden epidemic of a severe, unfamiliar dermatitis in ocean bathers prompted increased surveillance of cases and waters. Planula larvae of the phylum Cnidaria were collected from the ocean and beaches and inside bathing suits. They were examined, photographed, tested on healthy subjects, and observed in the laboratory for metamorphosis.
Three outbreaks of seabather's eruption have occurred on Long Island since 1975. The first, in August 1975, affected a small number of swimmers on the eastern end of Long Island. In 1980 there were thousands of cases along the entire south shore of the island, and in 1990 there were hundreds in the same area. In nonepidemic years, five or fewer cases have been reported yearly. Surveillance for larvae revealed them to be present during the swimming season in epidemic years, but in nonepidemic years they did not appear until autumn, after the swimming season. Applying larvae to the skin of healthy subjects produced a dermatitis indistinguishable from seabather's eruption. All larvae metamorphosed in the laboratory to the adult sea anemone Edwardsiella lineata.
Seabather's eruption, previously reported only as sporadic cases in southern climates, has occurred sporadically and in outbreaks 1000 miles north of most previously described cases. These Long Island episodes were probably caused by the planula larvae of E. lineata.
海水浴者皮疹是一种令人烦恼的瘙痒性皮肤病，表现为泳衣覆盖部位出现红斑性斑疹或丘疹性皮炎，可伴有或不伴有荨麻疹。该病在佛罗里达州、加勒比地区以及远至百慕大群岛的北部地区散在发生。病因不明。
我们收集了纽约州长岛拿骚县1970年至1991年期间由海滩工作人员、医疗服务提供者以及受影响的游泳者报告的各类与水相关的皮炎病例信息。同时，我们对拿骚县所有的游泳水域进行了调查，尤其是在夏季（6月至9月），以检测是否存在能够引起皮炎的生物。1980年，海洋浴者中突然爆发了一种严重的、不常见的皮炎，促使我们加强了对病例和水域的监测。从海洋、海滩以及泳衣内部采集了刺胞动物门的浮浪幼虫。对其进行检查、拍照、在健康受试者身上进行测试，并在实验室中观察其变态过程。
自1975年以来，长岛发生了三次海水浴者皮疹爆发。第一次是在1975年8月，影响了长岛东端的少数游泳者。1980年，该岛整个南岸有数千例病例，1990年同一地区有数百例。在非流行年份，每年报告的病例为5例或更少。对幼虫的监测显示，在流行年份的游泳季节有幼虫存在，但在非流行年份，它们直到游泳季节后的秋季才出现。将幼虫应用于健康受试者的皮肤上会产生与海水浴者皮疹难以区分的皮炎。所有幼虫在实验室中都变态为成年海葵细纹爱氏海葵。
海水浴者皮疹以前仅作为南方气候下的散发病例报道过，现在在比大多数先前描述病例向北1000英里的地区也有散发病例和爆发。长岛的这些病例可能是由细纹爱氏海葵的浮浪幼虫引起的。
