By COLIN M. STEWART
Tribune-Herald staff writer
A Maui man was scheduled to undergo skin graft surgery at Hilo Medical Center on Friday after allegedly contracting a rare flesh-eating disease from the “hot pond” at Ahalanui Park.
Meanwhile, the state Health Department’s Clean Water Branch worked to test the water in the pond at the popular lower-Puna park, which remained closed Friday after the County of Hawaii Department of Recreation shut it down Thursday afternoon.
In a news release issued late Thursday afternoon, spokesman Jason Armstrong explained that parks director Clayton Honma opted to close the park “in an abundance of caution.”
“Ensuring the health and safety of all park users remains the top priority of the Department of Parks and Recreation. … Ahalanui Park will remain closed pending the department’s receipt of the test results and assurance that the water quality continues to fall within safety guidelines,” the release stated.
Armstrong on Friday morning said that parks officials had not been able to tie the reported illness to conditions in the pond, and had not yet positively identified the person who was reported to have contracted the bacterial infection, known as necrotizing fasciitis.
“We haven’t heard from the injured person, and (privacy law) prevents us from gathering his info. We are working with the Health Department to find out the nature of his illness and how it might have been caused,” he said.
A friend called the Tribune-Herald and identified the man in question as 70-year-old Maui resident Steve Johnson.
In an interview Friday morning from his hospital room at Hilo Medical Center, Johnson said he was doing well despite the circumstances.
“It’s been three weeks and two days since I came into the hospital,” he said Friday. “I’m going to have surgery at 3 p.m., they’re going to put skin grafts on all the areas of my leg where I had the infection.”
Johnson said that doctors told him he had been very lucky because the infection did not spread into the muscles of his right leg, instead being relegated to multiple layers of skin, from the top of his foot to his thigh.
Necrotizing fasciitis is a relatively rare infection that is generally more likely to occur in people with compromised immune systems. But areas with warm, brackish water can promote the growth of the bacteria that causes flesh-eating disease, and signs posted at the pond warm swimmers not to enter if they have open wounds.
Johnson said Friday he never saw the signs, and he attributed his illness to the fact that he had recently cut his leg during a bike ride on Saturday, Aug. 31, before entering the pond.
“I was on the way to the hot ponds, and on the side of the road I saw the biggest lilikoi I’d ever seen in my life. So I stopped to get it and I scraped my leg. When I got to the park, I went to shower and cleaned off the blood, some had gotten into my sock. Then I ate the lilikoi, and it was the best one I’d ever had in my life,” he said.
He then took a dip in the hot pond. He said he didn’t feel anything until about 24 hours later.
“I was getting chills and fever,” he said. “It didn’t show on my leg for another 48 hours, on Wednesday. But Tuesday night it was just a high fever. I was house sitting for a friend in Orchidland, and when the fever subsided the next day, I saw my leg was red, and showing signs of what’s called cellulitis. My friends came to see me, and they looked at it and said, ‘You’re going to a hospital.’ Kaiser (Permanente) put me into the emergency room, and I went into surgery the next day.”
Johnson said he was holding up well, thanks to the care he was receiving and the support of friends and family. He said doctors expect him to spend another week in the hospital before he can go home, after which he’ll have to return for follow-up care.
Of the infection, Johnson said he was surprised by just how far it had spread.
“It’s amazing how it crawls and sits in different areas on your leg. It moved all over,” he said.
He added that he would hate to see the hot pond closed down as a result of his experience, but “they probably need to monitor what’s in that pond better. They need more testing,” he said.
Currently, the Health Department tests the water in the hot pond for fecal matter each Monday morning, Armstrong said.
In an interview Friday afternoon, Hilo Medical Center’s infection control officer Chad Shibuya said that patients contracting bacterial infections linked to the hot ponds is not uncommon; however, it’s difficult to quantify just how many cases the hospital sees in a given time period.
He added that flesh-eating disease is not communicable, so members of the community don’t have to worry about catching it from other people. Often, he said, such infections can be caused by “good” bacteria which spends its entire life on the surface of our skin.
“If you look at the actual cases where it happens, there’s usually certain pre-existing facts, such as some kind of chronic disease process, or weakened immune system, or an open wound. It’s not true for every single case, but in most cases,” he said.
Staying out of water like that found at the hot pond if you have an open wound is the most important way to prevent serious infections, he said. And if you get a cut or a scrape, be sure to clean it thoroughly, cover it with an antibacterial ointment like Neosporin and keep it covered and dry.
Email Colin M. Stewart at cstewart@hawaiitribune- herald.com.