Ever get your nails done at a nail salon?
A lot of people do: nail care is a $6 billion a year industry in the United States, and there are tens of thousands of nail salons all across the country, 7,500 in California alone.
One day in 2001 a dermatologist called the health department and reported that he had five patients with infections of the feet and legs that weren’t responding to antibiotics.
All of them had been customers of the same nail salon in Watsonville, California. The health department was a bit concerned, so officials paid a visit to the salon in question. Before long, they’d found the problem.
Seems the footbath in which people were soaking their feet for 10 or 15 minutes per session was contaminated with Mycobacterium fortuitum, a bacterium closely related to the one that causes tuberculosis. One hundred ten customers, all but one of them women, were infected in this way after soaking their feet, and one of the women had 37 boils on her feet and legs.
Some of the women got so badly scarred they needed skin grafts, and medical costs ran as high as $10,000. M. fortuitum is ubiquitous, and it sometimes causes human infections, but this was the first time it had ever caused such a widespread outbreak of disease.
The salon owner said he hadn’t cleaned or disinfected his footbaths since he installed them a year before, and the result was a buildup near an inlet screen of hair, grease, and clipped nails that formed a perfect culture medium for the bacteria. The New York Times quoted Dr. Kevin L. Winthrop, who did the investigation: “There was enough hair to make a toupee.”
Doxycycline and ciproflaxin are usually effective in combating Mycobacterium infections, but some of these women had been on antibiotics for months without having the problem clear up.
California health officials immediately began preparing to issue regulations about cleaning and disinfection of footbaths.