RX For Readers: Fishy treatment

Ichthiotherapy, the use of fish for medical problems, can be more dangerous than perceived.

Fishy treatment 370 (photo credit: Reuters)
Fishy treatment 370
(photo credit: Reuters)
I have noticed “salons” in shopping centers in Tel Aviv that offer “treatments” to remove dead skin from the feet by soaking them in water where little fish live and eat. I have dry skin on my heels, but I wouldn’t set foot in such a place. I wonder whether such fish carry bacteria that would be dangerous to people, especially if they have weak immune systems. Could this be the case, and if so shouldn’t the Health Ministry close them down or at least force these establishments to post health warnings and maintain the water tanks properly?

Z.M., Tel Aviv
Dr. Boaz Lev, associate director-general of the Health Ministry, replies:
There have been no reported cases – at least I have not heard of any either here or abroad – of health damage caused at fish pedicure salons. Pond fish [such as tilapia, mullet and bream] can be dangerous if someone is pricked by scales, gills and fins and gets a Vibrio vulnificus infection that can be dangerous to people with weak immune systems, and we warn about this every year. But tiny fish eating dead skin is an entirely different matter. If we obtain new evidence to the contrary, we would change our policy.
Dr. Kosta Mumcuoglu, a senior parasitologist at the Hebrew University’s microbiology institute, comments:
Although I have not examined what is going on in these fish pedicure salons, I think it is obvious that the Health Ministry should examine what exactly is being done there and issue regulations regarding the way these fish are used for treatment purposes. If the water in the fish tanks is not changed regularly, there is a possible danger of customers being infected.
In standing water that was used previously by someone else there could be all kinds of bacteria, especially when the water is also heated. I know that in Austria, for hygienic reasons, the tank water at these salons has to be changed after every customer. The water could be chlorinated to reduce the risk (if it does not interfere with the fish), but this may have some side effects.
The use of fish for medical problems is called ichthiotherapy. It has been known for hundreds of years in Turkey and India, for example, to clean the skin of patients with the serious skin disease psoriasis – and other conditions – and remove the hyperkeratotic parts of the skin. The fish are brought to pools that are poor in organic material, so they are permanently hungry and they will eat practically anything organic that falls into or enters the pool.
One usually takes some risks when undergoing treatment for a medical condition, and this includes secondary infections, but why do so for pleasure or for cosmetic purposes?
Why does Magen David Adom continue to prevent British citizens from giving blood – many years after it was discovered that bovine spongiform encephalopathy (BSE or “mad cow disease”) can be transmitted via the blood supply? The outbreak occurred in the UK and other parts of Europe so long ago. Can’t the prion that causes it be identified in the blood of people who actually have it? And why are homosexuals not allowed to give blood, now that the “window” identifying HIV infection but before the virus shows have has been narrowed so much. I understand that the US Food and Drug Administration is seriously considering changing its rules regarding homosexual blood donations.

A.C., Jerusalem

Prof. Eilat Shinar, head of MDA’s blood services, replies:
Policy about donation of blood by homosexuals is going to be discussed in the upcoming meeting of the Health Ministry’s advisory committee on transfusion medicine. We will announce any changes after that meeting.
Regarding the British, there is not yet a test to detect the agent causing CJD in blood donations, therefore at present, the only way to reduce the transfusion-transmitted risk of this disease is to defer donors from the UK. We all await the development of a test.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to [email protected], giving your initials, age and place of residence.