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Pica-Pica plagues Belizean bathers
It goes by many names, but there's no confusing the discomfort and disfigurement that first hits only after you've left the water. Jose Sanchez reports on a malady that will affect more and more Belizeans over the next few months.

Jose Sanchez, Reporting
The sea is one of the attractions that makes Belize and many other places in the Caribbean so enjoyable for both visitors and those of us lucky enough to live here. But that sea also has its dangers. Forget about sharks, stingrays and moray eels. Probably its biggest underwater enemy--especially during the hot summer months--is a condition known as pica-pica. According to Doctor Peter Craig, the cause of pica-pica comes from jellyfish.

Peter Craig, Clinical Dermatologist
"These adult jelly fish have small larva stages about the size of a pin head. And at times there are hundreds of these larvae in the sea. On exposure to these larvae, they get trapped into the swimming gear, the swim trunks, or bikinis. The causative factor is the release a nematocyst, which is a protective part of all of these creatures. It releases a harpoon with a thread under intense pressure that penetrates into the skin and into the dermis, and there you have the reaction beginning. The tip of this harpoon has toxins on it and it's our body's response to these toxins, which causes the clinical presentation."

That clinical presentation includes very intense itching, bumps and skin rashes that occurs once the person reaches the water. Some victims even experience fever and nausea. Just as the condition is known by various names, like sea bather's eruption and sea lice, according to James Azueta, of the Fisheries Department, pica-pica also has more than one suggested cause.

James Azueta, Co-ordinator, Ecosystems Management Unit
"Pica-Pica is actually caused by neurotoxins produced by bacterial blooms. This bacteria is also known as blue green algae. They do bloom during the hot weathers, we're getting into the hot months here in Belize and they do bloom at the same time with the sea thimbles, which are actually minute jellyfish. We cannot see the toxins in the water, but we can feel the effects, and we tend to blame the thimbles as pica-pica."

"The doctor was actually explaining to you the effects of jellyfish, where they actually stinging cells. The stinging cells, what they call nematocysts, they are the ones responsible. They go into the flesh and they stay in there then they have a reaction with the body. The body just tries to defend itself, that's why it itches and it swells and everything. That's common for the body to react to foreign bodies."

Jose Sanchez
"So the outbreak that we have right now could be a combination of both."

James Azueta
"It could be a combination of both."

Peter Craig
"The treatment of sea bathers eruption or pica-pica involves the use of topical creams and we use topical steroids. People with severe cases will need a short course of oral steroids for about five or seven days. There is a commercial preparation that people can buy over the counter, it's hydro cortisone cream that is one percent. That can be used, but in severe cases you will need a stronger topical steroid that is available by prescription."

Jose Sanchez
"And it lasts for how long?"

Peter Craig
"The eruption will last for two to three weeks and the bumps will eventually disappear."

Jose Sanchez
"What can people to avoid pica-pica and the sea thimbles?"

James Azueta
"They should avoid areas of high concentration, with what we call sea moss. You can see them on calm days on top of the water, so just try to avoid these areas."

If you're still tempted to swim in the sea, it's important to remember that there is no product you can use to prevent an eruption once you run into the pica-pica. Reporting for News 5, Jose Sanchez.

Outbreaks of pica-pica have been reported virtually all over Belize, including Turneffe, St. George's Caye and Placencia. SCUBA divers who wear wet suits are not immune, as the tiny creatures easily get inside and make the condition even worse.

When we were at the shore in Delaware we ran into the sea to find it was full of "sealice", so we were told. This was years ago, but sounds like this is what was there then. We ran for the showers on the boardwalk. No wonder we were the only ones that went into the water that day !

This pica pica really scares me. I have very sensitive skin and was planning a 2 week visit to AC in July/August. Has anybody had this happen to them? What should I bring if it does? What exactly do these patches of sea moss look like? How adept are the medical facilities if the case is severe?
I am sorry I sound paranoid, but I have had vacations (Cozumel) where I spent the entire trip itching and couldn't enjoy the sun, etc.
Thanks in advance for any answers, Erika

we just got back, and none of us saw any pica pica, nor did we hear of anyone else having problems with them.....

I was in AC recently and found that putting waterproof SPF 45 worked great...only got 1 tiny hit on the lip with I spit my Regulator out...
When you get out of the water use windex if you get hit..the local divers know where to dive and will do all they can to steer you away from them...
Don't sweat it...they are mostly on the top of the water from what I saw...
Enjoy your trip...just ask the dive masters when you get there about them...they don't like getting hit either...trust me

Erika! You should be fine in July/August. By that time they should be gone. Don't let that ruin your vacation plans.

Axeman, 2 questions. 1. is the SPF the important factor or just because it's waterproof? and 2. what does the windex do?

Here's my expert (unfortunately) advice:

rotect exposed areas with vasoline. When you get out of the water, rinse with viengar (amonia).

If you have a problem, use Eurozx lotion on your skin and if it's a bigger problem, use Eurox and buy Atarax antihistimines. Avaiable over the counter.

It seem the reaction gets worse with each repeated exposure.

You won't need a doc, but if you do, I just used Teresita Mendez (gp) and Julitta Bradley (dermatologist), both in Belize City and both familiar with how to treat this.

It will most likely pass thru our areas before most of you even visit and I spoke to dive people today who said they didn't get it over the weekend where they dived.

So ask before you leap, but should be fine.

Katie Valk
Maya Trvavel Services

We dove off Ambergris 5/3-5/9 and I experienced a bout with what we decided was pica pica. I wore a wetsuit skin and never got in the sea otherwise. What I first thought was a sunburn on my neck and chest, I realized was more puffy and red, like poison oak. I also had little bumps on my arms and legs, like goosebumps. It was not that uncomfortable but my neck was especially itchy and hot. All symptoms decreased in a few days and were not severe enough to interfere with my activities. The local response was "Windex" or anything with ammonia in it. I think that remedy is only for the cooling evaporative effect, although it probably wouldn't hurt after diving anyways. We went into the swimming pool after each dive just to refresh, so I think the pica pica reaction was already underway and ammonia bathing wouldn't be any different than chlorine bathing. We had some packets of cortisone cream in our first aid kit and that gave me the most relief. (Aloe vera gel felt good but wore off quickly.) After that stash was depleted, we went to the big supermarket for more cortisone cream and found it in the form of "Summer's Eve" female personal itching cream. What the heck, it worked! Expensive, though.
This was not a severe allergic reaction, just uncomfortable and unsightly. Our dive master before each dive slathered his neck and chest with vaseline and sunblock, he said to let the jelly babies slip off. I did it too, after being itchified. One of our dive companions said that letting off a big blast of air before surfacing can blow aside any floating irritants. Sounds useful if possible. In general, don't worry, just bring creams and have a great AC trip.WE DID!

LAUGH.......loved the Summer's Eve remedy.
Maybe it was the vinegar in the Summer's Eve!
If so, a bottle of vinegar would have been cheaper. LOL
Good to hear you took it all in stride and enjoyed your trip.