Human health effects and Pfiesteria exposure: a synthesis of available clinical data.

An association between human illness and exposure to Pfiesteria was first observed among laboratory personnel working with the microorganism. In 1997, in the setting of Pfiesteria activity on the Pocomoke River in Maryland, difficulties with learning and memory were epidemiologically associated with high-level exposure to waterways in which the organism was known to be present. In the Maryland studies, neurocognitive function of affected persons returned to within normal ranges within a period of 3-6 months. Persons with the most severe neurocognitive deficits were significantly more likely to have skin lesions characterized on biopsy by evidence of a toxic/allergic inflammatory reaction. Acute high-level exposures to waterways where Pfiesteria has been identified have been linked with eye and respiratory irritation, headache, and gastrointestinal complaints. Recent data, collected using molecular techniques, suggest that the organism is present in multiple locations in the Chesapeake Bay environment; available data are insufficient to comment on the possible cumulative health impact of chronic low-level environmental exposure to Pfiesteria.