Mycobacterium infection from nail salon whirlpool foot baths: A call to action from podiatric medical students

Furunculosis in the lower extremities caused by Mycobacterium fortunitum has emerged as a consequence of inadequate whirlpool foot bath disinfection in pedicure salons. The first reported outbreak occurred in 110 customers of a single nail salon in Watsonville, CA in 2000. All cases resolved after antibiotic treatment for up to 7 months. Genotyping confirmed the source as the drains in the pedicure salon foot baths. A total of 143 confirmed cases were reported in another outbreak that occurred in 33 different nail salons in 2004 in Northern California. A random survey conducted by the Center of Disease Control and Prevention in California reported 29 of 30 foot baths positive for Mycobacterium. Despite industry and health department directives on the steps required for adequate cleaning of the foot baths , reports continue to appear throughout the country. To address this problem , the student chapter of the American Public Health Association at the California School of Podiatric Medicine has developed a practice guideline for the prevention of these infections. The student chapter has worked with stakeholders in the nail salon industry to provide an acceptable and effective guideline for preventing furunculosis caused by whirlpool foot baths.