FLESH-EATING BCTERIAWhat Is the Potentially Deadly Flesh-Eating Bacteria and Why Can Infections Be So Hard to Treat?
Vibrio vulnificus thrives in warm, salty water. Cases are on the rise, with a man on Cape Cod being one of the latest to fall ill.
A surge in cases of a deadly flesh-eating bacteria that thrives in warm seawater is a chilling reminder of the potential danger associated with vacation pastimes like swimming and wading.
Dozens of cases have been reported this year across the South and Gulf states and at least 10 people have died, but one of the most recent cases occurred on Cape Cod in Massachusetts, where a man contracted the infection after going into the water on Old Silver Beach in Falmouth.
Rare but Deadly
Infections caused by the culprit, the bacteria Vibrio vulnificus, have a 20% fatality rate. That makes early and appropriate treatment crucially important, says Northeastern University professor Brandon Dionne, a clinical pharmacist in infectious diseases.
“It’s pretty rare when it happens, but it can be very severe,” he says.
Salty or brackish water of the type found in estuaries can harbor Vibrio vulnificus, which can enter the body through open wounds or cuts, says Dionne, an associate clinical professor of pharmacy and health systems sciences.
“The bacteria are not actually eating the flesh, but the toxins they make break down tissues and cause a lot of tissue damage and destruction,” he says.
“It can spread very quickly and progress quickly,” Dionne says. “If you get it in your foot from a cut or something, it can spread all the way up your leg and into the trunk of your body.”
He says the toxins destroy skin cells and the fascia layer between skin and muscle, which is why the infection is also known as necrotizing fasciitis.
“That tissue damage can happen very rapidly. It can put the body into shock and ultimately lead to mortality,” Dionne says.
If Vibrio vulnificus infections get into the bloodstream, they are fatal 50% of the time, according to the Florida Department of Health.
Double-Barreled Treatment
In most cases, treatment consists of surgical management of tissue damage and antibiotics to control the infection, says Dionne, who also works at Brigham and Women’s Hospital.
A medical procedure called debridement is used to remove dead tissue killed by toxins to allow healthy tissue to regrow, he says. It can be performed bedside or in the operating room, depending on the severity of tissue damage, Dionne says.
At the same time, the medical team will use antibiotics to attempt to kill the bacteria.
“We typically use two antibiotics, ceftazidime and doxycycline,” Dionne says. “Part of that is to ensure that at least one of them is active, but also because doxycycline works to inhibit protein synthesis, so it might help with reducing toxin production.”
“Treatment is very case by case, but patients will often be on antibiotics for a few weeks while they are trying to heal,” Dionne adds.
Who is at Risk
The CDC says older people and those with compromised immune systems are most at risk for contracting Vibrio vulnificus. People can also get the infection from handling or eating raw shellfish, which can also cause gastrointestinal symptoms, Dionne says.
Be Aware of Early Symptoms
If you’ve been to the beach and experience pain or redness at a wound site, that’s “your sign to get evaluated immediately,” Dionne says, adding that people may also see blisters form and develop fevers and chills.
Vibrio vulnificus “loves to live in warm water. So there’s a thought that rising global temperatures could be increasing the incidence,” Dionne says. “If there’s a more growth of bacteria, you’re more likely to have infections.”
If you are immunocompromised due to liver or kidney disease or other conditions, Florida public health officials recommend donning proper footwear to protect against cuts from rocks and shells while on the beach.
Cynthia McCormick Hibbert is a Northeastern Global News reporter. The article is published courtesy of Northeastern Global News.
