- About 20,000 people a year are infected by flesh-eating bacteria in the US. Only 145 cases of brain-eating amoeba have been confirmed since 1962.
- Warm seawater breeds flesh-eating bacteria. As seas get warmer each year with global warming, more cases are reported along beaches as far north as Delaware.
- To avoid infection, don’t swim in warm water if you have open cuts or scrapes. Be especially careful if you have compromised immunity. Get help immediately if you develop skin sores after swimming.
What is flesh-eating bacterial infection?
It’s that time of year again when the joy of swimming is undercut by the fear of dangers lurking in the water. As usual, sharks and jellyfish threaten the seas, but more worrisome of late are the reports of flesh-eating bacteria contracted at the shore. Most recently, Newsweek reported on a 68-year-old man who went for a swim in a gulf-side Florida beach and emerged with a boil on his butt that turned out to be a flesh-eating infection. Earlier in the month, six people contracted flesh-eating infections in Florida waters, and three of them died.
There are several types of flesh-eating bacterial infections, which cause a condition known as necrotizing fasciitis.1Davis, MD, Charles Patrick. “Necrotizing Fasciitis.” MedicineNet. 30 July 2019. http://www.medicinenet.com/necrotizing_fasciitis/article.htm The type that’s making all the media splash, typically contracted at Florida or Texas beaches, is caused by Vibrio vulnificus bacteria. Infections by Vibrio are still quite rare, although cases are becoming increasingly common as waters get warmer each year. Vibrio bacteria enter the body through breaks or scrapes in the skin or when water is swallowed. It’s also possible to get infected by Vibrio eating raw seafood, particularly oysters. Most people who get infected contract a mild case of vibriosis, and recover in a few days, but some, particularly those with weaker immune systems (the elderly, babies, diabetics, alcoholics, people with liver disease, and those taking immunosuppressive drugs), develop necrotizing fasciitis.
Once infection occurs, the bacteria kill the surrounding skin tissue and cause inflammation under the skin in the connective tissue surrounding muscles, nerves, and blood vessels. Eventually, organs are affected, and death can result. The rate of spread is very fast, as much as an inch an hour.2Mazziotta, Julie and Kimble, Lindsey. “What to Know About Necrotizing Fasciitis—the Flesh-Eating Bacteria Showing Up at Beaches.” 16 July 2019. People. 30 July 2019. http://people.com/health/necrotizing-fasciitis-flesh-eating-bacteria-what-to-know/
The most common type of necrotizing fasciitis, by far, is caused by Group A Streptococcus, the same bacteria that causes strep throat and scarlet fever. These infections typically occur after surgery, at the site of surgical wounds. Again, spread is rapid and prognosis poor.
How common is infection by flesh-eating Vibrio bacteria?
There’s an extraordinary amount of discrepancy, according to what source you consult, about how many people get infected each year. It’s possible to become infected by Vibrio and get sick, but not have it progress to necrotizing fasciitis. Instead, victims get a milder disease, called Vibriosis, that lasts a few days.
According to the Centers for Disease Control, “vibriosis causes 80,000 illnesses each year in the United States. About 52,000 of these illnesses are estimated to be the result of eating contaminated food.” That leaves about 28,000 cases contracted from swimming. The CDC also notes that infection progresses beyond Vibriosis to necrotizing fasciitis in as many as 1200 victims annually, although, as mentioned earlier, the organization admits this is “likely an underestimate.” While that’s a small number in comparison, say, to the number who get cancer or heart disease, it’s significant enough to justify worry for the immunosuppressed, especially because that number has been rising sharply as seas get warmer. Adding to the horror is the fact that mortality rates among the infected range from 25 percent, at best, to 75 percent, depending where on the body the infection begins and how fast treatment begins.
Where are Flesh-Eating Bacteria a Problem?
Vibrio bacteria thrive in warm coastal waters, particularly in the Southeastern US. Florida saw 92 cases of vibrio infection from 2017-2018, 20 of them fatal, mostly contracted along the Gulf coast. Texas is another favorite hangout for flesh-eating infection, just behind Florida, but the bacteria are migrating northward. In Delaware, there were five reported cases of infection from 2017-2018.
What happens if you get infected by Vibrio bacteria?
The first symptoms you may notice will resemble the flu. You may have fever, diarrhea, and nausea. Within a day or two, you’ll notice redness, swelling and pain at the site of infection. The pain may be out-of-proportion to the initial appearance. The infection spreads rapidly, along with increasing pain and possibly fever and chills. As it progresses, you’ll see blistering, scabs, and drainage. The key to survival is to get help as soon as possible.
How can you avoid infection by Vibrio?
Again, flesh-eating infections are rare, even if they do make startling headlines. The basic wisdom is that if you have an open cut, you’d be wise to stay out of warm seawater, particularly in the Southeast. If you have weakened immunity, you might want to be extra careful, since Vibrio can enter through scrapes and tiny abrasions, and there are plenty of reports of people contracting the infection without even going in the water, just from touching something wet or by walking the shoreline.
Don’t forget to bolster your immune system by eating well, avoiding junk foods, exercising, and supplementing with a good immune-boosting formula. And if you do notice any issues after swimming, run to the doctor. Antibiotics can contain the infection, but only if it’s caught very early. The infection spreads so fast that it can become impossible to contain within hours.
By the way, If you think you’re safe because you only swim at freshwater sites, like lakes, rivers, or hot springs, you might be startled to find out that there have been reports of a brain-eating amoeba, N. fowleri, that thrives in warm, shallow, fresh water. Fortunately, there have been only 145 cases of N. fowleri infection since 1962; unfortunately, all but four were fatal. The most recent case reported in July of 2019 involved a man who contracted the brain-eating disease at a North Carolina water park.3Horton, Alex. “A man swam at a water park with his church group. A rare brain-eating amoeba killed him.” 26 July 2019. The Washington Post. 31 July 2019. http://www.washingtonpost.com/health/2019/07/26/man-swam-water-park-with-his-church-group-rare-brain-eating-amoeba-killed-him/?utm_term=.7830a4dabd70
|↑1||Davis, MD, Charles Patrick. “Necrotizing Fasciitis.” MedicineNet. 30 July 2019. http://www.medicinenet.com/necrotizing_fasciitis/article.htm|
|↑2||Mazziotta, Julie and Kimble, Lindsey. “What to Know About Necrotizing Fasciitis—the Flesh-Eating Bacteria Showing Up at Beaches.” 16 July 2019. People. 30 July 2019. http://people.com/health/necrotizing-fasciitis-flesh-eating-bacteria-what-to-know/|
|↑3||Horton, Alex. “A man swam at a water park with his church group. A rare brain-eating amoeba killed him.” 26 July 2019. The Washington Post. 31 July 2019. http://www.washingtonpost.com/health/2019/07/26/man-swam-water-park-with-his-church-group-rare-brain-eating-amoeba-killed-him/?utm_term=.7830a4dabd70|