Dear Doctors: We live in Florida, and we keep seeing on the news about people dying from flesh-eating bacteria you can get when you go swimming. It seems like it’s happening a lot more often than it used to. Why is it so hard to be cured when someone gets sick?
Dear Reader: The term “flesh-eating bacteria” refers to certain types of bacteria that can cause a severe, fast-moving infection. These include group A streptococcus, pseudomonas, certain species of clostridium and aeromonas, and vibrio. The cases that you are citing are due to vibrio vulnificus found in warm, coastal waters.
Vibrio vulnificus, often shortened to “vibrio,” is a rod-shaped bacterium with a slight curve shape like a comma. This bacterium thrives in salt and warm water. It’s found in warm marine environments, including the ocean and brackish water. Brackish water is a mix of both salt and fresh water. It’s found in coastal areas such as marshes, lagoons, estuaries, river deltas, and inland lakes and ponds.
The majority of vibrio infections are from eating infected seafood. This is due to undercooked or raw seafood, most commonly oysters and shellfish. Known as vibriosis, symptoms include stomach cramps, nausea, vomiting, watery diarrhea, fever and chills. Vibriosis is unpleasant, but it’s usually not dangerous for healthy individuals. For people with weakened immune systems or underlying conditions such as diabetes or liver disease, the infection can escalate and become severe or even life-threatening. You can destroy vibrio by cooking shellfish to an internal temperature of 145 degrees Fahrenheit for 15 seconds before eating it.
Far less common, and yet far more publicized, are the “flesh-eating” vibrio wound infections you have been hearing about. These infections can occur when the bacteria enter the body through a break in the skin. This can be a cut, scrape, scratch, blister, burn, surgical site, or even a new piercing or tattoo. Initial symptoms of a vibrio wound infection include fever, redness, pain, swelling and discoloration at the entry point. Treatment includes antibiotics and may include removing dead tissue with surgery.
A vibrio wound infection can escalate to a serious condition known as necrotizing fasciitis, which causes tissue death. It progresses rapidly and can lead to organ failure, the need for limb amputation and even death. If vibrio reaches the bloodstream, it can cause a severe, potentially fatal infection called septicemia. Treatment can be difficult due to the rapid progression of the infection. Vibrio is adept at evading and resisting immune response. Prompt treatment gives the best chance of a good outcome.
You are correct that these infections are unfortunately on the rise. This is due to warming coastal waters, which are expanding the habitat of these bacteria. To be safe, never swim in warm salt or brackish water with an open wound, no matter how small. At the first sign of infection, seek immediate diagnosis and treatment.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
