Flesh-Eating Bacteria Cases on the Rise: Here Are the Symptoms

A "flesh-eating bacteria" called Vibrio vulnificus has been making headlines, with news of deaths and patients having to amputate limbs to control the infection.

While the bacteria tended to be more prominent in the Gulf Coast states, in recent months, cases have also spread northward, with cases in New York, North Carolina, and Connecticut.

So what is Vibrio vulnificus, and will they really eat flesh like in horror movies?

Flesh-Eating Bacteria Cases on the Rise

Vibrio vulnificus is a type of so-called flesh-eating bacteria that can cause life-threatening infections. Infections with this bacteria are rare but are on the rise.

Microbiologist and distinguished professor Rita Colwell from the University of Maryland, who has been studying Vibrio bacteria for 50 years, said that cases of infections have increased by many fold in recent decades.

Around 150 to 200 cases of V. vulnificus infections are reported to the U.S. Centers for Disease Control and Prevention (CDC) every year. About 20 percent of those infected die within a day or two of being infected.

Vibrio vulnificus thrive in warm, salty, and brackish waters. Hence, V. vulnificus infections are the most commonly reported in Gulf Coast states like Texas, Louisiana, Mississippi, Alabama, and particularly Florida, which has one of the longest coastlines in the United States.

However, there has also been an increase in V. vulnificus reports along the East Coast.

"Physicians along the Gulf Coast were familiar with this infection. But now that the Vibrio is moving up the Eastern Seaboard, I think physicians there—particularly those who work in the emergency room—are having to learn more about this infection," Dr. William Schaffner, a professor of preventive medicine and health policy at the infectious disease division in Vanderbilt University Medical Center, told The Epoch Times.

Between 1992 and 2022, infection cases of V. vulnificus increased fivefold in Florida, and eightfold in eastern states between 1988 and 2018, according to a recent paper led by Ms. Colwell.

The paper investigated the coastal waters for V. vulnificus and V. parahaemolyticus, a related bacteria in the same genus, after Hurricane Ian. Researchers found that hurricanes and floods may increase the prevalence of V. vulnificus in coastal waters.

Since V. vulnificus is rarer in coastal waters, Ms. Colwell was surprised by the concentration of the bacteria detected in water samples.

Hurricane Ian created an environment facilitating the growth of Vibrio bacteria.

"The turbulence that's created by the storm, where you have the sediments swept up and turned up—you have runoff with nutrients coming in from groundwater runoff. This brings heavy, rich nutrient mix into where you already give [the water] conditions good for the plankton populations (which the Vibrio bacteria attach to) to become abundant," she added.

"With the temperature of the water being so much higher, you've got this kind of colossal concatenation of events that are ideal for increased risk of bacteria being abundant in number and, hence, potential for infection."

How Do Flesh-Eating Bacteria Eat Flesh

Usually, if the skin barrier is intact, the bacteria cannot cause skin infection.

Skin-eating bacteria commonly infiltrate through a break in the skin's barrier, such as scrapes, cuts, or wounds, and cause rapid and progressive tissue death as the bacteria release toxins that break down nearby muscles, nerves, and blood vessels. They can also infiltrate the abdominal wall, perianal, and groin area, usually among immunocompromised patients.

The body's immune response also contributes to the worsening of infected tissue. As more immune cells attend infected tissues, pressure and air build up in the muscles, further accelerating the death of muscle tissues, nerves, and blood vessels.

This rapid tissue death is called necrotizing fasciitis and gives the impression that the bacteria is eating away at the flesh.

Several other bacteria can cause necrotizing fasciitis. The most common culprit behind this condition is group A Streptococcus, or group A strep.

The rise in Vibrio vulnificus cases, particularly with reports in states where infections were once rare, has alerted health agencies and local governments.

Signs of Infection

Flesh-eating or necrotizing fasciitis causes severe pain in the infected areas due to the pressure and tissue damage.

"Incredible pain is one of the tipping points," Dr. H. Dele Davies, a pediatric infectious disease expert and the senior vice chancellor for academic affairs and dean for graduate studies at the University of Nebraska Medical Center, told The Epoch Times.

Some patients may show no signs of physical injuries, as the bacteria may have entered the body through orifices. This tends to occur in the immunocompromised.

Even if the bacteria entered through a wound in the skin, the infection may not appear at that entry site. Patients may also develop redness or a blister near the wound opening.

"Occasionally ... you'll see a blister that's got blood or black blood underneath it," Dr. Davies said, "but the key message really is they just show up with a lot of pain," often without being able to explain the reason for that pain.

Redness, swelling, and pus formation may also occur.

Amputation Not Always Needed

Surgical intervention is the most important intervention in necrotizing fasciitis, Dr. Davies said.

The surgeon may perform a fasciotomy, opening up the skin at the area of pain to release pressure. Then, the surgeon examines the muscle, fascia, and soft tissues for signs of dead tissues. These are removed, and the open cut is washed with sterile water to remove any remaining bacteria.

Antibiotics are also injected into the blood for support. However, Dr. Davies said the antibiotics cannot enter the fascia, so they are only given to prevent blood infection.

Gradually, the infection in the limbs can infiltrate blood vessels, leading to sepsis. This can cause the organs to work poorly, and patients may suffer a dramatic drop in blood pressure that can damage the lungs, kidneys, liver, and other organs, potentially leading to death.

Symptoms of sepsis include fever, shaking, chills, a drop in blood pressure, and the patient looking very ill.

Amputation in infected limbs is the final resort if the infection becomes too extensive. Usually, doctors have tried removing damaged tissues and prescribed antibiotics by this stage, yet the infection is either failing to clear or worsening.

"If they're so sick that every time you check the blood, the bacteria is in there, that means you have a tap turned on somewhere," Dr. Davies said, comparing the bacterial infection to water leakage in a sink. "If you don't turn off that tap, no matter how much antibiotics you give, it's like wiping the floor while the tap is turned on. So part of the reason you do the amputations is to basically turn off the volume of water that's coming into the sink."

Most People Are Going to Be Fine

According to the CDC, one can reduce their risks of infection by staying out of salty or brackish water when they have a wound from a surgery, piercing, or tattoo.

The wound should also be covered with a waterproof bandage if there's a chance of being in contact with saltwater, brackish water, or raw or undercooked seafood and its juices.

Wounds and cuts should also be washed thoroughly with soap and water after coming in contact with any of those things. While this may not remove all the bacteria, it can help lower the overall bacterial count and make infections more manageable, Dr. Davies said.

"All in context, this is a rare condition. Most people who are in brackish water or saltwater are going to be fine," he said. However, anyone with underlying liver disease, diabetes, cancer, or who is in an immunocompromised condition should ensure they do not have any cuts or bruises before entering water.

Cook Oysters Thoroughly Before Eating

Less commonly, V. vulnificus can also cause foodborne poisoning through the consumption of raw shellfish and oysters.

Vibrio parahaemolyticus make up the majority of foodborne infections among Vibrio bacteria. Most people infected with Vibrio tend to suffer for three days with diarrhea, stomach cramps, and vomiting before recovering.

In rarer cases, people can die from a gut infection. Over 95 percent of deaths from the consumption of seafood are caused by V. vulnificus.

An infection can come from consuming raw or undercooked oysters and shellfish that entrap the bacteria.

However, healthy people usually do not develop a severe gut infection from consuming raw or undercooked shellfish contaminated with Vibrio, Dr. Schaffner said.

Immunocompromised people and those with liver cirrhosis or high iron concentration in the blood are particularly at risk. For people who develop a gut infection, if the infection is not eliminated, the bacteria may infiltrate the gut lining to the blood vessels, causing potentially fatal blood infections.

"This does not bother normal people [but] immunocompromised people are admonished not to eat raw oysters," Dr. Schaffner said.

Reposted from: https://www.theepochtimes.com/health/flesh-eating-bacteria-cases-on-the-rise-here-are-the-symptoms-5512129