As water temperatures rise and more Americans hit the beach, it’s not unusual to see an increase in cases of flesh-eating bacteria, or necrotizing fasciitis. This summer has been no exception, but climate change may be contributing to an increase in infections in more parts of the country.
The Bugs of Summer
According to an article published June 17, 2019, in The New England Journal of Medicine, bacteria associated with necrotizing fasciitis (known as Vibrio vulnificus) typically grow along the southeast coast of the United States and have been “previously found as far north as the Chesapeake Bay.” The bacteria thrive in salty waters with temperatures above 55 degrees F, which is why the microbes are usually found in Gulf States such as Louisiana and Texas.
But a study published June 18, 2019, in the journal Annals of Internal Medicine cited five cases further north, in people exposed to water and shellfish in Delaware Bay between New Jersey and Delaware.
“There have been some cases reported in the middle Atlantic states, and that’s led to speculation on whether the warming ocean has allowed the bacteria to wander up the East Coast farther than it usually gets,” says William Schaffner, MD, an infectious disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee. “There may be a new ecologic niche for this bacteria.”
What Kinds of Bacteria Cause Necrotizing Fasciitis?
Vibrio bacteria are one group that can cause necrotizing fasciitis. Bacteria called group A streptococcus (group A strep) are considered the most common cause of infections, according to the Centers for Disease Control and Prevention (CDC).
The CDC estimates that there are 700 to 1,200 cases of group A strep necrotizing fasciitis infections each year, but only a small percentage are invasive (spreading to healthy tissue).
Other bacteria that may cause the infection include:
How Do You Get Infected With Flesh-Eating Bacteria?
Flesh-eating bacteria enter the body through breaks in the skin, such as cuts or insect bites, but can also be ingested by eating contaminated seafood. The bacteria attack and kill the skin, fat just beneath the skin, and fasciae, thin tissue that encloses muscles or organs.
“The injury on the surface can appear relatively benign with a little redness and a little swelling of the skin,” says Dr. Schaffner. “But the damage going on underneath the skin can be quite extensive.”
Necrotizing fasciitis is relatively rare and seldom contagious. But an infected person needs to get treatment as soon as possible because the infection spreads very quickly. Left untreated, it can lead to sepsis, loss of limbs, or even death.
How Is Flesh-Eating Bacteria Treated?
Patients who do not respond to treatment with antibiotics may require one or more surgeries to remove any dead tissue and stop the infection from spreading further.
“Sometimes the muscle that needs to be removed can be very destructive, and people are left with disabilities afterward,” says Schaffner. “You can’t grow a new leg muscle. If that’s destroyed, it’s gone; and you have to enter rehabilitation.”
According to the CDC, up to 1 in 3 cases of necrotizing fasciitis are fatal.
Last month, 78-year-old Jerry Sebek became infected during a fishing trip near Palacios, Texas, and died two weeks later, per an article published in June 23, 2019, in MySanAntonio.com. Sebek’s daughter said that her father experienced chills, vomiting, disorientation, and labored breathing, which were initially diagnosed as signs of heat exhaustion.
More recently, 56-year-old Gary Evans was diagnosed with necrotizing fasciitis after going crabbing along the Gulf of Mexico on the Fourth of July. Evans, whose wife said had been in good health prior to the infection, died four days later, according to an article published July 12, 2019, in the Victoria Advocate.
What Are the Signs and Symptoms of Necrotizing Fasciitis?
Necrotizing fasciitis is rarely contagious, but it can be tricky to diagnose because its symptoms resemble other conditions or types of infection.
Early symptoms may include:
- A red or swollen area of skin that spreads quickly
- Severe pain, including pain beyond the area of the skin that is red or swollen
Later symptoms include:
- Ulcers, blisters, or black spots on the skin
- Changes in the color of the skin
- Pus or oozing from the infected area
- Diarrhea or nausea
Proper care of any cuts or injuries can prevent infection, and the CDC advises people with an open wound or skin infection to avoid hot tubs, swimming pools, and natural bodies of water, such as lakes and oceans.
Schaffner cautions that children, the elderly, and people with a weakened immune system are at higher risk of infection.
“If you do suspect you have flesh-eating disease, the sooner you get treatment the better,” he says. “This message goes out not to just patients and the general public, but to healthcare providers as well.”