After two cases of “flesh-eating bacteria” infections were reported recently from contact with waters off Florida’s west coast and panhandle, public health officials and physicians are reminding beach- and lake-goers to be extra cautious, especially if you have an open wound.
Recent media reports have referred to necrotizing fasciitis as the primary flesh-eating bacteria behind the two cases. But more than one type of bacteria can cause necrotizing fasciitis. “Necrotizing” means causing the death of tissues, and “fasciitis” means inflammation of the fascia (the tissue under the skin that surrounds muscles, nerves, fat, and blood vessels).
“Sea water is not sterile,” says Fernando Mendoza, M.D. , medical director of the Children’s Emergency Center  at Baptist Children’s Hospital  and associate medical director of Pediatric Emergency Services at West Kendall Baptist Hospital. “Sea life, seaweed and even sand on the beach can be sources for bacterial infection.”
Signs of a bacterial skin infection can include pain, swelling and blisters. Bacteria most commonly enter the body through a break in the skin, including: cuts and scrapes; burns; insect bites; puncture wounds (including those due to intravenous or IV drug use); and surgical wounds.
Necrotizing fasciitis is a rare bacterial infection, but it spreads quickly in the body after contracted and it can be fatal, espcially in children, older adults and those with compromised immune systems. A 77-year-old woman from Bradenton, Florida was infected by the bacteria and died nearly two weeks after she fell and scraped her leg while walking on Anna Maria Island. Previously, the mother of a 12-year-old Indiana girl said her daughter contracted the same infection during a trip to Destin in early June.
Although rare, one in three patients die from necrotizing fasciitis, according to the U.S. Centers for Disease Control and Prevention (CDC). Since 2010, the CDC estimates between 700 and 1,200 people a year have contracted the infection in the U.S. And cases have been increasing over the past 12 months.
Stay Out of Water with Open Wounds, Cuts
Dr. Mendoza says people with open wounds or cuts should to stay out of the water. There are other infectious hazards not as severe as flesh-eating bacteria to worry about. Vibrio vulnificus, a type of bacteria that lives naturally in warm coastal waters, causes diarrhea when ingested. It can also cause severe skin infections if it comes in contact with an open wound.
“If you start to suspect some type of infection, like noticing some redness or a rash that wasn’t there before, see a doctor,” Dr. Mendoza advises. “He or she can examine it to see if it’s an infection obtained at the beach or somewhere else.”
In April, there were two other cases of necrotizing fasciitis in Tampa Bay affecting men who spent time on the water. One was fishing when he cut his hand on a fish hook. The other was on a boating trip. Both survived their infections. But these two cases, however, were caused by “A Streptococcus” bacteria, the same bacteria that causes strep throat. It is considered a common cause of necrotizing fasciitis, the CDC says.
Early and Later Symptoms
According to the CDC, early symptoms of necrotizing fasciitis can 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 of necrotizing fasciitis can include:
- Ulcers, blisters, or black spots on the skin
- Changes in the color of the skin
- Pus or oozing from the infected area
- Fatigue (tiredness)
- Diarrhea or nausea
Because necrotizing fasciitis can spread so rapidly, patients often must undergo surgery quickly. Doctors also give antibiotics intravenously (IV) in an attempt to stop the infection. Sometimes antibiotics cannot reach all infected areas because the bacteria have killed too much tissue and reduced blood flow, the CDC states. When this happens, doctors have to surgically remove the dead tissue.
Most people who contract necrotizing fasciitis have other health problems that may lower their body’s ability to fight infections, the CDC says. Some conditions that weaken the body’s immune system include:
- Kidney disease
- Scarring (cirrhosis) of the liver