Flesh-Eating Bacteria Are Increasing Along East Coast, CDC Warns

The CDC warns that several East Coast states have reported severe and fatal cases of Vibrio vulnificus infections, a bacterium that causes skin tissue death.

On September 1, the CDC issued an official health advisory warning the public and healthcare providers of an increase in Vibrio vulnificus (V. vulnificus) infections among people living near the Gulf of Mexico and the East Coast.

Cases of Vibrio vulnificus, AKA Vibrio or "flesh-eating bacteria," typically occur around the Gulf Coast states. However, the CDC says that Vibrio infections along the East Coast have increased eightfold from 1988 to 2018. Moreover, the bacteria appear to be moving north at a rate of 48 km per year.

This summer, the United States has experienced widespread heatwaves and above-average coastal water surface temperatures. Simultaneously, East Coast states, including North Carolina, New York, and Connecticut, have reported severe and fatal Vibrio infections. Many of these infections occurred after the individual's open wounds were exposed to coastal waters that contained the bacteria.

Connecticut health officials report that since July 1, the state's Department of Health has reported three cases of Vibrio infections. One person acquired the illness from eating raw oysters out of state, and the other two individuals were infected after exposure to water in Long Island Sound. All three were hospitalized, and one individual died.

In addition, North Carolina reports three deaths due to Vibrio-related flesh-eating bacterial infections. The state's health department says that since 2019, they have received 47 reports of Vibrio cases, including eight fatalities.

Moreover, in New York, health officials recently reported the presence of flesh-eating bacteria in one deceased individual from Suffolk County.

What is Vibrio or "flesh-eating bacteria"?

Vibrio are bacteria typically found in coastal and brackish waters — a mixture of salt and fresh water. The bacteria survive best in warmer waters from May to October and marine environments with a low salt content, like bays and inlets.

However, coastal floods, storm surges, and hurricanes can push Vibrio-containing coastal waters into inland areas, putting residents of these regions at risk of infection.

In the United States, Vibrio bacteria cause an estimated 80,000 illnesses each year. Although several Vibrio species can cause illness in humans, one species — V. vulnificus — can cause life-threatening infections. The CDC reports that around 150 to 200 people experience V. vulnificus infections each year, and approximately one in five people die. Moreover, the illness can be fatal within one to two days after a person shows symptoms.

While most infections occur after eating raw or undercooked shellfish, especially oysters, some people get infected through an open wound while swimming or exposed to salt or brackish water that contains the bacteria.

Symptoms of a Vibrio infection from eating contaminated shellfish can include watery diarrhea, stomach cramps, vomiting, and fever. In an open wound, Vibrio infections can cause redness, pain, swelling, and skin erosion. In addition, the bacteria can cause bloodstream infections characterized by fever, chills, low blood pressure, and blistering skin lesions.

Those most at risk for wound infections include people with liver disease, diabetes, and underlying conditions that compromise the immune system.

How to prevent flesh-eating bacterial infections

In a September 6 American Medical Association (AMA) podcast, Andrea Garcia, J.D., M.P.H., the AMA's Vice President of Science, Medicine, and Public Health, suggests that people who are at increased risk for infection should exercise caution when engaging in coastal water activities.

"Stay out of saltwater [or] brackish water if you have an open wound or a cut," Garcia explained. "If you get a cut while you're in the water, leave the water immediately."

Garcia also says that if an open wound or cut comes into contact with salt or brackish water while handling undercooked seafood, wash the wound thoroughly with soap and clean running water.

"And then prompt treatment is really crucial," Garcia stresses. "So, it's important to seek medical attention immediately if you suspect an infection."

Garcia also says that healthcare providers should obtain cultures and send them to a public health laboratory if flesh-eating bacteria is suspected. They should also ask the patient or family about relevant exposures and initiate appropriate treatment, as early antibiotic therapy and surgical interventions improve survival.


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