‘Unusual’ infections after volcanic burns

Some patients are battling rare and somewhat mysterious infections as they recover from the burns sustained in the deadly Whakaari/White Island eruption.

And the emotional trauma is an added challenge as patients embark on lifelong recoveries, a plastic reconstructive surgeon and consultant for the Waikato Hospital, Dr Arthur Yang, said.

Eighteen people died following the eruption on December 9, a death toll that doesn’t include two bodies yet to be found.

Five weeks later, 12 patients are being treated in hospitals around the country, with one remaining in intensive care at Waikato, but the weeks to come could see patients redistributed over various hospitals.

‘‘A lot of these patients have done very well to get past the initial insults from the volcanic burn injury,’’ Yang said.

Initially, the focus was on resuscitating patients, removing non viable tissue and trying to keep patients alive. Now treatment involves simulating the functions of the skin, while many patients remain bedridden. ‘‘We’re trying to get [patients] up and ... moving as soon as possible. We know that increases long-term function outcomes, getting them moving early.’’

Complicating treatment are the ‘‘unusual and uncommon’’ infections some patients – from various hospitals – are battling.

‘‘We’re not sure if it’s to do with the nature of the volcanic burn,’’ Yang said. ‘‘It’s certainly not something that we commonly would encounter from a house fire.

‘‘What we have realised is there is multiple kinds of chemicals in [the ash]. Some of it we don’t fully understand yet.’’

Some chemicals were alkaline, others were acidic. But medical experts can’t know exactly which types of bacteria were in the volcanic environment.

And as most countries have limited experience in the treatment of volcanic burns, it was something experts were still looking into, Yang said.

‘‘This is unprecedented. It’s volcanic eruption injuries . . . This is new.’’

Dr Arthur Yang

Skin plays a big role in maintaining the body’s temperature, maintaining blood pressure, preventing infections and keeping bacteria out, Yang said. Other parts of skin on the body, such as on the hands, are vital for grip.

But a lot of these functions were lost after the eruption.

‘‘Everything we do at the moment is to try and help patients with that.’’

Another challenge was the psychological trauma, especially with language barriers in some cases. Finding medical staff and psychologists to liaise with each patient had been ‘‘difficult’’.

‘‘Psychology has a lot to do with long term recovery and it’s something we really try to get on top of early. But the specific challenge with this is, this is unprecedented. It’s volcanic eruption injuries, it’s a really major event. This is new.’’