As tem­per­a­tures rise, vib­rio ex­pert re­minds community of ‘flesh-eating’ bac­te­ria and its risks

Aware­ness is key

Maryland Independent - - News - By DANDAN ZOU dzou@somd­news.com Twit­ter: @Dan­danEn­tNews

May be­gins the peak sea­son for cases of the ag­gres­sive in­fec­tion known as “flesh-eating bac­te­ria,” which can find its way from lo­cal water­ways into a per­son through open cuts.

Dozens of lo­cal res­i­dents learned about the risks of vib­rio vul­nifi­cus from health ex­pert Rita Col­well from the Uni­ver­sity of Mary­land who spe­cial­izes in in­fec­tious dis­eases last Friday evening at the Calvert Ma­rine Mu­seum.

Vib­rio vul­nifi­cus is a wa­ter­borne and food­borne bac­te­ria that can be­come deadly quickly if not treated prop­erly in time.

The bac­te­ria lives in coastal wa­ters, and most in­fec­tions oc­cur from May through Oc­to­ber when wa­ter tem­per­a­tures are warmer, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Preven­tion. Of­ten re­ferred to as the “flesh-eating bac­te­ria,” the in­fec­tion can de­stroy the skin and tis­sue cov­er­ing the mus­cle and may re­quire in­ten­sive care or limb am­pu­ta­tion.

Most peo­ple re­cover from mild vib­rio in­fec­tions af­ter about three days with no last­ing ef­fect. The CDC said it re­ceives more than 400 vib­rio ill­ness re­ports ev­ery year, 90 of which are caused by vib­rio vul­nifi­cus. With this type of in­fec­tion, death can oc­cur in a mat­ter of days. About one in four die from a vib­rio vul­nifi­cus in­fec­tion, some­times within a day or two af­ter be­com­ing ill, ac­cord­ing to the CDC.

Vib­rio vul­nifi­cus is a nat­u­rally oc­cur­ring bac­te­ria that live in brack­ish wa­ter, Col­well said. It thrives in warm wa­ter and be­comes dor­mant when tem­per­a­tures get cold.

When the tem­per­a­ture drops, the bac­te­ria shut down — they don’t die, they close up and wait un­til it gets warmer, she said. If peo­ple har­vest oys­ters in the win­ter, leav­ing them around in the house could warm up the oys­ters and in­cu­bate the bac­te­ria.

Col­well’s ex­pla­na­tion con­firmed David Ryan’s sus­pi­cion that he had a vibiro in­fec­tion over the win­ter. In Jan­uary, Ryan got a scrape on one of his knees when work­ing on oys­ters near his home in Hol­ly­wood.

It was about 40 de­grees out­side, he said. He didn’t give the abra­sion too much thought and went home with wet jeans.

In ret­ro­spect, Ryan be­lieved he had a vib­rio in­fec­tion af­ter his body tem­per­a­ture warmed up the bac­te­ria and ac­ti­vated it af­ter he went inside. Af­ter ex­pe­ri­enc­ing some ex­cru­ci­at­ing pain, he went to the emer­gency room at MedStar St. Mary’s Hos­pi­tal.

“The ER in St. Mary’s Hos­pi­tal has not learned its les­son,” Ryan said. They ig­nored his sug­ges­tion that he might have had a vib­rio in­fec­tion and didn’t give him the right an­tibi­otics, he said.

“Don’t ex­pect the physi­cians in the emer­gency room to know a damn thing about vib­rio. They don’t,” said Dr. John Roache, a re­tired physi­cian from Me­chan­icsville. “Keep hol­ler­ing” if you are not sat­is­fied or taken se­ri­ously, he said.

Af­ter work­ing with lo­cal wa­ter­men for decades, Roache said what seemed to make a big dif­fer­ence is us­ing a so­lu­tion of bleach and wa­ter to wash the boats and clean gloves, he said.

Col­well agreed that the use of bleached wa­ter is a good pre­ven­tive mea­sure as it re­duces bac­te­rial load and de­bris.

But if an in­di­vid­ual has a wound and it comes into con­tact with con­tam­i­nated crabs, fish, gear or wa­ter from the bay or sea­wa­ter, there is still risk of a vib­rio in­fec­tion, she said in an email. If the in­fec­tion is deep, bleach won’t pen­e­trate, and the in­fec­tion can turn lethal quickly.

Other than cuts, the bac­te­ria can also en­ter the body when peo­ple eat con­tam­i­nated shell­fish, es­pe­cially oys­ters.

“So how do you pro­tect your­self? Well, you don’t want to hear this. But frankly, don’t eat raw or un­der­cooked oys­ters or shell­fish,” Col­well said.

For those who have un­der­ly­ing health con­di­tions such as a com­pro­mised im­mune sys­tem or liver dis­eases, Col­well said eating raw or un­cooked shell­fish is like play­ing Rus­sian roulette.

“You don’t want to be an­other statis­tic,” she said. “Be care­ful, be very care­ful. Def­i­nitely stay away from raw oys­ters.”

An at­tendee asked Col­well the po­ten­tial ef­fect of raw oys­ters on chil­dren af­ter shar­ing that she was “ap­palled” to hear her niece al­low­ing a 4-yearold child to eat raw oys­ters.

“I’m not ex­actly a he­li­copter mother, but I prob­a­bly wouldn’t be thrilled about it,” Col­well said. “But on the other hand, I wouldn’t have a hissy fit over it ei­ther.”

For par­ents who are tak­ing their kids to the beach this summer, Col­well said there’s no need to do a full-body “in­spec­tion” be­fore al­low­ing them to go play in the wa­ter. But if the kids had cut their fin­gers the day be­fore, for ex­am­ple, par­ents may want to keep them out of the wa­ter.

“You don’t have to get ter­ror­ized or ter­ror­ize your child,” she said. “Just make sure you treat that abra­sion very se­ri­ously.”

An­other at­tendee said in a jok­ing way that lis­ten­ing to the lec­ture gave him a sim­i­lar feel­ing that he had af­ter watch­ing “Jaws,” a Steven Spiel­berg film about shark at­tacks in the wa­ter.

“Let’s put it this way: I think it’s like any­thing in life,” Col­well said, not­ing that she lived in Bethesda and had to drive back home that night.

“It’s prob­a­bly more dan­ger­ous for me to drive back to Bethesda than for you to eat a raw oys­ter,” she said. The key is about know­ing the risks of an in­fec­tion and what to do when peo­ple see symp­toms, she con­cluded.

STAFF PHOTO BY DANDAN ZOU

For­mer state sen­a­tor Bernie Fowler, mid­dle, of Prince Fred­er­ick and oth­ers lis­ten as re­tired physi­cian John Roache of Me­chan­icsville, not pic­tured, speaks Friday evening at a lec­ture given by Rita Col­well, a pro­fes­sor from the Uni­ver­sity of Mary­land who spe­cial­izes in in­fec­tious dis­eases.

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