The Real Deal on Flesh Eating Bacteria on the Texas Coast

It’s summertime in Texas, which means many people and their families are heading to the coast to get some much needed fun in the sun, but as some families are finding out, there is more than just salt in those coastal waters.

There have been almost 30 cases of Vibrio vulnificus reported in Texas so far in 2016, which is causing concern for beachgoers this summer. The warm and salty Gulf Coast is the perfect breeding ground for the halophilic (salt-loving) microorganism. Its need for warm water temperatures is why cases of infection, known as vibriosis, are more likely to occur between the months of May and October.

V. vulnificus can be contracted by water and by food. For waterborne illnesses, the bacteria enter the body through any cut or scrape in the skin, even one as small as a nick from a razor. Although many of the cases that have been reported have been waterborne, Dr. Edward Goodman, epidemiologist and physician on the medical staff at Texas Health Dallas says you’re more likely to contract it from consuming raw or undercooked shellfish.

“The most important thing is to avoid eating raw or undercooked shellfish from the Gulf Coast,” Goodman says. “This applies to everyone but in particular those who are predisposed to serious infection: persons with cirrhosis and immunosuppression such as transplants, HIV/AIDS and on immunosuppressive treatment such as for cancer, rheumatoid arthritis, etc.”

Microscopic view of Vibrio vulnificus bacteria.

Microscopic view of Vibrio vulnificus bacteria. Photo courtesy of the CDC Public Health Image Library.

He warns that persons with suppressed immune systems should also avoid swimming in the Gulf, but he says there is little to no risk for generally healthy individuals.

Symptoms, which typically appear within 72 hours, differ between the two distinct ways to contract the bacteria. In people with a generally healthy immune system, ingesting seafood contaminated by V. vulnificus causes acute gastroenteritis which includes vomiting, diarrhea and abdominal pain.

“For an otherwise healthy person, gastroenteritis should resolve in a day or two,” Goodman says. “If it does not or they become dehydrated, they should seek medical attention.”

Patients who are immunocompromised may develop a life-threatening infection within the bloodstream. Symptoms include fever, chills, sepsis (difficulty breathing, low blood pressure, fast heart rate, and confusion), and skin lesions.

“Those who are immunosuppressed or have cirrhosis and have eaten undercooked shellfish or had contact with the water in the Gulf should seek attention immediately,” Goodman says.

According to the Centers for Disease Control and Prevention, people with a preexisting condition are 80 times more likely to develop a bloodstream infection than someone who is generally healthy.

When the bacteria is contracted through a cut or open wound, symptoms include swelling, redness and pain near that area. Infection may also lead to necrotizing fasciitis, where the bacteria destroys the skin and tissue covering the muscle. In an attempt to keep the infection from spreading, doctors may choose to amputate the affected limb, but Goodman said this is a last resort.

“Since the worst outcomes occur in patients with cirrhosis or immunosuppression, this outcome would be expected more so in such patients,” Goodman said. “A healthy patient who contracted Vibrio vulnificus from a wound wouldn’t be likely to have to undergo an amputation.”

According to the CDC’s most recent data, there were more than 900 reported cases of vibriosis between 1998 and 2006 in the Gulf Coast region, which includes Alabama, Florida, Louisiana, Texas and Mississippi. According to Dallas County Health and Human Services, from 2012 to 2016, two Vibrio vulnificus infections have been reported in Dallas County, with one fatality.

As for Texas Health Resources, Goodman advises that although no special preparations are necessary because this is not an epidemic disease or transmitted from person to person, infectious disease physicians are well aware of the illness and are knowledgeable on its treatment.

Despite all the media attention Vibrio has been receiving, Goodman insists it’s nothing to cancel your vacation plans over.

“For normal persons with [unbroken] skin there is little or no risk from swimming in the Gulf,” Goodman says. “Unless healthy children have open sores or wounds, they should be able to play in the water.”

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