Vibrio vulnificus from Gulf waters causes flesh-eating disease
Last week’s death of an Ocean Springs man within days of an infection of vibrio vulnificus has brought more attention to the seriousness of the flesh-eating bacteria to the Mississippi Gulf Coast.
Nick Duvernay, 38, died early Friday morning from complications caused by an infection he contracted on the previous Sunday during a family boat trip in the Gulf of Mexico.
It is a bacteria that thrives in warm salt water, like the northern Gulf, yet many swimmers, anglers and others who enter the water know very little about vibrio vulnificus and the flesh-eating disease it causes.
According to scientists at the Gulf Coast Research Laboratory (GCRL) in Ocean Springs, a branch of the University of Southern Mississippi, Duvernay’s case will be one of nearly 100 cases expected in the United States this year.
According to the GCRL, the U.S. Center for Disease Control (CDC) said the long-term national average of serious cases of vibrio vulnificus infection is 96, including both food-borne and wound-related causes.
The overall death rate is 50 percent, but 90 percent of deaths are caused by consuming raw seafood, particularly oysters.
Vibrio vulnificus is one of about 100 species of vibrio bacteria, but only a few are pathogens that are harmful to humans. Cholera is caused by a strain of vibrio — vibrio cholerae. The most common is Vibrio parahaemolyticus, causing an annual average of about 45,000 cases of infection in the U.S., of which 86 percent are food-borne gastorenteritis. The death rate is low, about two percent of gastroenteritis cases and 20 to 30 percent for wound-related cases.
Vibrio vulnificus is not the only vibrio known to cause wound infections, but it is the most likely to cause infection.
According to the CDC, it can cause an infection of the skin when open wounds are exposed to warm seawater. The infections may lead to skin breakdown and ulcerated and people who are immunocompromised are at higher risk for invasion of the organism into the bloodstream and potentially fatal complications.
Once in the blood stream, either from food-borne or wound related, the bacteria can cause a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock) and blistering skin lesions. Bloodstream infections are fatal in 50 percent of cases.
During the winter, populations of vibrio vulnificus are lower and seem almost dormant, so they present little threat to the general public.
As temperatures rise, vibrio vulnificus multiplies. Warmer weather also brings coastal residents and visitors into contact with the water. This increases the chance of encountering the organism. Infections are seasonal with over 85 percent occurring between April and October.
According to the CDC, wounds account for approximately 60 percent of all U.S. vibrio vulnificus cases. Every Gulf state from Florida to Texas has reported vibrio vulnificus wound infections, but only the serious cases make the news.
In 2012, in Ocean Springs, Joseph Smith contracted vibrio while fishing and physicians had to remove his leg. In Florida, there were 13 deaths in 2011 and nine deaths in 2012 attributed to the bacterium.
In June and July of 2013 at Grand Isle, La., there were several cases of wound infections of that resulted in hospitalization and one death. Several more cases have been reported in 2014.
The GCRL said small wounds can happen easily while fishing or enjoying some time on the beaches. For examples, it lists getting hooked on your own fishing tackle or stepping on an oyster shell. At the time, it may seem an insignificant injury, but vibrio vulnificus bacterium can enter through a new or existing wound, like a tiny cut, scratch or even a mosquito bite.
For most healthy individuals, any infection or irritation is minor and hardly noticed. The case is different for people who have weakened immune systems. The bacterium invades the bloodstream, potentially causing a severe and life-threatening illness. Vibrio wound infections happen fast; symptoms may become evident in only four hours.
In the case of Duvernay, his immune system was weakened, his family said, by years of untreated high blood pressure. He began showing symptoms immediately after the end of a July 6 boat trip, but he didn’t seek medical attention until Wednesday. He died shortly after midnight on Friday morning.
Because of the rapid onset, doctors said seeking immediate medical help is crucial in beating an infection. Do not try to “tough it out.”
“The earlier you seek help, the more likely a good outcome is possible,” Dr. Ekenna Okechukwu, Infectious Disease Specialist and Doctor of Internal Medicine at Singing River Health Systems of Pascagoula and Ocean Springs, told the GCRL. “Do not delay in seeking help. Treatment of a vibrio vulnificus wound infection will usually include antibiotics and surgery.”
Okechukwu said that people at greatest risk are those with other serious health factors.
“People with underlying diseases like liver cirrhosis or other chronic liver disease, chronic alcoholism, cancer, or persons on treatment with immunosuppressive drugs, including chemotherapy or steroids may be more prone to get sick and complicated infections, especially if they have an open wound,” Okechukwu said.
According to the GCRL, one clinical study reported that people with compromised immune systems are 80 times more likely to develop vibrio bloodstream infections than healthy people.
Vibrio vulnificus problems will likely grow in the coming years and decades, according to Dr. Jay Grimes, Professor of Marine Microbiology at the GCRL. He said that with global climate change, vibrio vulnificus populations are increasing as water temperatures rise.
Grimes added that new cases of the bacterium are being found in waters where they were not previously perceived as a threat.
Click here for some tips for preventing infection.
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