In the wake of Hurricane Ian’s flooding, Lee County, Florida, has seen what the state Department of Health called an “abnormal increase” in cases of rare bacterial infections.
Florida has reported 64 Vibrio vulnificus infections and 13 deaths this year as of Friday, according to the health department, up from 34 cases and 10 deaths last year. It’s the first time the number of cases has exceeded 50 since 2008, when the state began tracking it.
Many of the cases are concentrated in Lee County, where residents are cleaning up after Category 4 Hurricane Ian made landfall in late September.
These infections are rare but serious. Vibrio vulnificus causes 80,000 illnesses and 100 deaths in the United States each year, according to the US Centers for Disease Control and Prevention.
Vibrio vulnificus naturally lives in warm, brackish or brackish water. It comes from the same family as the bacteria that cause cholera.
Vibrio can be found in water all over the world. In the US, it lives in the Gulf of Mexico and some coastal waters on the East and West coasts. The bacterium thrives in warm months, when ocean temperatures are highest.
Infections can occur when someone comes into contact with water that contains large amounts of the bacteria or eats contaminated seafood.
A mild case of vibriosis includes chills, fever, diarrhea, abdominal pain, and possibly vomiting. Usually, people get sick within the first day of exposure to the bacteria.
Skin wounds infected with Vibrio vulnificus commonly develop blisters, abscesses, and ulcers.
Vibrio vulnificus is one of the bacteria known as a meat-eating infection. Necrotizing fasciitis eats away at the skin, muscles, nerves, fat, and blood vessels around an infected wound.
In more severe cases, people can develop septicemia. This is more common in those with underlying health conditions, especially liver disease, cancer, diabetes, HIV or other diseases that suppress the immune system.
Septicemia is when bacteria enter the bloodstream and spread. It can cause fever, chills, low blood pressure or skin blisters.
This can lead to septic shock, when blood pressure drops dangerously low. The bacteria release toxins into the bloodstream, which can cause blood flow to slow down, damaging tissues and organs.
It can also cause sepsis, in which the body mounts a powerful immune response that shuts down important organs such as the heart or kidneys. Or it can cause acute respiratory distress syndrome, or ARDS, a condition in which oxygen from the lungs does not reach the blood. This can cause brain damage and permanent lung damage.
If the infection moves into the bloodstream, the consequences can be fatal.
Typically, the death rate is about 25% with wound infections, research shows. It is much higher for people who are exposed to the bacteria from eating contaminated food.
Most Vibrio infections in the US generally do not occur through an infected wound, but from eating raw or undercooked shellfish such as oysters, especially during the summer months.
The bacteria can live in the stomachs of fish, oysters and other shellfish. People can consume or be exposed to the bacteria when cooking raw seafood.
Vibrio vulnificus infection is the leading cause of seafood-related death in the United States. Most of these cases are primary septicemia or blood bacteria.
With skin infections, the doctor will first take samples from the infected area to find out if Vibrio vulnificus is causing the problem.
All abscesses will be drained and treated infected area, sometimes covering the wound with a topical antibiotic and a skin barrier, in addition to other antibiotics. If necrotizing fasciitis is present, surgery or even amputation of the affected limb may be necessary to prevent the infection from spreading.
Doctors say it’s important to seek treatment quickly. People who get medical attention as soon as an infection is noticed respond better to treatment, research shows, and their infections are less likely to become fatal.
However, this particular bacterium has developed some antimicrobial resistance. 50% of Vibrio vulnificus infections no longer respond to certain antibiotics, research shows.
The 28 cases of Vibrio infection linked to Hurricane Ian in Lee County, according to the health department, carried high concentrations of the bacteria into the homes of people affected by the flooding. Some may have been exposed while cleaning up after the storm.
Six deaths from Vibrio infection have been reported in Lee County.
While these infections are still rare, this isn’t the first time a hurricane has led to a small spike in cases. A tipping point came after Hurricane Katrina in 2005, when people were also exposed to Vibrio vulnificus in floods, according to the US Centers for Disease Control and Prevention.
Scientists are concerned that infections will continue to rise with climate change. Warmer oceans create a friendlier environment for bacteria and increase the frequency of hurricanes, increasing people’s exposure to flooding.
The only way to prevent Vibrio infection is to avoid exposure.
If you have a skin wound, as well as a new tattoo or piercing, doctors recommend that you stay out of the ocean and avoid saltwater, or at least cover the area with waterproofs.
If exposed to salt water, the CDC recommends washing hands and cuts thoroughly with soap and water.
If you must enter the water, as with hurricane cleanup, wear clothing and shoes that protect against cuts or injuries from flooding.
You can also reduce your risk of vibriosis by making sure your seafood is properly prepared. Avoid raw or undercooked oysters or other shellfish, and be sure to wash your hands with soap and water after handling raw shellfish.
For cooked seafood, eat only those that open during cooking. For shucked oysters, the CDC recommends boiling, frying or broiling for at least three minutes or baking at 450 degrees for 10 minutes.