FORT MYERS, Fla. – With two months to go, Florida has already smashed a grim record this year: 65 infections of Vibrio vulnificus, a potentially deadly microbe known, though not quite correctly, as flesh-eating bacteria.
West Florida’s Lee County has 29 cases and four deaths, the most in the state in both categories, a count Calusa Waterkeeper John Cassani calls “off the charts.”
The state’s total is the highest ever since V. vulnificus infections started being tracked in 2008. The next-highest year was 2017, when Hurricane Irma caused extensive flooding. That year saw 50 cases statewide and 11 deaths, as many as this year.
Health officials did not immediately specify how many cases had been reported since Hurricane Ian’s landfall.
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The blame for 2022’s spike goes to Hurricane Ian, says the Florida Department of Health, which is warning people to stay out of flood and standing water left by the storm.
“Sewage spills in coastal waters, like those caused by Hurricane Ian, may increase bacteria levels,” wrote Lee County department spokeswoman Tammy Soliz in a release. “People with open wounds, cuts, or scratches can be exposed to Vibrio vulnificus through direct contact with sea water or brackish water.” So can those who eat raw or undercooked oysters and shellfish, she points out.
Once acquired, the infection can destroy soft tissue, a condition called necrotizing fasciitis, though other infections can cause it as well. Symptoms include chills, fever, swelling, blistering, skin lesions, severe pain, low blood pressure and discharge from the wound. Without treatment, death can occur in just a few days.
Related to cholera, which is also in the Vibrio genus, V. vulnificus occurs naturally in the kind of warm salty water found around Southwest Florida’s barrier islands and estuaries, says Anthony Ouellette, professor of biology and chemistry at Jacksonville University. In general, Ouellette says, they’re fairly picky about where they live: “They don’t like full-strength seawater and they can’t live in streams and rivers,” he said, but Hurricane Ian helped create new habitat.
Since the storm, the bacteria are now likely also in marshes and retention ponds that got filled with hurricane-pushed overwash, “And it’s still warm down there, so you have bacteria where they normally shouldn’t be that are now probably thriving,” he said.
Though healthy people can get it, their cases are generally mild.
“Only those who are immunocompromised should have really cause to worry,” Oullette said, and even then, “only if you’re going out into the floodwaters.”
Unfortunately, many had to do that to escape Ian – or return home once they’d escaped.
What makes this difficult for Southwest Florida is that age itself can challenge immune systems, as can a number of common diseases: diabetes, kidney and liver disorders – and medications like steroids and chemotherapy.
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‘They make a buffet for themselves’
The species name, vulnificus, is Latin for wound-causing, which is just what the organism does, Oullette says.
“They can break open your red blood cells to get the iron from hemoglobin … they have enzymes that can break down elastin, which makes up our soft tissues, or collagen, which is also in our soft tissues. They degrade our proteins, then they can get our amino acids – so they make a buffet for themselves. And that’s what destroys the tissue – they’re getting their food.”
Plus, he says, they have a protective carbohydrate capsule that helps them “evade our immune system and kind of hide out from us once they get in there.”
But first, the bacteria have to get into your body. “You either eat it, it gets into your ears or it gets in your blood through a wound,” he said . They can enter through any breach in the skin: “cuts, sores – fresh tattoos, new piercings, any kind of body modification where your skin has been penetrated,” Oullette said. “People don’t always think about that awesome tattoo they got or that new nose ring,” but those can become routes of infection as well.
His advice: “Really protect your feet if you’re walking round out there. Have some good boots that are waterproof and sturdy. If you do get into these standing waters, wash it with soap and water and use an over-the-counter disinfectant, whether it’s alcohol or hydrogen peroxide or Betadine.”
And if anything seems amiss, get medical help right away, Soliz said.
Once Gulf floodwaters recede, the risk will be reduced, but they’ll remain in coastal estuary waters. Although the state’s Healthy Beaches testing program checks for fecal indicator bacteria at Gulf islands and beaches, it doesn’t monitor levels of Vibrio, so it’s always prudent to be careful.
Even so, Cassani is dismayed conditions haven’t been updated for almost a month. “(The program) hasn’t sampled or posted results since September 19,” he wrote in an email.
That’s a critical information gap, he says, because “fecal indicator bacteria are just that – indicators of more severe pathogens like Salmonella, Shigella, and Vibrio, and can result in several types of illnesses and diseases in humans, including gastroenteritis and bacillary dysentery, typhoid fever, and cholera. FIB can also be indicators of human viruses and parasites from animals including Giardia and Cryptosporidia from wild or domestic animals.”
