It’s summer’s scariest health threat. But how worried should you be about necrotizing fasciitis, better known as “flesh-eating disease”?
Although US officials haven’t issued any warnings this summer about the stomach-turning, sometimes-fatal condition, cases of necrotizing fasciitis seem to be popping up with alarming frequency this year. In the US, there have already been nine reported incidences of the rare infection — including some unsettlingly close to home — and three deaths.
Often, the patients are ordinary people who dared to take a dip at the beach on a hot day.
“These are very dramatic, horrible cases,” Bruce Hirsch, MD, an infectious disease doctor at Manhasset, LI’s North Shore University Hospital tells The Post.
Here’s what you need to know to stay safe.
What is flesh eating bacteria?
For starters, there isn’t just one flesh-eating bacteria to avoid.
The serious infection can be caused by numerous strains of bugs — almost 30 — that can be found in all kinds of environments, including saltwater (Vibrio vulnificus), freshwater (Aeromonas hydrophila) and simply on your skin (group A Streptococcus).
How do you get it?
Often, the disease enters a person’s system when they swim in bacteria-infested waters while they have a “disruption on the surface of the skin” — meaning a cut, burn, scrape or bug bite of any size, says Hirsch.
But some patients insist that they had no open wounds — and the CDC notes that a cut might not even be necessary, as necrotizing fasciitis cases have been reported after blunt trauma that did not break the skin.
Plus, patients can contract Vibrio bacteria in another, wound-free way: It can be ingested in raw or undercooked seafood, according to the CDC.
What are the first signs of necrotizing fasciitis?
However the bacteria breaches the body, once the flesh-eating bugs get an outlet, they proceed to attack the skin and other tissues surrounding nerves, muscles and blood vessels, according to the National Organization for Rare Disorders.
“It gets deep into the tissue and spreads quickly. These are powerful toxins that digest and destroy tissue,” says Hirsch.
So quickly, in fact, that NORD says the bacteria can destroy an inch of flesh per hour. It can also be life-threatening, leading to toxic shock syndrome or organ failure.
Early symptoms of a flesh-eating bacteria infection can mimic the flu, with fever, body aches, and “severe pain” at the wound site being common, says Hirsch.
Although it’s known for its gruesome photos, flesh-eating bacteria sometimes looks like nothing at all: Many patients have no sign of visible infection, which makes the condition difficult for doctors to diagnose. People, Hirsch says, will be in “extreme pain and have nothing to show for it.”
Other symptoms include redness, swelling and tenderness around the infected area, oozing from the wound, dizziness, fatigue and diarrhea. The CDC recommends going to the hospital if you have a fever accompanied by a red or swollen area of the body.
One in three people infected with necrotizing fasciitis who will die, according to the CDC.
Who’s at risk?
Necrotizing fasciitis “can affect anybody at any age,” says Hirsch. That includes patients as young as 7-year-old Amilian Villa (pictured) from The Bronx, who had to have her left arm amputated after contracting the disease in 2017, and the elderly, such as 77-year-old Carolyn Fleming, of Ellenton, Fla., who died after a stumble on the beach left her vulnerable to the infection in June.
Although it can happen to anyone, people with weakened immune systems — those with diabetes, kidney or liver disease, or cancer — should be extra cautious, according to the CDC.
What’s the treatment for necrotizing fasciitis?
Now, for some good news: Necrotizing fasciitis is still very rare, and rarely contagious, according to the CDC. It can be treated with antibiotics if it’s caught early enough, and surgically (often, via amputation) if necessary.
You’re also unlikely to contract it if you’re in fairly good health, according to researchers at the Cooper University Hospital in Camden, NJ, who have treated several patients for the disease in recent years.
“In all the cases we’ve seen, the patients have had known risk factors (liver disease, diabetes, or other immune compromises),” they wrote in a recent report.
Should you avoid the beach?
Of course not, says Hirsch: Despite the barrage of news coverage, the doctor and his Manhasset team only saw one case of flesh-eating disease last summer, and it hasn’t been on their radar yet in 2019.
“I have not seen or heard of any local cases this year, and I work in a busy hospital,” Hirsch says. “Not this summer, not yet, and hopefully not at all.”
Flesh-eating bacteria map
The map above breaks down cases of flesh-eating bacteria in 2019. Each blue dot represents a report of necrotizing fasciitis. Of 2019’s nine reported cases of necrotizing fasciitis, six were contracted in the Gulf of Mexico. The warm waters there are ideal conditions for bacteria, which thrives in waters 55 degrees or warmer.
Tri-state waters were once thought to be too cold for flesh-eating bacteria to thrive — but not anymore. From 2008 to 2016, Cooper University Hospital in Camden, NJ, only saw one case of Vibrio vulnificus infection. But in 2017 and 2018, the doctors treated five infections — all of which were linked to water or seafood from the Delaware Bay, which borders New Jersey. In a report, researchers hypothesized that the bacteria could be spreading “due to rising ocean temperatures due to climate change.”