Hurricane season has already produced indelible images of flooded streets and wind-beaten buildings, as Harvey and Irma have battered the southern United States. The dangers of wind and rain are usually obvious, but for those wading through the deluge of water, there's an even more insidious threat: infection, including from potentially deadly bacteria.
A first responder in Texas recently contracted necrotizing fasciitis, the fast-spreading, tissue-destroying infection better known as flesh-eating bacteria, after a mosquito bite near his wrist became infected. J.R. Atkins is a former firefighter and medic who boated through his Missouri City neighborhood rescuing people from the Harvey floodwaters on August 29. Thanks to his training, he realized the seriousness of his situation as the infection spread overnight.
"There was a small little tiny bite on Tuesday, a little tiny bite on me that by Tuesday night grew to about a nickel size," Atkins told KPRC-TV in Houston. "The next morning, it had gone across the bone on the bottom side of my wrist and then like maybe 4 or 5 hours later it crossed the wrist and got into my hand and anytime the swell[ing] moves across the joint that's…I've always told that's been a bad thing."
Atkins figured the bite had left him susceptible to bacteria in the water, so he went to the Sugar Land branch of Houston Methodist hospital. Emergency room nurses saw that he was developing sepsis, meaning the infection could easily kill Atkins. He was rushed into intensive care, where he received multiple operations to remove dead and infected tissue. He was released from the hospital on Sunday and was lucky enough not to need a skin graft.
"If it wouldn't have been for the nurses here at Methodist, I probably would have not been able to make it through it. I mean, there's no way I could have made it through it," he said, while wearing a sling on his bandaged left arm and with tubes hanging from his neck.
Atkins shared his story as a warning to anyone who might not realize that floodwaters are a breeding ground for potentially life-threatening bacteria. "I knew what I was getting into which is the scary thing. I was fully aware that this could happen," Atkins said, adding, "What I would like people to understand is that I went out in storm water. I didn't go out in sewage, and so if you look at what's going on in Houston and you look at the drainage issues, there's way worse stuff in there."
The Centers for Disease Control and Prevention explains that what's known as flesh-eating bacteria can be caused by a number of different bacteria, with group A Streptococcus being the most common. The "flesh-eating" part of the moniker, though, is pretty accurate, as the bacteria spread through the fascia, connective tissue around the muscles, nerves, fat, and blood vessels. Poisons in the bacteria can kill off the infected tissue, meaning the patient can lose limbs and even die. (Thus the name necrotizing fasciitis: "necrotizing" means death of cells or tissue, while "fasciitis" indicates the body's soft tissues.)
Symptoms can appear rapidly as pain or soreness in the infected area—it might feel like a pulled muscle, and the skin might become warm and swollen, with a red or purple color, according to the CDC. Ulcers, blisters, or black spots may appear. The person may have a fever or chills and vomiting and fatigue are also common.
These are all signs of serious infection—necrotizing fasciitis is a medical emergency that requires immediate hospitalization. In another recent incident, Wayne Atkins (no relation to J.R.) developed a Streptococcus A infection through blisters after hiking in New Hampshire this summer. His organs began shutting down and he spent more than 2 weeks in a medically induced coma while doctors worked to treat him with antibiotics and remove infected chunks of his leg. Strong IV antibiotics can fight the bacterial infection, while surgery removes the dead tissue and keeps the bacteria from spreading. Even with treatment, nearly a quarter of patients don't survive.
Prevention, then, is the best cure, and preventing infection means practicing basic wound care. Any break in the skin—any cut, scrape, or bite—should receive first aid as soon possible, and be kept clean and covered with dry bandages. Water is a great vehicle for infection, so open cuts should be kept dry and you should avoid spending time in any body of water, including whirlpools, swimming pools, lakes and rivers. As Atkin could certainly tell you, even the smallest cut needs to be taken seriously.
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