What is Flesh-Eating Bacteria... and how to prevent it

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How to Guard Against Very Real and Potentially Deadly Flesh-Eating Bacteria (Necrotizing Fasciitis)

Imagine suffering an accidental cut or scrape today that results in amputations, organ failure or life-threatening infection within days. (It happens in the U.S. every day.)

What Is Flesh-Eating Bacteria Infection?

In reality, "flesh-eating bacteria" isn't just one bacteria, but is a label applied to many types -- some which are very common in our surroundings and probably live on your skin and in your mouth at this moment! It is only when one, or a combination, of these bacteria penetrates the skin to infect deeper tissue and fat that they have the potential to be "flesh-eating bacteria." And it can begin with something as simple as a minor cut, scrape, burn, broken blister, insect bite (such as tick1 or even mosquito2) or puncture wound. Even a paper cut, staple puncture or pin prick can provide enough of an opening.3

Most Common Causes of Cuts and Wounds4

Puncture wounds

  • Stepping or falling on sharp objects
  • Animal, snake or human bites

Cuts and abrasions

  • Falling
  • Automobile accidents
  • Broken glass or razor cuts
  • Stabbings
  • Sports injuries

And, while the gaping, ghastly cavities that can result from infection look as if flesh is being eaten, what actually happens is that the bacteria are producing toxins that cause tissue to die. That's why, the condition of "flesh-eating bacteria" is technically called Necrotizing Fasciitis (necrotizing meaning "cause of tissue death" and fasciitis referring to inflammation of the fascia, which is the connective tissue surrounding muscles, blood vessels and nerves). In advanced cases, damaged or dead tissue is surgically removed and/or affected limbs amputated, allowing antibiotics to reach affected area.

Am I At Risk?

Necrotizing fasciitis is common enough that most doctors will see at least one case during the time of their practice -- but so rare that they probably won’t recognize it.5 In 1996, the CDC provided a conservative estimate of up to 1,500 cases of necrotizing fasciitis in the U.S. per year,3 of which 25%-30% result in death. Group a Streptococcus, the most common cause, accounts for about half of these cases while infections from the other types of bacteria are much less common and not well tracked.6 In 2012, a Georgia woman suffered multiple organ failure and amputation of a leg and fingers due to Aeromonas hydrophila infection (a bacteria that's common in warm, fresh and brackish waters) and there are about 95 Vibrio vulnificus (a warm, salt water bacteria) infections in the US annually.7

While perfectly healthy people can, and do become infected, those with a weakened immune system are most at risk. This includes anyone suffering from diabetes, kidney disease or cancer and people who smoke or abuse alcohol and/or drugs. Also, people who already have infected wounds and those recovering from surgery are especially at-risk. And to protect others, avoid contact if you have strep infection and are not being treated.8

What Can I Do To Protect Myself?

A great many victims already had some form of extremity or wound infection prior to becoming exposed to flesh eating bacteria9 so it is important to prevent injuries as much as possible. In the case of children, childproof your home to prevent falls onto table corners or sharp objects, shoes should be worn when playing outside, and teens should be closely monitored around kitchen knives, lawn mowers, etc.10 When injuries occur, however, follow these basic first aid steps:

First aid care for cuts, scrapes and puncture wounds11

For minor cuts, blisters or scrapes

  • To avoid introducing more germs, first wash hands with soap and water. If no water is available, use antibacterial cleanser or alcohol-based hand rub.
  • Wash cut with mild soap and water.
  • To stop bleeding:
    • Apply direct pressure to wound with the palm of your hand over a clean cloth, tissue or gauze for 5 minutes. If blood soaks through, do not remove cloth, etc., place another on top and apply pressure for 20-30 minutes.
    • If wound is on arm or leg, elevating it above heart will also help to slow bleeding.
  • Antibacterial ointment isn't usually necessary for minor cuts and scrapes. Ointment helps to keep wound moist and clean -- pretty much the same as a bandage. Some ointments may cause allergic reaction.
  • If wound is large or in an area that's likely to get dirty or irritated by clothing, cover it with bandage or a sterile gauze and adhesive tape. Replace daily to keep clean and dry if it becomes wet or dirty. Otherwise, small wounds can be left uncovered.
  • Once a scab forms, bandages are no longer necessary. Allow scab to fall off naturally. Do not pick-at or remove scabs.
  • Call your doctor if wound is on face or neck; you're unable to stop bleeding or clean out dirt or debris completely; wound becomes inflamed (red, swollen, warm, numb or tender); you develop a temperature over 100° F; or pus (thick, creamy, grayish fluid) begins draining from wound.

For Minor Punctures

  • To avoid introducing more germs, first wash hands with soap and water. If no water is available, use antibacterial cleanser or alcohol-based hand rub.
  • Rinse puncture under cool, running water for 5 minutes. Then wash with soap, water and a soft wash cloth. To prevent irritation, avoid getting soap in the wound itself and do not use strong cleansing solutions such as hydrogen peroxide. Gently remove visible, remaining dirt with tweezers.
  • Without poking, inspect puncture for objects inside wound. If any are visible, DO NOT REMOVE. Immediately seek medical attention.
  • If you are unable to find whatever caused the puncture, seek immediate medical attention.
  • If you are confident that no object remains inside the wound, apply antibacterial ointment and a clean, non-stick bandage.

For Major Wounds -- this includes any deep or large wound where stitches may be needed; animal or human bite; cut or puncture by fishhook, nail or rusty metal; if object is stuck in wound; any sign of infection; or if victim has not had a tetanus shot within 10 years and wound is small or 5 years if wound is severe.

  • Try to control bleeding but do not attempt to clean the wound.
  • Call 911 or seek immediate medical attention.

Special precautions for swimmers12

  • Stay out of lakes, rivers, swimming pools and hot tubs if you have an open wound or active infection.
  • Never swim or wade in polluted waters (especially within 48 hours of heavy rains when pollution run-off may be highest) or where blue-green algae is present.
  • Shower immediately after swimming.

What are the symptoms of flesh-eating bacteria infection?

Necrotizing fasciitis can progress alarmingly quickly so early diagnosis and treatment is critical. Unfortunately, visual signs may not be apparent if infection is deep within the tissues. Left untreated, however, 73% of cases end in death.

Though no two cases are alike, symptoms often include:13

Within first 24 hours

  • Pain from the infected site may be far worse than what would be expected.
  • Flu-like symptoms may develop (nausea, fever, diarrhea, etc.).

Within 3-4 days

  • Affected area becomes much more painful, swollen and purplish.
  • Blisters may develop containing blackish fluid.
  • Tissue death may begin with area appearing white, dark or flaky.

Within 4-5 days

  • Blood pressure may drop dramatically.
  • Body may go into toxic shock.
  • Person may lose consciousness as body become too weak to fight infection.

To learn more about Flesh-Eating Bacteria and other health issues, visit AtlantaHealth.com

Sources of information for this infographic:

1. http://www.ncbi.nlm.nih.gov/pubmed/23921771
2. http://www.ncbi.nlm.nih.gov/pubmed/12941105
3. http://www.nnff.org/nnff_factsheet.htm
4. http://www.healthline.com/symptom/puncture-wound
4. http://www.cdc.gov/features/necrotizingfasciitis/
5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762295/
6. http://www.nydailynews.com/life-style/health/common-flesh-eating-bacteria-article-1.1079722
7. http://www.cnn.com/2014/08/07/health/vibrio-vulnificus-bacteria/
8. http://www.medicinenet.com/script/main/mobileart.asp?articlekey=99347&page=1
9. http://www.kidshealth.org/parent/firstaid_safe/sheets/cuts_sheet.html
10. http://www.nlm.nih.gov/medlineplus/ency/article/000043.htm
10. http://familydoctor.org/familydoctor/en/prevention-wellness/staying-healthy/first-aid/
first-aid-cuts-scrapes-and-stitches.printerview.all.html

10. http://kidshealth.org/parent/firstaid_safe/emergencies/bleeding.html
11. http://baltimoresun.com/news/maryland/bs-md-cap-gaz-bacteria-0805-20140804-story.html
12. http://en.wikipedia.org/wiki/Necrotizing_fasciitis

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