A crabber is Florida's latest casualty of the flesh-eating bacteria Vibrio Vulnificus. Jacqui Goddard on the ‘horrific’ infection that ‘crept through his body like acid’ and how it spreads.
Henry
Konietzky thought little of it when he stepped on some ants just before
wading knee-deep into Florida’s saltwater Halifax River to set crab
traps on a Saturday afternoon.
But
severely aching legs and a developing sore on his ankle woke him at 2
a.m. the next day. By 6 a.m., lesions were spreading across his body.
Last Monday, after just 28 hours in hospital, the 59-year-old was dead,
the ninth person killed in Florida this year by the waterborne,
flesh-eating Vibrio Vulnificus.
One
of the world’s most deadly bacteria, it is thought to have entered his
foot through the minute puncture wound of an ant bite, then set up an
infection that “crept through his body like acid,” destroying tissue and
ultimately shutting down organs, said his shell-shocked widow Patty, of
Palm Coast.
“It’s the most horrific thing I have ever seen in my life,” she added.
In
a state given to peculiarity—with environmental perils including
Burmese pythons, Dengue fever-carrying mosquitoes, herpes-infected feral
monkeys, venomous lionfish from Asia, Africanized honeybees, biting
sharks, rabid otters, jellyfish invasions, hurricanes, lightning strikes
and home-devouring sinkholes—the headlines that Konietzky’s death
generated might seem to represent Vibrio Vulnificus as the newest
addition to Florida’s compendium of the bizarre.
“I felt like I had just two heartbeats left in me.”
Yet
the bacteria has many years’ history here and along the Gulf Coast
states, where public-health officials are working to increase awareness
and reduce risks relating to the microscopic killer. With each new
tragedy that unfolds comes grief and heartache, but also an opportunity
to educate.
In
2013 to date, the Florida Department of Health (DOH) has recorded 27
cases of Vibrio Vulnificus infection in humans, including the nine
fatalities. That toll matches precisely the toll wreaked on the state in
the whole of last year. In 2011, there were 35 cases and 10 deaths.
The
Sunshine State has consistently accounted for more than half of the
infections in the entire Gulf Coast region, which average around 50 a
year in total. A naturally occurring bacteria related to cholera, it is
transmitted in one of two ways; either through ingestion of raw
shellfish—generally oysters—or via open wounds in water.
What
happens next is influenced by the victim’s medical history. “People who
have underlying health conditions, like a poor immune system or
especially chronic liver disease, can develop bloodstream infections
that are fatal up to 50 percent of the time,” says Dr. Carina Blackmore,
interim state epidemiologist at the Florida DOH.
“Studies
have shown that people with pre-existing medical conditions are about
80 times more likely to develop these severe bloodstream infections than
healthy people.”
Florida’s
abundance of retirees and water-based activities, popularity as a
tourist destination, and plentiful breeding grounds for the
bacteria—which thrive in warm, salty water—are among the factors that
combine to make it the No. 1 state for Vibrio Vulnificus infections.
“The
last thing we want to do, though, is make people think that if they go
to the beach they’re going to die,” said Dr. James Oliver, a professor
of biology at the University of North Carolina Charlotte and the world’s
foremost expert on Vibrio Vulnificus. “Look how many people go to the
beach in a year, and look how many people fall victim to this in a year.
It’s easy math,” he stresses.
He
has studied the Vibrio genus of bacteria for more than 40 years and
still finds it eminently fascinating. Vibrio Vulnificus divides once
every 20 or so minutes—a particularly rapid rate that accounts for its
swift takeover of the human body once it has won access.
For
George Clarke, 79, a fisherman now fighting for his life in a
Jacksonville hospital, it took just a few hours for things to turn bad
after the bacteria entered through a nip on his right arm that was
inflicted by a crab in the Amelia River two weekends ago.
At
4 a.m. that Sunday, he woke with severe shakes and his forearm “felt
like it was on fire,” said his wife, Shirley. It turned swiftly black.
Most of the skin has now gone as surgeons battle to keep the infection
from spreading, and he is on four antibiotics. His distraught wife can
only holler in his ear as he lies unconscious that he should keep
fighting. “We’ve got a wedding anniversary to celebrate on Tuesday,” she
reminds him.
Richard
Garey, 56, a soccer coach in Gonzales, Louisiana, knows how it feels.
His wife “watched me dying in front of her” after he picked up a Vibrio
Vulnificus infection in June, after gashing his foot on barnacle-covered
rocks on Grand Isle.
For
a day or so, he just felt rough. “Then it hit that critical mass where
things went south very quickly. It’s eating your flesh and the toxins it
releases in doing so are what overloads your system,” he explains,
recalling how medics could not even get a blood pressure reading for him
when he got to hospital, suffering from septic shock.
“I
was on the edge. I was kind of in that world, and kind of outta that
world…The nurse was saying ‘Don’t go, don’t go, keep fighting,’” he
says. “I felt like I had just two heartbeats left in me.”
Without
even waiting for the results of a laboratory culture, a doctor
recognized the signs and symptoms of Vibrio Vulnificus—including the
smell of the necrotizing flesh. The swift diagnosis saved his life, and
his infected limb. “They told me if it had been another three to four
hours, they would have had to take my leg off,” he said.
Four
months later, he is still undergoing intense physiotherapy. He has
undergone seven surgeries and one skin graft. Photographs of his foot
and lower leg at their worst resemble something from a horror movie.
“Who
knew this could happen,” he said. “I’ve been in those marshes thousands
of times, over 45 years, and a bacteria I’d never heard of came along
and put me in this life-or-death fight.”
Jacqui Goddard is a freelance foreign correspondent for British national newspapers including The Times, Sunday Telegraph, and The Scotsman. Based in Florida since 2002, she has also written for publications including the South China Morning Post, The Australian, The Christian Science Monitor, The Globe and Mail (Canada), and has reported for BBC radio.
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