[Editors Note: NRNS reporter Jessica Forres provided research and assistance to ABC 7 News-WJLA investigative correspondent Roberta Baskin for her story about Vibrio bacteria which aired May 23, 2007.]
As Americans look forward to the beach this summer there is a threat more dangerous than man-eating sharks. This man-eater gives its victims no warning. There is no dorsal fin circling its prey. Instead the Vibrio bacteria, moving north due to rising water temperatures, quietly enters a tiny cut or mosquito bite to invade its victim. For swimmers and fishermen unlucky enough to be nearby, the fiery pain in a few hours turns to death from a massive flesh-eating infection.
Since 2000, a Natural Resources News Service survey shows that Vibrio wound infections have increased each year and the reports are spreading northward to places where swimmers, fishermen and the emergency room doctors who see them are less likely to recognize the dangerous pathogen. For example, Vibrio wound infections have increased from one victim reported to Maryland public health authorities in 2000 to 13 reported last year in that state.
The Centers for Disease Control and Prevention reported 134 cases nationally in 2005, a 51 percent increase in six years. That is a rate of 7.1 percent a year. The CDC doesn’t require states to report infections, but estimates 1,900 people a year contract a Vibrio wound infection.
There are several species in the Vibrio genus that cause wound infections, and each year, more die from them in the United States than are killed by shark attacks worldwide. That conclusion is based on a study of 813 Vibrio victims 1997 through 2004. The scientists conducting the study, some of whom work for CDC, reported 77 deaths, or 9.6 victims per year in the United States. National Geographic reports that only about six people are killed worldwide by sharks.
One Vibrio species, Vibrio cholerae, is the pathogen that causes cholera. That species and others in the Vibrio genus are also well known as sources of food poisoning from eating raw seafood, especially oysters. Vibrio cholerae survive in fresh water, but most other Vibrio bacteria are found only in salt and brackish water where they pose the greatest threat of wound infections – especially in warmer water like the Gulf of Mexico.
But now a survey of state health departments by NRNS finds the number of wound infections increasing rapidly in more northerly states.
Rhode Island had its first reported Vibrio wound infection last year, and the bacteria are turning up in other regions where they were previously unknown. Vibrio bacteria infected unexpected areas in Europe like Sweden and Denmark, according to Dr. Paul R. Hunter, professor of Health Protection at University of East Anglia in Norwich, England. Hunter is an expert on the spread of infectious diseases caused by climate change.
Rising water temperatures caused by climate change may explain why Atlantic coastal states are seeing more wound infections and more Vibrio food poisoning infections.
According to a report recently released by The Foodborne Diseases Active Surveillance Network of the CDC Emerging Infections Program, Vibrio seafood-related cases have increased by 78 percent since 1996.
Vibrio parahaemolyticus, a species of Vibrio that usually infects oysters but also causes wound infections, had never been a problem for oystermen in Prince William Sound, Alaska and Puerto Mott, Chile. But in 2004 in Alaska and 2005 in Chile, Vibrio parahaemolyticus contaminated oyster farms and caused thousands of people to get sick with diarrhea and gastroenteritis.
Dr. Joseph McLaughlin, Acting Chief, Alaska Section of Epidemiology at that state’s Department of Health and Human Services and one of the investigators of the outbreak, found the affected oyster farm extended 621 miles north of British Columbia, the northernmost recorded source of Vibrio parahaemolyticus infections carried by oysters. He also found rising surface water temperatures where the oyster farm was located.
“The outbreak in Alaska is a good example of how global warming is bringing infectious diseases northward,” Dr. McLaughlin said. The Chesapeake Bay has also seen a rise in water temperatures, and the data collected by NRNS show an increase in Vibrio wound infections in Maryland and Virginia.
“In the last couple of decades, water temperatures in the Bay have increased by two degrees and by three to five degrees in some of its tributaries,” said Dr. Kevin Sellner, Director of the Chesapeake Research Consortium.
Though Sellner hasn’t studied the relation between water temperature and Vibrio infections, he says that, “these increases are significant and if water temperatures continue increasing it is only logical to assume that there will be an increase in pathogens.”
Dr. Martin Polz, an associate professor of the Civil and Environmental Engineering at Massachusetts Institutes of Technology, who is currently researching certain environmental conditions that cause Vibrios to proliferate, suspects algal blooms are having an effect on the abundance of the genus.
“Small microscopic algae will secrete carbon into the water and the Vibrios can sense that and can digest that carbon,” Polz said. “This can lead to transient blooms where the numbers can go up significantly.”
Such may have been the case in 2004 when three fishermen, one of whom died, contracted Vibrio vulnificus wound infections during a fishing tournament in Texas.
“Since the state of Texas refused to admit that this was the first time there has ever been more than one person who got Vibrio vulnificus at the same time/place, no samples were taken, and we’ll never know why this happened,” Dr. James D. Oliver a professor of Biology at the University of North Carolina in Charlotte who has studied Vibrio vulnificus since 1976, wrote in an email to NRNS.
Charles Newton, a fishing guide, of Rockport, Texas remembers the outbreak when Vibrio vulnificus infected a small cut he got from his dog’s tooth while fishing one day in July. Fortunately, doctors scraped off the infected flesh in enough time to save his arm, but if he had waited two more hours to receive medical treatment he would’ve lost it. Geographical clustering also occurred in Australia where three victims, a disproportionately high number for such a remote location, contracted Vibrio vulnificus and Vibrio parahaemolyticus wound infections over a four-year period while fishing in the remote western part of the Gulf of Carpentaria, according to a study that was published in the Journal of Infection by the British Infection Society.
“Vibrio vulnificus, Vibrio cholerae and Vibrio parahaemolyticus are heterotrophic organisms, meaning they consume organic matter just like humans and a source of organic matter comes from runoff from the land,” Byron said. “The nutrients from the land get the algae going and the algae feed the Vibrio.”
Oliver Johnson died from a Vibrio vulnificus infection after he fell into a canal in Hawaii, where 48 million gallons of sewage spilled two days before. Terri Dorsey of New Orleans, Louisiana, lost her leg to Vibrio vulnificus, after wading in Hurricane Katrina flood waters. She was one of 22 people, five of whom died, who contracted a Vibrio wound infection after Katrina.
Most people who contract a Vibrio wound infection are healthy, even though most of those who die have underlying diseases, according to Dr. Oliver.
Lou Groth, a geologist in Lafayette, Louisiana, was perfectly healthy when a small prick from a bait shrimp on his wedding ring finger became infected with Vibrio vulnificus. Groth was never in danger of dying but he lost four fingers.
Victims like Dorsey, Newton and Groth are lucky by comparison. Those who were hospitalized more than two days after the onset of symptoms were likely to die, according to an unreleased CDC study.
Victims and doctors need to recognize the infection and treat it immediately, said Dr. Oliver.
Al Holt of Marion, Massachusetts probably wouldn’t have died if emergency room doctors hadn’t misdiagnosed his symptoms. He went to Tobey Hospital in Wareham, Massachusetts after he returned home from fishing with a sore and swollen pinkie. Doctors there treated him for gout and sent him home instead of treating him for Vibrio damsela. The excruciating pain brought Holt back to the hospital where doctors rushed him to the New England Medical Center in Boston.
Holt had four four-hour surgeries where doctors removed his hand, arm and portions of his back in order to keep the bacteria from spreading but it was too late. His organs had already started shutting down and he was put on life support. He died 15 days later. The Quincy, Massachusetts Patriot Ledger reported Holt’s story, which was confirmed to NRNS by family members.
Increasing awareness of these wound infections will help prevent cases from occurring. If you have the following symptoms – swelling, pain, fever, blistering or redness – run don’t walk to the emergency room.
The only sure protection is to stay out of the water if you have an open wound and to wear protective clothing when handling raw shellfish.
Victims of Vibrio vulnificus:
– Candace Scott, 45, died after Vibrio vulnificus entered an open wound while riding a watercraft on St. Johns River in Florida. August 2005
– Al Holt, a fisherman in Massachusetts, died when Vibrio damsela infected a wound on his pinkie. August 2002
– Dr. Kenneth Dean Creamer, 52, a Houston dentist, died after Vibrio vulnificus infected a cut on his leg while he was fishing in Port O’Connor, Texas. July 2005
– Oliver Johnson, a mortgage broker in Hawaii, died from a Vibrio vulnificus wound infection after falling into the Ala Wai canal in Hawaii. April 2006
– Terri Dorsey from New Orleans lost her leg to Vibrio vulnificus when she cut herself while wading in Hurricane Katrina waters. August 2005
– John Roche lost his leg, suffered from congestive heart failure and a 17-day comma after coming in contact with the deadly bacteria in Northeast, Florida. August 2001
– Ethel Morris lost her leg to Vibrio vulnificus and almost died while fishing in Doctor’s Lake in Florida. July 2006
– Lou Groth of Lafayette, Louisiana lost four fingers while fishing off the coast of Louisiana. July 2000
– Pete Tiller of Deltaville, Virginia was able to save his arm after contracting a Vibrio vulnificus infection. 1998
– Ronnie Campbell of Deltaville, Virginia contracted a Vibrio infection while cleaning the bait well on his boat. 2000
– Rob Whittman of Montross, Virginia contracted a Vibrio vulnificus infection while fishing near the Eastern Shore. 2000
– Doug Lemke of Oxford, Maryland lost his father to Vibrio vulnificus who contracted the infection while fishing. 2005
– Chilly Orme of Mayo, Maryland was able to save his leg after contracting Vibrio vulnificus while wading for 5 minutes in Rhodes River. June 2006
– Charles Newton was able save his arm after he contracted Vibrio vulnificus while fishing in Port Arthur, Texas. July 2004