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Flesh-Eating Bacteria a Threat in Warm Water

Thu, 08/24/2023 - 11:35
A species of waterborne bacteria that can cause life-threatening wound infections has killed three people and sickened others in New York and Connecticut. One East Hampton Town resident was sickened after swimming off Gerard Drive in Springs.
Christopher Walsh

As if the extreme heat, exceptionally heavy rainfall events, and out-of-control wildfires that characterize the summer of 2023 were not adequate signals that the climate is changing, in recent weeks a deadly bacterium found in warm seawater and in raw seafood has killed at least three people in New York and Connecticut, including a Brookhaven Town resident, and sickened at least one resident of East Hampton Town.

Vibrio vulnificus is a pathogenic waterborne bacterium that “can cause life-threatening wound infections,” according to the federal Centers for Disease Control and Prevention, and in addition to consuming raw or undercooked seafood such as oysters, a person can be infected through an open wound. It is treated with antibiotics, but “many people with vibrio vulnificus infection require intensive care or limb amputations,” according to the C.D.C., “and about one in five people with this infection died, sometimes within a day or two of becoming ill.”

Around four days after swimming off Gerard Drive in Springs on Aug. 1, Paul Munoz was hospitalized and remained there for about a week. “I did have two bacteria, and one of them is vibrio” vulnificus, he said on Monday. The owner of a landscaping company, he had a few blisters resulting from a poison ivy rash at the time of his swim. “They’re thinking that’s where the bacteria had access to get in,” he said.

Mr. Munoz, who is chairman of the town’s energy and sustainability advisory committee, said that his primary care physician wanted him to see an orthopedic doctor. “They were concerned that this infection could spread to the bone,” he said. “They had me on IV antibiotics, then oral antibiotics. I am just now getting blood work done — I might have to go back on antibiotics.”

 Vibrio vulnificus has been referred to as a “flesh-eating bacterium” as severe infections can cause the flesh around an open wound to die. According to the C.D.C., vibrio vulnificus kills around 100 people and sickens some 80,000 more in the United States every year.

Vibrio vulnificus bacteria “occur naturally in saltwater coastal environments and can be found in higher concentrations from May to October when the weather is warmer,” according to an Aug. 16 statement by Gov. Kathy Hochul.

But “15 to 20 years ago, we only talked about it existing in the Gulf of Mexico,” said Melody Butler, Stony Brook Southampton Hospital’s director of infection prevention and control. “It was not something we would be looking for on Long Island. Now, since the beginning of July, four people in the greater New York area have been infected, including three who have died, one from Long Island and two in Connecticut. Obviously, it is now in the forefront of everyone’s mind when taking care of patients who have recently eaten seafood and are presenting with severe gastrointestinal disease or have been swimming and have skin infections.”

Infection with vibriosis “can cause a range of symptoms when ingested, including diarrhea, stomach cramps, vomiting, fever, and chills,” the governor’s statement reads. “Exposure can also result in ear infections and cause sepsis and life-threatening wound infections.” Symptoms usually present soon after exposure, Ms. Butler said, and include an onset of stomach pain within 12 to 24 hours. Stony Brook Southampton Hospital has had only one patient with vibrio vulnificus this year, she said.

The State Health Department “reminded health care providers to consider vibrio vulnificus when seeing individuals with severe wound infections or sepsis with or without wound infections.”

The vibrio vulnificus infections in this region are “a terrible turn of events, to be sure,” said Christopher Gobler of Stony Brook University’s School of Marine and Atmospheric Sciences. There is a mantra in microbiology, said Dr. Gobler, who has long studied water quality on the South Fork: “Everything is everywhere and the environment selects. So, this microbe is lingering in the background, and coming to prominence when water temperatures rise.” As the organism prefers brackish water, lower salinity, a function of freshwater input, can promote its prevalence.

Brackish water has more salinity than freshwater but not as much as seawater, and can be found where the two meet, such as in estuaries. Along with wildlife, such areas can attract bathers, as the water tends to be warmer and shallower, Ms. Butler said. “So you’d want to aim for swimming in larger, colder areas, where water has a good flow to it,” she said. “You don’t want to swim after a large rain.”

The South Fork and wider region have seen several extreme rainfall events this summer. This “can lead to transitory low salinity conditions” in New York and Connecticut, Dr. Gobler said, adding that Connecticut “has many more large rivers than Long Island, leading to lower-salinity water in some regions.”

Those with a wound — a cut or scrape, a recent tattoo, piercing, or surgery, even a recent ear infection — should “stay out of saltwater or brackish water,” Ms. Butler said. “But if you’re on vacation and this is your one and only opportunity to swim in Montauk, cover the wound with a waterproof bandage.” This also applies to those cooking with seafood, she said, “and if handling raw seafood, you need to wear gloves and/or cover wounds on your hands that can come in contact with the juices from cooking the seafood.” Those with compromised immune systems should avoid eating raw or undercooked shellfish, according to the governor’s statement, and wear gloves when handling raw shellfish and thoroughly wash hands afterward.

Asked if the infections are another manifestation of climate change, Dr. Gobler answered yes. “Our summer water temperatures are significantly warmer than they were in the 20th century,” he said. He cited a National Oceanic and Atmospheric Administration statistic: In the northeastern United States, intense rainfall events, defined as greater than one inch at a time, increased by 71 percent from 1958 to 2012. “This summer proves that trend has continued,” he said. Higher temperatures and lower salinities “are likely making conditions more permissive for the expansion of this bacterium.”



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