Florida: Uptick Of Vibrio Infections Following Hurricane Ian

Credit Florida DOH 

#17,073

Prior to the landfall of Hurricane Ian, in a blog called `After The Storm Passes' we talked about the dangers of floodwaters that may contain toxic chemicals, dangerous viruses and bacteria, and hidden hazards like snakes, rats, and broken glass, sharp metal, or even live electrical wires.

While most people worry about sharks of alligators, each summer I try to devote a blog to the microscopic threats that claim far more lives each year; Naegleria Fowleri and Vibrio Vulnificus. 

Naelgeria is the rarer of the two, and comes from warm, stagnant, fresh water sources, causing 3 or 4 cases of PAM (Primary Amebic Meningoencephalitis) in the United States each year (see map below).

But in 2017 a research letter written by epidemiologists at the CDC (see EID Journal: Estimation of Undiagnosed Naegleria fowleri (PAM), United States) estimated the yearly number PAM cases in the United States probably averages closer to 16 (8 males, 8 females).

While still rare, more common are infections with vibrio vulnificus, a bacterium commonly found in warm, brackish, saltwater.  

Ingestion of Vibrio vulnificus can cause gastrointestinal symptoms, but for healthy people, rarely causes serious illness.  The State of Florida warns, however: Vibrio vulnificus infections can be a serious concern for people who have weakened immune systems, particularly those with chronic liver disease.  

The most common route of infection is by eating raw or undercooked shellfish (oysters, mainly). Which is why I’ll take my oysters deep fried or steamed, thank you.

It is also possible to contract this infection from swimming, or wading, in contaminated waters, such as are common following a hurricane. These skin infections can prove quite nasty. Antibiotics and extensive debridement of necrotic tissue are the standard treatments, and in some instances amputation is required.

Most years, Florida reports a couple of dozen cases, and a handful of deaths (see chart below)  But those numbers have been going up over the past decade, with last month's hurricane producing a sharp spike in hard-hit Lee County (29 cases & 4 deaths). 

It should be noted that millions of people swim in the Gulf and Atlantic waters off Florida every year, and only a small handful are affected. Frankly, you have a far better chance of drowning than acquiring this bacterial infection.

But warm, stagnant, pools of saltwater left behind following the hurricane are an ideal breeding environment for this nasty bacterium.

Anyone who has been exposed to these conditions, and develops any sign of infection, will want to get medical treatment immediately. 

For information on another environmental threat, recently reported along the upper Gulf Coast, you may wish to revisit CDC HAN Advisory: Melioidosis Locally Endemic in Areas of the Mississippi Gulf Coast.