What to know about the rare flesh-eating bacteria, Vibrio vulnificus, in coastal waters

The recent death of a Town of Brookhaven man due to a rare flesh-eating bacterial infection has cast a spotlight on Vibrio vulnificus.

This bacteria is commonly found in some coastal waters as well as in uncooked and raw shellfish. In rare cases, it can cause serious illness and death among people with certain health conditions.

The Centers for Disease Control and Prevention estimates there are about 80,000 illnesses each year in the U.S. from the different species of Vibrio bacteria. About 52,000 are believed to be the result of eating contaminated food. About 80% of the infections take place between May and October due to warmer water temperatures.

Nassau has had 14 Vibrio infections this year and Suffolk 18. Connecticut has reported two deaths this year.

But deaths are rare, and experts said the risk remains low for most healthy people. The Brookhaven man's death, announced on Aug. 16, was the first in Suffolk since at least 2016. His named was not released.

Here is what you need to know about Vibrio vulnificus, a bacteria that causes vibriosis:

 Where is Vibrio vulnificus found?

Vibrio is a bacteria that naturally lives in some coastal waters.

“There is a mantra in microbiology: Everything is everywhere, and the environment selects,” said Christopher Gobler, a professor at Stony Brook University’s School of Marine and Atmospheric Sciences and director of the New York State Center for Clean Water Technology. “This microbe is lingering in the background, and coming to prominence when water temperatures rise. The organism also prefers brackish water.”

Brackish water is a mix of fresh water and seawater found in estuaries.

Suffolk County Health Commissioner Dr. Gregson Pigott has said that it's "not something to worry about" at ocean beaches, like Smith Point Beach or Jones Beach. But where streams or stormwater runoff meets saltwater, in bays or harbors, there might be more of the bacteria in larger numbers.

Are changing temperatures a factor?

Gobler said climate change is a factor, pointing out that summer water temperatures are “significantly warmer” in recent years while rain has increased.
“Higher temperatures and lower salinities are likely making conditions more permissive for the expansion of this bacterium,” he said.

How do you become infected with Vibrio vulnificus?

Many infections happen when people eat raw or undercooked shellfish, especially oysters, according to the CDC.

But an infection also can happen through a wound in the skin, said Dr. Alan Bulbin, director of infectious disease at St. Francis Hospital in Flower Hill. “Even a mild wound can cause infection if you come in contact with water or seafood that’s contaminated,” he said.

What happens if you are infected? And what does 'flesh-eating' mean?

In most cases, people who are otherwise healthy and become infected will experience symptoms such as vomiting, cramps, fever and diarrhea but recover.

But for people who are immunocompromised or have certain other health conditions, an open wound that is infected with Vibrio vulnificus can quickly turn into serious lesions and necrotizing fasciitis, a condition that causes the flesh around an open wound to die, the CDC said. In some cases, amputation might be necessary to save the individual.

That’s why Vibrio and other bacteria that cause the condition are often called “flesh-eating bacteria.” The infection also can enter the bloodstream and cause sepsis, which can lead to death.

“In general, severe infections from this bacteria are seen in high-risk individuals who are immunocompromised, have liver disease, or have certain blood disorders,” said Dr. Amesh Adalja, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security. “It’s unlikely that someone outside those risk groups gets seriously ill.”

Where did the individual from Long Island who died after becoming infected with Vibrio vulnificus come in contact with the bacteria?

Both the state Health Department and Suffolk County Department of Health said last week they did not have information on where the individual became infected. They did say he was a man over the age of 55, with an underlying health condition and a wound on his leg.

What can I do to protect myself from getting infected?

People who are in the high-risk groups should be vigilant and avoid going near saltwater, Bulbin said, especially if they have an open wound or are in rocky areas where they might get cut or scraped. They should stay away from eating or coming in contact with raw seafood, especially shellfish.

“If you are an otherwise healthy individual, common sense always wins the day,” he said. “If you have an open wound, a fresh tattoo or piercing, you probably want to avoid direct contact with any kind of water source that you don't know about.”

Healthy people without open wounds or other skin issues should be able to participate in saltwater-related activities, Bulbin said.

“Severe outcomes from these bacteria is still a very rare event,” he said.