Contaminated floodwaters following hurricanes can bring life-threatening skin infection

The damage of Hurricane Harvey is widespread, and well known, but even one month after the storm there are lingering effects that still pose risks to Texas residents.

“In these flood situations, there’s all that brackish water contaminated with sewage, and water, human waste, and animal filth and other things being a kind of culture broth for bacteria,” said Dr. Whitney High, the director of dermatopathology at the University of Colorado School of Medicine.

It is often forgotten that floodwaters are contaminated with unsafe materials. The Texas Department of State Health Services has been urging residents to avoid floodwater at all costs, even after the storm, according to Director of Media Relations Chris Van Deusen. Floodwater poses risks past destroying furniture; the water actually carries a multitude of bacterium that could lead to infectious diseases if exposed to them.

“In terms of hurricanes and flooding, that’s just a big old petri dish,” said Adam Friedman, an associate professor for dermatology at the George Washington school of medicine.

One such infectious disease is necrotizing fasciitis, commonly referred to as a “flesh-eating virus infection.” While the disease does not “eat” one’s flesh, the bacteria releases a toxin that kills the body’s soft tissue, according to the Centers for Disease Control.

“Your tissue is literally dying,” Friedman said.

In mid-September, necrotizing fasciitis claimed the life of a Harris County resident, Nancy Reed, according to a report by the Harris County Institute of Forensic Sciences. Reed was infected when she fell into contaminated floodwater.

The most common way to identify necrotizing fasciitis is if a patient has a wound that is much more painful than they would expect based upon the wound’s appearance. If the disease is suspected, a patient should seek emergency care and the infection should be diagnosed by a health professional.

“There isn’t one thing you look at on the skin and say ‘that’s necrotizing fasciitis’, it’s the speed and the progression of necrotizing fasciitis and pain that’s out of proportion compared to what you see visually,” High said.

The virus will first be treated with IV antibiotics. If the condition is caught too late, surgery and amputation may be necessary to stop the virus from spreading.

If not treated, more symptoms will arise after the initial pain including fever, chills, fatigue and vomiting. Speed is most important in minimizing damage from the disease, so if it is suspected, immediate medical attention is recommended.

Those cleaning up after hurricanes need to be mindful of any wounds they have. Open wounds should be cleaned and fully covered until healed. The most common form of contraction is from bacteria entering the body through a break in the skin. Open wounds include cuts, scrapes, burns, insect bites and puncture wounds.

Though the occurrence of a hurricane increases the risk of contracting this disease, necrotizing fasciitis is extremely rare.

Approximately 700 to 1,100 cases of necrotizing fasciitis occur in the United States each year, according to the CDC.

While the disease is rare, it is fierce when it takes hold. One study cited a 73 percent mortality rate, according to the pathology department at the Harris County Institute of Forensic Sciences.

Those with compromised immune systems are more at risk for contracting the disease. For example, obesity, diabetes, kidney disease and cancer all put someone at greater risk of being harmed by the disease. Those with any weaknesses in their immune system should be extremely careful during and after storms.

“People are so occupied by trying to get their lives back in order that often times they won’t have the time or ability to pay attention to this,” said Dr. Bruce Robinson, a certified adult and pediatric dermatologist. “But you really want to pay attention to any mild injury and take care of it immediately.”