Vulnificus season

Posted in Bioterrorism, Culture of Lickspittle at 1:47 pm by George Smith

It’s the season for flesh-eating disease on the Gulf Coast. Warmer water at this time of year results in more of the marine vibrio, V. vulnificus in the water, on the rocks and submerged objects in shallow water, and in shell fish.

The microbe is always present but the summer months give it optimal growth conditions. Coupled with the tourist season, there is a yearly arrival of cases of flesh-eating disease and septicemia caused by the organism I earned my doctorate on.

“V. vulnificus is a rare cause of disease, but it is also underreported,” reads the Centers for Disease Control. “Between 1988 and 2006, CDC received reports of more than 900 V. vulnificus infections from the Gulf Coast states, where most cases occur. Before 2007, there was no national surveillance system for V. vulnificus …”

“An average of 50 culture-confirmed cases, 45 hospitalizations, and 16 deaths are reported each year from the Gulf Coast region (reporting states are Alabama, Florida, Louisiana, Mississippi, and Texas). Nationwide, there are as many as 95 cases (half of which are culture confirmed), 85 hospitalizations, and 35 deaths.”

In years to come, the effect of global warming on its incidence will bear watching.

Statistically, V. vulnificus disease carries about a 50 percent rate of mortality if it becomes systemic, infiltrating large portions of the body or in the blood stream. That’s high. And it’s because, while the organism is easy to treat with antibiotics, it must be caught early in the course of an infection. Those who go to the emergency room or doctor immediately upon seeing a festering wound with spreading systemic component, do best.

Excerpts from the Gulf Coast news wires:

A Treasure Coast man is recovering from a flesh-eating bacterial infection that took over his leg in a constellation-like pattern starting with a cut he got on his ankle.

“Diarrhea, fatigued, not to mention everyday waking up everyday with the weight of what is wrong with me and am I going to be okay?” JJ Davidson said of his 4-week progression since contracting Vibrio Vulnificus ..

Vibrio Vulnificus infected 30 people last year and killed 10 in Florida.

Itís invisible and rare, but often deadly.

Davidson says he knows he became infected at the popular Stuart sandbar, where after he cut his foot, he became incredibly sick.

“I was walking through the water about knee deep and I had an anchor cut my ankle,” JJ said days later he noticed a painful sore develop, and fatigue set in, “I noticed my calf started to get a blistery infection that started to pop up on it. My thigh up here broke out in the same blistery rash.”

Florida health officials have already reported six cases this year; four due to the infection of an open wound and two from consuming raw shellfish.

On June 7, 2013, while fishing along the rocks in front of Grand Isle [Louisiana], Rick Garey contracted the flesh-eating bacteria vibrio vulnificus through a minor scrape on his left ankle.

Within 48 hours, he was literally fighting for his life at Lady of the Sea General Hospital in Cut Off and then at Terrebonne General Medical Center in Houma, where he endured seven surgeries and a two-week stay, including three days in critical care …

ďIím real happy I can see 57,??? Garey said. ďI didnít know if Iíd see 56 for a while.???

ďVibrio is bad news. Itís nasty stuff. When you mention vibrio around doctors, you can almost see the color change in their face,??? Garey said. ďIt happens fast and itís wickedly efficient, and you donít even know it.

ďIt doesnít matter if youíre a macho NFL lineman, it will eat you up just as fast.???

My lasting contribution to science was the determination and partial characterization of an enzyme called a collagenase produced by V. vulnificus.

It was my doctoral thesis. And in formulating the problem, I had looked at the disease, then just emergent and the causative organism with the reasoning that production of a collagenase would be quite likely in such a case.

Collagenase in an enzyme the brings about a fast degradation of collagen which makes up 30 percent of the protein in people. Collagen is found in skin, blood vessels, muscle and liver.

As part of the marine estuarine environment, the microbe produces its collagenase in the digestion of food sources for use.

When large numbers of V. vulnificus proliferate in a wound or in a blood infection, the production of this enzyme, which is always on, contributes to the catastrophic results.

“Clinical characteristics of V. vulnificus suggest that the organism is capable of invading healthy tissue, which to us raises the possibility that the organism produces collagenolytic enzymes,” reads my paper, “Collagenolytic activity of Vibrio vulnficus: Potential Contribution to its Invasiveness,” from 1982.

“Vibrio vulnficus produces two disease states, a rapidly progressive cellulitis from wound infection and a bacteremia which, in some cases, produces secondary lesions which allow the organism to infiltrate the dermis and, in one extreme example, the cerebrospinal fluid. Production of collagenase in vivo could contribute to the invasive property in these cases.”

The data collected showed that the collagenase did digest collagen, ours extracted from the skins of freshly-slaughtered calfs, quite efficiently.

Over the years, the paper was well-received.

The disease is still rare. That is, most people who come in contact with the organism never know it. But it is a recognized hazard, one that has gradually increased since my work on it decades ago.

Consequences of disease caused by V. vulnificus are well documented in pictures at images.google.com. Be advised: They’re unsettling.

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