Necrotizing fasciitis (the so-called “flesh-eating disease”) is a rare manifestation of infection with the group A streptococcus (Streptococcus pyogenes, though occasionally other bacteria cause it as well). Apparently, it’s been a banner year for the infection in Boulder, Colorado. The Daily Camera (registration required) has the story:
Sixteen months after University of Colorado physicist Eric Cornell lost his left arm and shoulder to a rare, invasive form of strep A, at least three more otherwise healthy Boulder residents have been stricken by the same disease in the past four months.
Two who live within one-half mile of each other developed necrotizing fasciitis, otherwise known as flesh-eating bacteria, and had to have multiple surgeries to remove infected tissue. A third developed an infection in the blood and brain and died within 48 hours after first complaining of an ear infection.
“I went into the ER one night thinking I had a bad case of the flu. The next night they were telling my wife and daughters to say goodbye because I wasn’t going to make it,” said Robb Kimbrough, 50, who returned home from the hospital Dec. 9, after recovering from organ failure due to septic shock and having both legs amputated below the knee.
That’s pretty impressive that he made it right there. Once you get to the organ failure portion, your chances of survival are pretty slim.
There seems to be disagreement over whether the incidence of invasive group A strep infections in Colorado are stable or rising:
The county does not track the incidence of invasive strep A, but chief epidemiologist Heath Harmon said judging by national estimates the county could expect to see as many as nine cases in a 12-month period. Dr. Ken Gershman, chief of the communicable disease program for the state health department, said that in the five-county Denver-metro area, which does track cases, incidence of invasive strep A definitely is on the rise, spiking from 122 cases in 2002 to 188 in 2005.
The neighbor of the lucky-to-be-alive guy also developed necrotizing fasciitis:
Regina Daly, a 39-year-old marathon runner who lives just down the road from Kimbrough up Fourmile Canyon, said she started feeling pain in her shoulder about 10 p.m. Dec. 19, but assumed it was just sore from her morning swim. By the next day, she was vomiting from the pain and had a 103-degree fever. When she fainted on the bathroom floor, her husband rushed her to the emergency room at Boulder Community Hospital.
By that night, she had been diagnosed with necrotizing fasciitis and was undergoing surgery to remove an eight-inch swath of tissue across her torso and under her armpit.
The cases were separated by 2 months’ time, and don’t appear to have an obvious common source of the infection. Still, 2 cases of necrotizing fasciitis within a few months in people that close geographically is quite rare. According to the CDC, there are only ~700 cases of nec fash every year in the US.
I’ve written previously on the changing virulence of streptococci, and this is just another example of some of the damage invasive strep can do. What the article doesn’t mention–and I’ve not seen any reports of this outbreak in the scientific literature yet, but they may be in progress–is if the strains are clones, or totally unrelated. They imply the latter, saying scientists don’t have a reason to believe the infections are connected, but don’t say what led them to that conclusion.