Four months after Hurricane Ian made landfall in Southwest Florida, state health officials are again warning people to stay out of beach water, but this time their alert mentions the sand, too.
The Florida Department of Health’s unprecedented health advisory in Lee County comes after testing continues to find that Ian stirred up years’ worth of pollution on land, scuttled boats filled with gas and oil in bays and on beaches, and left behind shards of metal, glass and other dangerous debris along the shoreline.
Notable is the health department’s wholesale abandonment of the softer wording typically found in water quality advisories. Normally, there is a certain type of understatement inherent in beach advisories so as to not scare away tourists.
“Swimming is not recommended. You should assume that water contact may pose an increased risk of disease or illness," health officials in Lee County wrote. “As a result of Hurricane Ian, debris remains in area beaches including debris buried under shallow sand and not immediately visible.”
Ian dropped more than a foot of rain and a storm surge up to 14 feet was pushed onshore. The stormwater became filled with the detritus of human life: nitrogen-rich fertilizer, human waste from faulty septic systems, animal, feces, microplastics and other chemicals from facemasks or cigarette butts dropped on the ground, oil and rubber from roadways, soot and grime from buildings and billboards and so on, hour after hour, as the slow-moving storm spun over the region.
As the hurricane moved inland, all that water flowed back out into the Gulf of Mexico by washing across roads and parking lots, backyards and beaches.
Flesh-eating bacteria
The scariest ailment on the rise since Ian is an infection by the bacteria Vibrio vulnificus, which can lead to necrotizing fasciitis, a severe infection in which the flesh around an open wound dies.
It’s better known to the public as flesh-eating disease.
The good news is it’s extremely rare. The bad news is everything else about it.
Vibrio is a bacterium that is endemic in background concentrations in warm waters like the Gulf, especially brackish areas where freshwater streams and estuaries meet the ocean. There were no cases of flesh-eating disease in Lee County in 2020; last year there were at least 28.
Vibrio most often gets into a person’s bloodstream by eating uncooked or undercooked shellfish, but can also enter a body through a minute scrape or even a nick from shaving.
Death from necrotizing fasciitis is at first very painful. And quick. A person with a preexisting condition such as cirrhosis or high blood pressure can move from the moment of infection to death within 72 hours. Older people are also at risk.
About 20 percent will die. Many of those who live will have large patches of scarring or will lose a limb.
At first, a small red spot appears and starts to swell accompanied by pain far out of proportion with the small lesion. Within hours, the small red spot has grown much larger and the damage begins as the skin, muscle, and connective tissue start to die.
The infected tissues darken from red to purple to blue to black. As gangrene sets in, the severe pain goes away because the nerves in the remaining skin are destroyed, but fever and fatigue grab hold and blisters form on the skin.
Untreated, sepsis, organ failure, and death can follow.
The victims who seek medical treatment fast enough to live will often have lost so much muscle, sinew and fat that they require intensive care and limb amputations.
Survivors will often appear as if they suffered third-degree burns at the affected area due to all the tissue that had to be cut out or was lost to the infection.
About 80 percent of infections occur between May and October when water temperatures are warmer.
The Centers for Disease Control and Prevention reports about 80,000 Vibrio illnesses and 100 deaths in the country every year. Florida health department records show 74 people caught Vibrio and 14 died from it. Both agencies admit their numbers are most likely an undercount because of misdiagnosis and the speed with which the disease progresses.
The pollution Hurricane Ian washed into the water may be fostering more cases. Lee County health officials recorded no necrotizing fasciitis cases in 2020, five infections two years ago resulting in one death, and 28 infections last year with eight deaths.
In Collier County, health officials tallied no infections in 2021 and three last year while reporting no deaths. However, a Michigan man helping a friend recover from Ian in Naples died from a flesh-eating bacterial infection acquired near the friend’s home one month after the storm.
Staying healthy
The Florida Department of Health recommends the following precautions to ward off flesh-eating bacteria:
- Follow basic hygiene. Always wash your hands with soap and water before eating and after toilet use.
- If you have open cuts or sores exposed to sea water or brackish water, keep them as clean as possible by washing them with soap and disinfected or boiled then cooled water or commercially bottled water.
- Apply antibiotic cream to reduce the risk of infection.
- After helping in cleanup activities and after handling items contaminated by sewage, wash hands with soap and water.
- If a wound or sore develops redness, swelling or drainage, see a physician right away.
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