What causes flesh-eating bacteria cases?

HOUSTON – Two women in the United States have made headlines because of their battles with flesh-eating bacteria. The condition is rare, life-altering and often fatal.

Aimee Copeland took her first breath free of a ventilator on Monday. In order to save her life from flesh-eating bacteria, the Georgia woman had her feet, hands and part of a leg amputated.

The 24-year-old slashed her leg in a homemade zip-line accident. Doctors said they believe that when she fell into an area with brackish water, the cut was infected by a form of flesh-eating bacteria.

Another case making headlines is that of 36-year-old South Carolina mom Lana Kuykendall. She is believed to have contracted the flesh-eating disease from Group A streptococcus that entered her body after delivering twins a few days before.

Both stories bring flashes of haunting memories to the minds of one local family.

"I had no clue, no clue, what it was," said Sharon Jamison whose daughter, Tomi, was diagnosed with flesh-eating bacteria last November. "Tomi thought she had stubbed her toe. The next day her ankle hurt and then the next day it was black with blisters all over it and she was screaming in pain."

Three days after the first spike of pain, doctors amputated Tomi's foot and eventually had to amputate the left just below the knee.

"The hospital called and said they had to take off more of her leg because it was spreading so fast. When we went to the hospital, they said had we waited, she would have been dead within two hours. During the surgery, she flatlined three times," Jamison said.

Flesh-eating disease is what the public calls it. Necrotizing fasciitis is the medical term. Fewer than three out of every 100,000 people will get it, but 50 percent of those cases are fatal and, in most, amputation is the only way to stop it.

"The good news is it is a rare disease. The bad news is because it is rare, many of the physicians who are seeing these patients don't think of it. From a parent or spouse point of view, you think of other more common things. You don't think my spouse or child has this necrotizing fasciitis," said Dr. James Musser, co-director of The Methodist Hospital Research Institute.

All patients see is a growing bruise on the skin and maybe feel some pain or a slight fever. Symptoms can mimic the flu.

Musser, a world leader in researching necrotizing fasciitis, said the only common symptom patients share is at some point an excruciating pain coming from what looks like a minor cut or should be a slight sprain.

"Most of what is happening is happening internally, and there is no single tip-off. Diagnosis is tricky. That's a problem because every minute, and sometimes every second, their tissue is literally being digested by toxins," Musser said.

The Houston area has at least one severe case every year, but they don't have the same causes.

In 2007, Steve Gilpatrick had small infection that weakened his immune system. He contracted flesh-eating disease when Vibrio bacteria, which lives in the still water areas of bays and bayous, entered his leg through a small cut.

In 2009, flight attendant Glenda Pogue lost part of her tongue and some of her finger tips on her right hand. Local 2 reported she had undergone dental surgery before going on vacation and came in contact with the bacteria somewhere.

In 2010, Kingwood mom Katy Hayes had both arms and legs amputated to save her life. A streptococcus infection she came in contact with after giving birth led to necrotizing fasciitis.

In 2011, Ginger Ling of Port Bolivar died after getting the flesh-eating bacteria through a cut in her arm while cleaning fish in the sink.

In the beginning, Jamison didn't know how her daughter came into contact with the bacteria.

"She hadn't had a pedicure or even been in water before this happened," Jamison said.

When the Jamison and Tomi went over what they were doing last November, they remembered cleaning up after the sewer system backed up into their yard.

A microbiologist told Jamison that Tomi may have had a small cut on her foot and been exposed then.

LSU Health Science Center's Dr. Russell Russo said any break in the skin can be an entry point, even an injection site. The doctor wrote a paper about a woman who came into the clinic with necrotizing fasciitis after injecting a street drug called "bath salts." Russo theorizes the bacteria could have been in the unregulated "salts" or could have come from woman's mouth. Russo said drug users do something called "greasing the needle," which means they lick it before injecting. Since some forms of flesh-eating come from Group A streptococcus, that can also be a source for the disease.

"We saw one person this year with steroid use that brought it on," Russo said.

Musser and his team at The Methodist Hospital Research Institute have broken down the disease to its DNA to find out what causes the rapid deterioration and which antibiotics work for which bacteria. Musser said one day they may even have a vaccine for those people at the highest risk. In the case of necrotizing fasciitis, that is people with weakened immune systems from illnesses or chronic diseases and those who abuse alcohol or drugs.

Regardless of the cause, the condition, which often involves losing a limb, is life-altering.

"I want her to be the mom she can be again, so she can be the Tomi we know and love, because she is such a sweet girl," Jamison said.

Doctors said one simple thing early on can stop the bacteria in its tracks -- pour rubbing alcohol in an exposed cut after exposure to contaminated water. That can kill the bacteria before it spreads.


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