Strep that eats flesh scares me!

Dear Alice,

There has been lot of concern in the media regarding the strep variant of bacteria which eats flesh! Unfortunately not much literature is easily available for the prevention of this infection. Could you please post the general precautions?


Dear Concerned!!,

The incidence of flesh-eating bacteria, despite sounding like a scene straight from a sci-fi flick, has increased in the last decade. But because people affected by this bacterium are so few, getting infected with Streptococcus pyogenes (the most common tissue-killing strain of bacteria in these cases) is still very unlikely.

Necrotizing fasciitis, or "flesh-eating strep," is a very rare bacterial infection that destroys skin and soft tissues beneath the skin, including fat and muscle tissues. Streptococcus pyogenes is the same streptococcal bacterium that induces strep throat. However, in rare cases, this bacterium produces toxins that move rapidly through tissue, a very dangerous condition. The speed of tissue deterioration is where this bacterial infection gets its flesh "eating" nightmarish reputation. Symptoms of necrotizing fasciitis usually set in between 24 and 36 hours after an injury, and include fever, chills, and nausea or vomiting. The skin usually becomes red, swollen, and hot to the touch, although if the bacteria attack deeper tissue, inflammation signs may not be immediately evident.

In some ways, necrotizing fasciitis earns its scary popular fixation: about 30 percent of everyone infected with it will die. Many people who get necrotizing fasciitis are in good health prior to the infection. People at increased risk of developing the infection are those who:

  • Have weakened immune systems or lack proper antibodies to fight off infection
  • Have chronic health problems, such as diabetes, cancer, liver, or kidney problems
  • Have recently undergone surgery and have healing open wounds
  • Recently had the chickenpox or other viral infection that caused a rash on the skin
  • Used steroid medications, which can lower the body's resistance to infection

Most people will not get necrotizing fasciitis. Even with intimidating stats on the bacteria that eat flesh, the incidence of necrotizing fasciitis in adults is reported to be 0.40 cases per 100,000 in the general population, with a much lower incidence in children. The increase in cases over the last decade is presumably due to an increase in numbers of immuno-compromised people in the population, as medicines have improved to sustain these individuals.

General sanitation guidelines apply in preventing necrotizing fasciitis: wash hands often and keep cuts, scrapes, burns, sores, or bites clean. In the event of an infection, immediate medical care in a hospital is always necessary.

The media has a tendency to grab on to the most sensational of medical phenomenon, making a serious yet rare bacterial event seem like a widespread epidemic. In the age of bioterrorism, it is understandable that media hype around flesh-eating bacteria would carry heavy popular resonance. But be careful not to let the media exploit your fears of personal safety as you go about your everyday life. It is extremely unlikely that you will fall victim to flesh-eating bacteria.

Last updated Apr 21, 2015
Originally published May 01, 1994

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