Good morning my little horrors, if there's one Giant holiday I love, it's Halloween! I'm Ms. Becky Lafarge and I was once a villain to the Giants, but now I am here at the Society of Symbionts teaching you young microbes about the seemingly 'bad' microbes. The Giants are quite strange this time of year, they celebrate all things terrifying and spooky; dressing up like made-up monsters and stuffing themselves full of candy and sweets, leading to more opportunities for microbes to have some fun! Today we have one of their most feared microbes, scary microscopic creatures that actually eat them alive, and boy does it scare the Giants to hear about harmful bacteria! Funny though, I've not seen any Flesh-Eating Bacteria costumes during trick or treating or in the horror films they love to watch!
Necrotizing Fasciitis - Halloween Horror Of Flesh Eating Bacteria
It’s an interesting trait of Giants to humanize and personalize everything they cannot explain, even the things they can, which is pitifully little when it comes to us microbes! They take everything good as a blessing bestowed upon them personally as rewards for being so gosh-darned good and bad things as a curse of some deserved punishment or plague upon the innocent. They cannot seem to help themselves, creating stories of monsters and creatures that prey upon them with malice and cruelty, when in reality, the truth is far more clinical and pragmatic - everything from one-celled organisms to complex multi-system organisms are merely consuming, reproducing, and dying according to their molecular makeup and environment. But the Giants are very self-centric, it's all about them and there must be some sort of motive and reason for the terrible things that happen - because after all, that reason can be used to rationalize why that terrible thing could never happen to them! What could be more horrible than being eaten alive?!?
Illustration by Noémie Matthey, twitter @NoemieMatthey
Grisly headlines make the Giants think twice about taking a dip at the local beach: Elderly San Marcos man dies from flesh-eating bacteria after Texas Gulf Coast Fishing trip or Five Connecticut residents infected with flesh-eating bacteria in Long Island Sound. Pretty much all you have to say is flesh-eating bacteria and the Giant’s skin starts to crawl! They think, surely something evil is at work here. Or are there just poor misunderstood microbes doing their thing to thrive and survive with no other intent whatsoever. (See, personalization can be done both ways).
There are a number of bacteria that can cause necrotizing fasciitis, including Vibrio vulnificus, which is what we’ll focus on today. This microbe is found in warmer salt or brackish water and is transmitted when it infiltrates via breaks/cuts in the skin including burns, bites, surgical wounds and puncture wounds. Initial symptoms include redness, warmness and swelling of the area which can spread very quickly (sometimes as much as an inch per hour)! The infection is quite painful and will also lead to flu-like symptoms of fever, muscle pain, diarrhea, fatigue, etc.
If left untreated, the infection can kill so much tissue that it leads to treatments becoming ineffective, resulting in the necessity to surgically remove dead tissue to stop the spread of infection.
Since a lot of the damage is under the skin, the diagnosis can be difficult and delays in care can ultimately lead to septic shock and death. So while horrifying to think about one’s flesh being eaten, what’s really going on here from the bacteria’s point of view - is there evil intent trying to disfigure and kill unsuspecting victims?
Like all organisms, Vibrio vulnificus has its own story. It was first recognized as a distinct species in the late 1970s. Virtually every oyster harvested in the USA during summer months harbor this organism. It is a Gram-negative bacterium that’s shaped like a curved rod with a single polar flagellum (a lash-like appendage that protrudes from the cell body, which is used to propel the cell around).
It also has hairlike appendages called pili to help motility and adherence. Iron is important to its growth. Vibrio vulnificus lives in seawater (low to moderate salinity) and enjoys temperatures between 20-30 degrees Celsius (68-86 degrees Fahrenheit). Sounds relatable so far, right? It likes salt water, warm temps, oysters - most Giants do too! It’s a plucky little organism, and can go into a dormant state when the temperature is too low, and when it likes the weather a little better, it becomes active again - don’t you wish you could do that?
But here’s where things start to become a little monstrous with Vibrio vulnificus. If it finds its way in via ingestion i.e. food, the incubation rate is quick and symptoms can arise after 24 hours. It is also tough enough to survive the stomach acid and will enter the bloodstream by penetrating the intestinal wall.
A healthy person will likely experience gastroenteritis (diarrhea and intestinal distress). But, for those with underlying health issues, like liver disease, death can be as quick as 24-72 hours, if left untreated, is more than 50% likely to kill its host. It is often resistant to treatment, so sometimes the infection is fatal even with treatment! Ingestion of Vibrio vulnificus accounts for 95% of seafood related deaths.
It is not fully understood how it does so much damage, but researchers believe it kills lymphocytes in the blood, and that the LPS (lipopolysaccharides) in its cell walls cause the death of cells around it. It also seems to produce an exotoxin that facilitates the release of iron from hemoglobin within the bloodstream. The capsule around it seems to protect it from the body’s defenses, so it is free to multiply and travel throughout the body.
If it gets in via a wound, it can still be deadly, but is more likely to merely cause ghastly injury and illness. Check this picture out!
'Ewwwwwwwwwww! Gross!' Ms. Lafarge! Did tiny microbes really do that to a Giant?!'
'Yes, isn't it amazing! When microbes put their minds to something, they can really do some awesome parasitic work!'
'But, that doesn't seem fair to that Giant's leg! Doesn't he need that?' Mia asked with a shocked look.
'Well, maybe, but the Vibrio need to eat and why shouldn't they if they can. Vibrio vulnificus works very hard to enter the bloodstream via a cut in the skin (the body’s greatest defense against infection). It uses pili to attach itself to cells and the resulting necrosis (death) of the surrounding cells can result in skin lesions, tissue damage, black spots, pus and flu-like symptoms in its host. Because there are so many types of infections, diagnosis can be delayed and oftentimes the damage to the cells is so severe that antibiotics, which the giants use to kill microbes, are not effective enough to stop it, resulting in surgical debridement (removal) of affected tissue and sometimes amputation becomes necessary.'
'Oh, so they fight back and microbes are killed? I bet it doesn't look that gross! But it's sad that microbes get killed too.' Mia said with a little tear in her eye.
The giants demonize Vibrio vulnificus and many other microbes that cause them harm. But the reality is that it is just another organism just trying to enjoy a day swimming in the salt water in the nice warm weather. There are some simple things humans can do to avoid Vibrio vulnificus (i.e. the giants are famous for doing dumb things in their horror movies like hiding in the graveyard or behind the wall of torture instruments! They shouldn't eat raw seafood, but many do anyways, even if they know it can make them sick! Just boiling/cooking and freezing the seafood kills this bacteria - especially if they have any immunocompromising conditions (liver disease, cancer). So, if a giant is headed for a swim in salty water, whirlpool, pool or a hot tub, they need to know if there are any breaks in their membrane (skin) and make sure nothing can get in. When shucking oysters, handling seafood or dealing with tanks or equipment near the ocean, they should wear gloves and wash up afterwards. But they are often silly giants who walk down the basement stairs after a creepy old door mysteriously creaks open all by itself, so I say maybe the Vibrio vulnificus isn't an evil monstrous microbe - it's not personal, they are just eating their 'Halloween Treat'!
For More Monstrous Microbes Check Out These Blogs!
What's the scariest microbe you've heard of? Leave a comment!