Flesh-eating bacteria Hawaii

[hikatz]

This ties in with opihikao's post on Hawaii County closing Ahalanui Hot Ponds.

KITV local news last night showed an interview with Steve Johnson, who's leg possibly became infected, after swimming in the hot spring with a fresh scrape on his leg.

http://www.kitv.com/news/hawaii/cases-of...z2g5BSLDyF

Doctors on the Big Island said they had treated 6-7 patients with this disease in the last month.

[terracore]

OR, he got infected when he scraped his leg and the hot pond failed to rinse all the bacteria out. So maybe he infected other people in the pond. I hope the water tests shed some light.

We always treat any scrape, puncture, bug bite, or scratch as though it could be very serious, regardless of how harmless it looks. A wash and triple antibiotic ointment as soon as practical.

[kimo wires]

Immediate attention is paramount. Even Antibiotic resistant bacteria can be killed if wounds are treated immediately. Once the infection sets in its a lot harder to get rid of.

Use hydrogen peroxide on fresh cuts. that kills all the bacteria. then put on antibiotic ointment, keep it covered until the wound seals.
And STAY OUT OF THE WATER.

[HawaiiTedd]

I agree with kimowires methods...have worked well for me.

Clean it, treat it, cover it, and keep out of the water until healed. Always.

[Lee M-S]

We like to use povidone--they use it for cleaning wounds in the emergency room and prepping for surgery. You can get it at any pharmacy, Walmart, Target, etc. Cylindrical plastic pint bottle, with a dark red-orange color liquid.

One time my husband cut his foot on rusty metal while swimming. He went to the doctor the next day, who noticeably relaxed when told it had been soaked in a povidone solution.

I've noticed that if I treat an existing infection with povidone, it clears up really fast.

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[steve1]

in 2007 I was snorkeling at Kapoho and got a 4 inch scrape on coral. I immediately got out of the water and rinsed it with Hydrogen Peroxide then applied triple antibiotic which I had in my first aid kit onshore.

I got a raging infection and had to be IV'd a cocktail of antibiotics for a week at Hilo hospital. The food there is terrible and they can't even make miso soup that doesn't just come out inedible and disgusting.

Doctors said once you get a coral scrape it doesn't matter what you put on it, the infectuous agent is already inside your body. They suspect I had MRSA (Methicillin Resistant Staphylococcus Aureus) but weren't 100% certain.

Washing out the wound didn't help at all. One of the nurses told me the hot ponds were worse because the mix of cold fresh water with volcanically heated seawater makes a great breeding ground for bacteria. Also, cold fresh water can transfer Leptospirosis bacteria which are corkscrew shaped and can trash your liver and kidneys, and may even kill you. Lepto bacteria are transmitted in the urine of infected animals, primarily rats and pigs, so it isn't just about carrying away soiled diapers.

Unfortunately many of our antibiotics are becoming less effective and bacteria are becoming resistant due to overuse by humans. It s excreted from our bodies into sewage, septic systems and cesspools, and of course into the tidepools of Kapoho. Bacteria that survive low doses of antibiotics can eventually become resistant to those antibiotics.

The other major source of contamination is from farmers routinely feeding antibiotics to their herds of <your favorite meat here>. The mechanization of food production and continual search for a cheaper means of production leads farmers to routinely overfeed antibiotics to their herds so their sick animals don't die before they are harvested and sold to unwitting customers. Something like 60% of chickens are infected with Salmonella bacteria and people keep eating that cheap chicken. I don't know of any commercial chicken operations here on BI but a recent study found that Kosher and Organic chicken actually had higher levels of Salmonella than the shrink wrapped stuff you get at the grocery store.

Europe, which has state sponsored health care and centralized tracking of data, has started immunizing all of their chickens for Salmonella, and in countries that pay for and track health care costs have found it to be a wise choice and beneficial for society at large.

Happy chicken sushi.

[Kapohocat]

quote:

---

Originally posted by kimo wires

Immediate attention is paramount. Even Antibiotic resistant bacteria can be killed if wounds are treated immediately. Once the infection sets in its a lot harder to get rid of.

Use hydrogen peroxide on fresh cuts. that kills all the bacteria. then put on antibiotic ointment, keep it covered until the wound seals.
And STAY OUT OF THE WATER.

---

let me add what we were told by Puna urgent care - only use HP on the first day, then use a vinegar. HP will also kill the new growth as the wound tries to heal. Vinegar will not. As for the covered part - we were told if you can keep it open to the air yet clean, do not cover it, MRSA thrives in a oxygen-less or oxygen poor environment.

Also if they even suspect staph make sure your medical provider gives you both the anti-biotic AND bactrim in combination. (this was a CDC directive about 10 yrs ago and I still see docs NOT doing it).

For the record, my dad got the staph, refused to see doc, ended up in ER, died a month later in Hilo - never going near the water at any time. He had a small little scrape on his leg from his yard hose rubbing on his leg. That was it. The outcome was necrotizing fasiitius and death.

I got it too at work from someone who had the t" staph infection. She touched something then I touched something and then i probably rubbed my leg and *poof* i had it - never going near the hot ponds. I got to ER within 24 hrs because I went to doc right away and 1 hang bag of antibiotics and a 10 day oral antibiotics with bactrim and it was okay.

So you can argue all you want about the ponds, I dont care, but if you get a cut keep an eye on it no matter where you go. If it doesnt heal, or gets hot to the touch, or run a fever, you are actually a few days behind "shoulda gone to docs"...

Staph is everywhere on almost everything - comprised immune systems, open cuts, etc allow it to flare.

[7Shadows]

This is scary stuff, I haven't made it out to the islands yet but reading this is making me do a double take with the staff/flesh eating problems. I have a young boy 3 years old that's going to be falling down and getting cuts all the time.

I as well am always scraping or cutting myself with the work I do. Is Hawaii a scary place if you have a scrape or cut? Sounds like every scrape or cut you get could be the one that finally does you in.

I hope it's not really this bad out there. I would assume I would have come across it already with all the reading I've done. But this thread makes it sound like every time you get a little scrape or cut you better rush to the doctors office.

Are doctors offices full of people with cuts and scrapes? crazy...

[peteadams]

"As for the covered part - we were told if you can keep it open to the air yet clean, do not cover it..."

Not medical advice, please get advice from your medical people, but based on some widely separated but consistent advice I agree with Kapohocat that keeping an injury open and clean is the best course.

Years ago we had horses and once in a while they would run into barb wire and in their thrashing inflict significant cuts on themselves. We were told by the vet to make sure that scabs were removed, the cuts cleaned and left open to the air. Needless to say, ripping scabs off of a horse's leg is traumatic to the horse and dangerous to the human, but it worked. Some deep cuts healed well with no impediment to the horse.

More recently in the family we had a skin tumor biopsied which involved cutting off the top of the bump. Typically the resulting open sore will likely heal slowly if at all until the tumor can be removed. The medical protocol prescribed that scabs must be removed and the surface cleaned with vaseline and a Q-tip and generally left open to the air. There is no sign of infection or any other problem at this point.

"Are doctors offices full of people with cuts and scrapes? crazy..."

I damage myself frequently with cuts and scrapes working around our place. No significant infections yet, but as quickly as possible I scrub with soap, occasionally povidone (Betadine) as recommended earlier, and make sure the injury is well exposed to the air. Often the latter involves cutting back a flap of skin so don't be squeamish or definitely check in with the docs to get it done. I only use bandaids occasionally to protect from working in the dirt or to avoid scrubbing the injury on clothes or sheets.

So far the only minor infection has been from a sleeping grass thorn in the underside base of a toe that was nearly unnoticed (yes, I have stopped mowing the grass in slippers!) While getting it fixed at PCMC I expressed a bit of embarrassment that I had the full panoply of medical care available to get only a teeny tiny thorn removed. In return I got a good (and appropriate) lecture of not ignoring even the little injuries, with a lurid example of someone who didn't pay attention. So again definitely check with your medical people, but keeping minor skin injuries open (unscabbed) and clean seems like the best hope for avoiding infections.

[Carey]

7S - I am always shredding skin...& have been lucky & careful not to have gotten anything major...but did have one itty bitty tiny cut get a little out of hand (knew I cut it, but thought, I'm too busy to wash it right now - in a minute.... & what harm can an hour or so do??? luckily antibiotics did the trick when it blew up a bit the next day!)

There is usually one or more news stories a year on this, and if you search this forum, one or so threads every year...
Why? usually, there is one incidence of an extreme infection that is reported every year or so... One or so extreme infections per year per over 1 million people... not horrendous if you look at those stats...

However, many have had a small nothing cut get to be a bigger problem, and there are infectious agents here (just like at many beaches all over the world in the summer...but the big difference is the weather here is fairly consistent...and not real far off from body temp)...so an agent that is happy living here will not have a temp stress & the temp is close enough to human temp that it might be happy with us if it finds a nice quick dirty little cut.... so the best defense is trying to avoid cuts & scrapes, if they happen keep them clean & dry & monitor those cuts 'n scrapes