- ALBUQUERQUE, N.M. (September 3, 1997 01:15 a.m. EDT) - The deadly
infection known as "flesh-eating bacteria" is ravaging more and
more people in New Mexico, say University Hospital doctors who are diagnosing
"frightening" cases from all over the state.
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- About 400 people in New Mexico have been
afflicted in the past seven years, estimates Dr. Donald Fry, chairman of
the surgery department at the University of New Mexico School of Medicine.
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- In the past decade, 34 people in New
Mexico have died from the infection, according to records from the state
Office of the Medical Investigator.
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- The deaths hold steady with the national
rate, but the cases themselves have risen in the last two or three years,
New Mexico researchers say.
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- About half of those infected had conditions
that lowered their immune system, such as diabetes, obesity or blood-vessel
disease.
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- But some of the fatalities involved 3-year-olds
with chickenpox and healthy adults just stung by a bee.
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- "We're seeing a catastrophic case
every three to four weeks at University Hospital," said Fry, who has
been compiling data on the infections.
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- Known in the medical world as necrotizing
fasciitis, the infection is caused by bacteria that usually enters through
a cut, scrape or other break in the skin. The infection attacks the fascia,
the deepest layer of skin, and irreparably destroys tissue as it marches
through a victim's arms, legs, stomach or back.
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- It can spread as fast as 1 inch per hour.
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- So rapidly does the infection move, doctors
must remove skin, large muscle groups or amputate limbs to save a person's
life.
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- "The kinds of cases we've seen are
really kind of frightening," Fry said. "With some people, we've
been forced to remove their entire leg."
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- The last New Mexico death occurred in
June. A 33-year-old man stumbled while mowing his lawn, bruising his shoulder.
Thirty-six hours later, he was dead after the bacteria devoured his back.
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- The Centers for Disease Control and Prevention
in Atlanta estimate about 1,000 Americans annually contract necrotizing
fasciitis and 350 die from it, said Dion Gallant, a third-year UNM medical
student who researched the disease after seeing its damage during an autopsy
this summer at OMI.
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- The infections are caused by a common
bacteria, group A streptococcus. This is the same bug associated with strep
throat and chickenpox.
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- "This is not a new bacteria,"
Fry said. "But this is a new strain of strep. It seems to have a special
gene that makes it a very special kind of toxin, and that makes it unusually
virulent."
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- Researchers cannot fully answer why the
strep is attacking now and why just a few unlucky individuals. After all,
we all get scratches, bites, bumps and bruises.
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- "Practically all of us are walking
around with strep A, but it doesn't make us sick," said Dr. Fred Koster,
professor of medicine at UNM. "Most of us get rid of it in a week
without even knowing we had it.
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- "Why this relatively rare infection
occurs in relatively healthy people is a mystery that nobody understands."
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- New Mexico's climate may be one factor,
Fry said.
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- "There seems to be a higher frequency
in higher-altitude climates and within arid climates," Fry said. "Other
Rocky Mountain states have also seen increased cases."
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- Patients of all ages from all over New
Mexico have landed at University Hospital's emergency room with the symptoms
of flesh-eating bacteria: excruciating pain in an area of a fresh small
cut or insect bite. Fever is also common, as is shock and sometimes delirium,
Koster said.
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- The bacteria can kill perfectly healthy
people within two days.
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- In the cases that Fry said he attended
in recent years, 11 were children with chickenpox. Some were as young as
3 and 4 years old.
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- "Three of them died," he said.
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- To save a person's life, doctors must
immediately operate, peeling away a person's skin to get at the infection
just below the surface.
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- The skin and tissue removal is called
debridement. If a patient survives the operation, the body resembles a
huge wound. Doctors must then graft skin from other areas of the body,
much like the technique for burn victims.
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- If milder cases are successfully halted,
a good recovery is predicted, although it may involve a five-week hospital
stay to heal the skin.
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- "Most of the cases we see are luckily
more mild cases," Koster said.
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