INDEPTH: HEALTH
Hospital infections
Flesh-eating disease
CBC News Online | March 16, 2006
There are between 90 and 200 cases of necrotizing fasciitis per year in Canada.
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Necrotizing fasciitis, or flesh-eating disease, is a fast-spreading infection caused by streptococcus bacteria that themselves have been infected with a virus.
Streptococcus bacteria cause infections such as strep throat and scarlet fever, but a more aggressive form is responsible for flesh-eating disease, an infection that works its way rapidly through the layers of tissue (the fascia) that surround muscles.
There are between 90 and 200 cases of necrotizing fasciitis per year in Canada, about 20 to 30 per cent of these are fatal. Health Canada emphasizes that the disease is very rare.
Early symptoms of the disease include a high fever and a red, severely painful swelling that feels hot and spreads rapidly.
The infection sometimes starts at the site of a minor injury, such as a cut or bruise, but sometimes there is no obvious source of infection.
Former Quebec premier Lucien Bouchard became infected with flesh-eating disease while leader of the Bloc Québécois. He lost a leg to the illness.
What is the risk?
Scientists don't know why streptococcus bacteria causes only minor infections in some people but poses a serious threat to others.
According to Health Canada, some of the risk factors that have been identified include:
- A weakened immune system, which could be caused by such factors as disease (HIV infection, AIDS), cancer treatments (radiation and chemotherapy), or by anti-rejection drugs taken following a bone marrow or organ transplant.
- Chronic diseases, including heart, lung and liver disease.
- Recent close contact with someone who has flesh-eating disease that was caused by group A streptococcus (GAS) bacteria.
- Chickenpox infection. (It should be noted that while flesh-eating disease can be a complication of chickenpox in children, such occurrences are very rare.)
Should you be concerned about flesh eating disease if you contract strep throat?
No. Millions of people in North America get strep throat every year, but less than one in a million will actually develop flesh-eating disease. The vast majority of cases of flesh-eating disease arise from skin and soft tissue disease, not from strep throat.
How can you tell if you've contracted flesh-eating disease?
There are no specific signs when a person has become infected with the disease. Early on, an infected person will often complain of flu-like symptoms, such as fever, aches, pains and chills. Some may develop signs of pneumonia, with shortness of breath or a cough. However, it's important to remember that flesh-eating disease is extremely rare. The vast majority of patients who display the symptoms described above are more likely to have influenza.
Flesh-eating disease is often accompanied by severe pain but little visible evidence of marks or sores; the area involved may be exquisitely sensitive to touch. In any case, if you are concerned about your health, it is wise to be examined by a doctor.
Can you get flesh-eating disease from someone else?
There is some evidence that people in close contact (more than four hours a day) with someone infected with flesh-eating disease are at increased risk of developing the condition. Although this risk is still low, most health authorities in Canada suggest also treating family members to decrease the risk.
How is flesh-eating disease treated?
Because the disease progresses so rapidly (the infection destroys tissue so quickly that it can cause death within 12 to 24 hours), treatment usually involves antibiotics to fight the infection and surgery to remove the infected tissue. There is no vaccine to prevent flesh-eating disease.
[Sources: Health Canada, Canadian Paediatric Society]
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