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By Bahk Eun-ji
This year's summer monsoon was the longest since Korea commenced keeping weather records. Although the rainy streak has shown some signs of letting up, the sweltering heat looks set to continue until late summer.
In addition to the COVID-19 pandemic, the health authorities have warned the public to be cautious about vibrio vulnificus infection, a gram-negative bacterium that can cause serious, potentially fatal infections.
The infection is caused by an organism that inhabits coastal waters, and occurs mostly in August and September.
According to the Korea Centers for Disease Control and Prevention (KCDC), 37 patients were reported to have been infected up until Aug.31 this year, more than doubled from the same period in 2019. Over the past five years, 228 patients with vibrio vulnificus infections have been reported nationwide. Among those, 77 (34 percent) were detected in the first two days of September.
In particular, epidemiological investigations of five patients who died from vibrio vulnificus infection found that all of them were at high risk for the illness, with underlying conditions such as alcoholism, diabetes and liver disease.
Vibrio vulnificus septicemia can result from eating raw or undercooked seafood, especially for people who have compromised immune systems or liver disease. Some of the infections were contracted from swallowing ocean water contaminated with bacteria such as cryptosporidiosis, shigellosis, or E. Coli.
It can be also dangerous when swimming with an open wound, the KCDC said. Such cases resulting from bacteria entering via a wound are rare, but do occur and can be fatal. If a wound is infected with the bacteria, it will swell, redden, weep and cause high fever. In serious cases, it can lead to necrotizing fasciitis, sometimes referred to as "flesh-eating disease."
In cases of infection, symptoms such as acute fever, chills, decreased blood pressure, abdominal pain, vomiting and diarrhea occur, and skin lesions appear within 24 hours after symptoms begin.
The lesions usually appear on the lower part of the body, along with a rash or swelling. They later forms blisters or hemorrhagic bullae, and then gradually expand and progress into necrotic lesions.
Prevention is of great importance since the infection usually occurs in high-risk groups with the underlying conditions where the fatality rate increases to 50 percent.
As a preventative measure, it is recommended to avoid eating uncooked fish and shellfish, and people with skin wounds should avoid contact with seawater that could be contaminated.
Also, it is recommended to store fish and shellfish at below five degrees Celsius, and cook them at temperatures above 85 degrees Celsius. Before cooking, wash them in running fresh tap water, and always use clean kitchen utensils.
To treat infection, antibiotics are necessary. In the case of an infected wound, aggressive debridement is necessary, but vibrio vulnificus bacteria are usually susceptible to most antibiotics.
Quick diagnosis and fast treatment is important to increase patient recovery rate, especially in severe phases of the disease such as wound infections or systemic septicemia. The longer delay in treatment, the higher the death rate regardless of the infection route, the KCDC said.
Doxycycline, and ceftazidime are the best antibiotics to treat the infection in adults; while the best treatment for children is trimethoprim-sulfamethoxazole (co-trimoxazole).
"More attention should be paid to the prevention of vibrio vulnificus especially during the late summer in September. It is more dangerous for people with underlying diseases, so it is necessary to detect the infection early through regular checkups and taking care of one's health in the summer through improved living habits," said KCDC chief Jeong Eun-kyeong in a statement.
