3 Cases of necrotizing fasciitis caused by Vibrio vulnificus
5 August 2005
During the past four weeks in July and August 2005, t hree cases of Necrotizing Fasciitis caused by Vibrio vulnificus came to notice to the Centre for Health Protection (CHP) of the Department of Health . The most recent notification was received on August 4.
Case details are as follows:
Case 1:
Age: 55
Sex: Female
District of residence: Kwun Tong
Date of Onset: July 7
Symptoms: pain and swelling in left knee
Present Condition: Admitted to United Christian Hospital since July 9 and now in stable condition.
Travel history: No recent travel history.
Others: Scratch over left knee after visiting a wet market.
Case 2:
Age: 78
Sex: Male
District of residence: Fanling
Date of Onset: May 10
Symptoms: pain and swelling in right upper limb
Present Condition: Admitted to North District Hospital on May 11. Died on the same day.
Travel history: No recent travel history.
Others: Injur y over right upper limb.
Case 3:
Age: 62
Sex: Female
District of residence: Tai Po
Date of Onset: June 4
Symptoms: pain and swelling in left ankle
Present Condition: Admitted to Alice Ho Miu Ling Nethersole Hospital on June 5. Died on June 9.
Travel history: No recent travel history.
A spokesman for the CHP said the clinical features of Necrotizing Fasciitis are wound or soft tissue infections, manifesting as intense pain, redness, swelling and rapidly developing tissue destruction. In persons with underlying medical conditions, especially liver disease, it can cause bloodstream infections characterized by fever, chills, decreased blood pressure, blistering skin lesions, and death in severe cases. In healthy persons, it can cause diarrhoea, vomiting, and abdominal pain.
Vibrio vulnificus is a bacterial cause of necrotizing fasciitis. The bacterium is naturally present in warm seawaters. It may cause infection through open wounds of the skin. It is not transmissible between persons. People with weakened immunity and liver diseases in particularly are more susceptible to Vibrio vulnificus infection.
Vibrio vulnificus infections have a worldwide occurrence. In the US (1988-95), there were over 300 reports of V. vulnificus infections from the Gulf Coast States. In Taiwan , an annual number of 13-26 cases were reported during 1996-2000.
The CHP is liaising with the Hospital Authority (HA) to monitor the situation. The Centre will send letters to doctors alerting them about Vibrio vulnificus as a differential diagnosis of necrotizing fasciitis to facilitate recognition and reporting of such cases.
Members of the public are reminded to adopt the following preventive measures:
* Avoid exposure of open wounds or broken skin to seawater or salty water
* Wounds should be thoroughly cleansed and properly covered;
*Wear protective clothing (e.g., gloves) when handling raw shellfish;
*Cook shellfish (oysters, clams, mussels) thoroughly;
*For shellfish in the shell, either boil until the shells open and continue boiling for 5 more minutes, or steam until the shells open and then continue cooking for 9 more minutes. Do not eat shellfish that do not open during cooking.
*Handle and keep raw seafood separately from cooked seafood.
The spokesman said patients should seek medical advice promptly if symptoms and signs of infection like increasing redness, pain and swelling, were found.
End/Friday, August 5, 2005
