A small cut from a can left me fighting for my life against the flesh-eating bacteria. Now experts say the number of cases is skyrocketing… and for a terrifying reason

Grandmother Sue Wheatley was rinsing out a can of crabmeat when she cut her finger on the sharp lid. The wound was only about an inch long, so she put a band-aid on it – and didn’t think much more about it.

But within two weeks, this innocent wound left her in a ten-day coma, fighting for her life.

Bacteria that appeared to have entered through the cut had penetrated deep into Sue’s body, causing a dangerous infection called necrotizing fasciitis (NF) – also known as the flesh-eating disease because of the speed at which it destroys tissue such as muscle, skin and other tissues destroys. tissues.

Fourteen days after cutting her finger – which had since healed – Sue was spending the morning collecting rubbish for a community project when she noticed her right shoulder was hurting.

“I just thought I’d pulled a muscle,” says Sue, 64, a retired administrator from Dudley, in the West Midlands, who has two grown-up children and three grandsons. ‘But just a few hours later I was in pain, with pain down my arm and in my chest, like I was having a heart attack. I also got hot and cold chills, so I crawled into bed.’

Her husband, Paul, 66, a retired company director, called NHS 111 – the operator said the symptoms sounded serious and sent an ambulance to take Sue to hospital. In the emergency room, Sue’s health deteriorated rapidly.

“I started to get sick repeatedly,” she says of the event in June 2023. She was admitted to a ward: “I had severe pain all over and the next morning the skin of my entire right arm had turned black and bruised and colorless fluid to seep through the skin.’

Sue is one of a small but growing number of people in Britain developing NF as cases of the life-threatening condition have increased since the pandemic – possibly because we are still feeling the effects on our immune systems.

According to the Lee Spark NF Foundation, there are typically around 1,000 cases of NF per year in Britain, named after a previously healthy 23-year-old who died from the condition in 1999.

But data from a recent poll of 28 hospitals across England, presented at a British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) conference in Newport, Wales, in December, shows that 57 percent reported an increase in the number affected patients in hospital. 2023, compared to previous years.

This is believed to be due to a drop in immunity as lockdowns and social distancing prevented people from building up resistance to common insects.

NF usually occurs when bacteria that many people carry harmlessly on their skin or in their throats enter deep into the body, usually through a wound, scrape, or their blood supply; the recent increase has been linked to Strep A, a common cause of tonsillitis and scarlet fever (more on this later).

When it reaches the fascia, the thin connective tissue that covers muscles, blood vessels and around organs, the invading bacteria can begin to spread quickly, secreting toxic chemicals that kill the soft tissue.

Even with treatment (which usually includes emergency surgery and antibiotics), up to 30 percent of patients die, a study in the journal BMC Infectious Diseases reported in 2021.

Those who survived often underwent amputations to stop the spread of the infection, and skin grafts after extensive surgery to remove infected tissue.

The recent survey, carried out by Sheffield Teaching Hospitals NHS Foundation Trust, was initiated by plastic surgeons based there, who had noticed an increase in the number of cases – 27 in 2023, compared to an average of eight cases per year between 2019 and 2022.

The team contacted other hospitals and found that almost six in 10 had noticed a similar increase, says Dr Helen Richards, a plastic surgeon in Sheffield, and one of the doctors who initiated the survey.

Increases have also been reported in Japan, Germany and Switzerland, she says. ‘Emerging evidence suggests it is a global phenomenon, with increasing numbers of cases following the pandemic. We want to raise awareness without causing unnecessary alarm; NF remains rare.’

The Sheffield study found that more cases were now caused by group A Streptococcus (Strep A) than before the pandemic.

This bacteria has been found in 39 percent of cases since the pandemic, compared to 27 percent in previous years. A newer, more aggressive strain of Strep A is believed to be responsible for this post-pandemic wave of invasive infections such as NF, researchers from the UK Health Security Agency reported earlier last year.

Common early symptoms of NF include swelling and redness as the bacteria invade and destroy the soft tissue.

The main sign to look out for is severe, aching pain in the affected area after a cut or injury, which is out of proportion to any visible signs, and is caused by the infection spreading along the deep tissues.

As the infection spreads to the skin (which can typically take three to four days, although it can be faster and slower), it can cause blisters, a black or purple rash and shiny, stretched skin, experts warn.

The invading bacteria produce toxins that can cause vomiting and diarrhea, which can be misdiagnosed as food poisoning.

But most importantly, if the patient becomes seriously ill – which can happen within hours – life-threatening complications can occur.

These include toxic shock (caused by the toxic toxins) and sepsis (when the immune system overreacts to an infection and starts attacking its own tissues), both of which can be fatal.

People with diabetes, high blood pressure, or steroid medications are at greater risk for NF because they have a higher risk of infections in general – but NF can also affect anyone of any age.

It’s not clear why some people have bacteria on or near a wound and don’t develop the condition, while others do.

‘You need a perfect storm of factors to come together to get NF, and the patients who do are incredibly unlucky,’ says Dr Marina Morgan, consultant in clinical microbiology and infection at Royal Devon University Healthcare NHS Foundation Trust.

But it is a medical emergency: ‘The bacteria multiply every 20 minutes on the fascia and spread very quickly. It’s hidden and hard to know it’s happening.”

Dr. Morgan adds: ‘The one question that will spare most patients from being misdiagnosed is: How bad is the pain? If the pain is eight to ten out of ten, consider necrotizing fasciitis.” (Taking ibuprofen can worsen the condition by dampening the immune system, she says.)

Time is of the essence: NF must be identified quickly — which can be challenging because doctors only encounter it once or twice in their careers — and the patient must be given high doses of antibiotics and surgery to cut away the dead tissue where the bacteria are located. multiply quickly.

‘As we operate, we can sometimes see the dead tissue spreading before our eyes; the bacteria spread so quickly,” says Dr. Richards.

Several operations may be necessary over a few days to repeat the process. Patients who continue to deteriorate may be given immunoglobulin (immune cells extracted from donated blood) to help neutralize the toxic toxins secreted by the bacteria.

In Sue’s case, hospital doctors initially diagnosed cellulitis (an infection of the deeper layers of the skin).

She was given antibiotics, but because the skin on her arm turned a blackish color the next day, necrotizing fasciitis was suspected and she was rushed into surgery – large areas of the dying skin and muscle in her arm were cut away, especially on the inside of her arm. her forearm.

Three days later she was returned to the theater to cut away more dead tissue, this time from her back. Further operations involved taking skin grafts from her legs to cover open wounds on her arm and back.

“At that point my kidneys shut down and I was given a machine to breathe for me in intensive care,” Sue recalls. ‘My heart was also struggling and I was in a coma for ten days. The doctors told Paul and the children that I only had a 50 percent chance of surviving.”

Despite their worst fears, Sue slowly recovered. “When I left the hospital after six weeks, I needed a frame to walk,” she says.

‘Now, 20 months later, I still have no feeling between my wrist and elbow and my grip is weaker, but I can write and drive.

“More than anything, I feel so lucky to be here. I know many people do not survive this condition. I’m so grateful.’