Beware of polluted water

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A 40-year-old man who was infected by the flesh-eating bacterium Aeromonas hydrophila being treated at the National Hospital of Tropical Diseases in Hanoi in April. Photos courtesy of the hospital

A leading hospital in Hanoi recently saved a man infected with a heterotrophic bacterium that can digest hemoglobin.

Doctor Nguyen Trung Cap of the National Hospital of Tropical Diseases, which treated the patient, said the man is one of four survivors among 11 cases sent to the hospital over the past two years, all of them men between 30 and 77 years of age.

The patients were infected with Aeromonas hydrophila, also known as flesh-eating bacterium as it travels through the bloodstream and produces a toxin that can cause tissue damage.

"The infection is rare and thus people would not think about the bacterium at first, while it develops very fast into fatal blood poisoning and necrosis," Cap said in a Dan Tri report.

He said the bacterium is common in fresh and brackish water but usually infects aquatic creatures rather than humans.

The recent 40-year-old patient from the northern province of Thai Binh, only identified by his initials P.V.T., was admitted on April 12 when one of his arms was necrotizing.

He received dialysis and other treatments during ten days before being transferred to the National Institute of Burns for skin transplant.

Cap said most patients including the latest one are not clear how they were infected, but the infection usually happens through physical contact between exposed cuts and dirty water. One patient was cut by a fish spine after eating raw seafood.

The doctor said people should be aware of the danger of the bacterium, but not panic as it is only severe when penetrating through open cuts or at people with weak immune system such as those having chronic kidney or liver problems, Cap said in a May 24 statement on the government website.

He said seven of the patients sent to his hospital had cirrhosis, and the bacterium had caused biliary infection which leads to blood poisoning.

Otherwise, the bacterium would only cause normal diarrhea in people digesting infected water, or skin rashes from external touch, the doctor said.

He also noted that the bacterium penetration is easily recognized through swelling and inflammation of the injuries, and people can save themselves by seeking early treatment, as the bacterium is sensitive to many kinds of antibiotics.

The bacterium resists penicillin, but can be eliminated by formaldehyde solutions at 2 percent concentration, alcohol of 70 percent or Javel water, doctors said.

Several people in South Carolina were hospitalized last year with necrotizing fasciitis the severest development of A. hydrophila infection involving the decay of tissue fascia between muscles or around organs. One patient, Anthony Hills, 55, died in August just hours after he was rushed to hospital.

Doctors amputated his right arm after finding that it was infected, but he died before doctors decided to amputate his infected right leg as well.

An AP report said around 750 people are infected with flesh-rottening disease each year, including fewer than 250 in the United States.

But the bacterium has almost never been reported as causing a severe outbreak.

One major outbreak was reported in Australia, when 26 people were rushed to a hospital in the rural town of Collie in February 2002 with many infected scratches and pustules over their bodies. All the patients had participated in a mud football competition the previous day, together with 74 others.

The patients were saved although one required removal of an infected thumbnail, and another required surgical debridement of an infected toe, according to Australia medical reports.

Follow-up investigations found that the muddy football field was prepared with water pumped from an adjacent river, whose water samples later tested positive for the bacterium.

Cap said as the infection is rare, medical facilities in Vietnam are not familiar with it. So people should protect themselves in the first place by avoiding direct contact with polluted water.

Those working in such environments such as fishermen, farmers in flooded water, or sewer cleaners need to wear appropriate protection, he said.

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