Necrotizing fasciitis is a rare and dangerous infection, but knowing the signs and when to get treatment is critical

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The unexpected can happen when you’re enjoying your time off at a beach resort far away from the cold winter in Canada. You can end up with a bad sunburn without proper sun protection or diarrhea from contaminated food or water.

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Read more about how to avoid travel-related illnesses

But you wouldn’t expect to get flesh-eating disease, also known as necrotizing fasciitis. But that’s what happened to Maia Stock, 25, of Edmonton.

Stock was on vacation in Puerto Vallarta with her parents and woke up at 3 a.m. with leg pain. “My leg was just super swollen and red and hot to touch,” she told CBC News. “I had a fever.”

The resort doctor sent her to hospital where she was diagnosed with necrotizing fasciitis — a rare bacterial infection that spreads rapidly in the body and can cause death, according to the Centers for Disease Control and Prevention, attacking the tissue under the skin that surrounds muscles, nerves, fat and blood vessels. Stock, who also had pneumonia, needed immediate surgery to contain the bacteria and save her leg.   

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The first surgery was done in a local hospital on Boxing Day, but she also needed two other operations, the last one scheduled for Jan. 2. She’s now recovering out of the hospital and reportedly doing well.

Even with treatment, though, one in five people with necrotizing fasciitis died from the infection, says the CDC of data from the most recent five years.   

Stock’s story recently made headlines because her parents couldn’t get their daughter back to Alberta for the remaining two surgeries there were no beds available. Alberta Health Services explained the bed shortage and stress on the health-care system in a statement reported by CTV News: “ … our hospitals continue to experience significant capacity challenges due to an ongoing surge in respiratory illnesses, and the number of patients who need to be admitted for care.” 

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Travellers, keep Canada’s hospital bed shortage in mind

Sheila Burns, director of health and disability policy with the Canadian Life and Health Insurance Association, told CBC that people travelling need to keep the hospital bed shortage in mind.

“It’s good to be aware that it might take longer than normal to be returned to Canada if you need the continuing care in a hospital here,” she said.

And while having travel insurance is critical to making sure you get the treatment you need wherever you are, there’s also a takeaway here about knowing there are risks to your health when you’re travelling, however rare, says Dr. Andrew Morris, an infectious diseases specialist in Toronto and medical director of the Sinai Health System-University Health Network Antimicrobial Stewardship Program. 

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“It can happen almost anywhere”

“It’s extremely rare,” he says of necrotizing fasciitis. “I had a patient who had it, but it was a really long time ago. It can happen almost anywhere, to be honest with you.” 

How it happens can be a bit of a mystery, but the problematic germ usually gets into your body through a break in your skin, like a cut or scratch, Morris says, and some people are more susceptible to it because of genetics or compromised immunity.   

“There are many different kinds of germs that people can get being in the water, especially fresh water, where they have a scratch and they get a germ that way,” he says. “People scratched with rusty tools or metal can get different germs.”

 In most instances of flesh-eating disease, the invading germ is related to group A Streptococcus, or “group A strep,” where certain strains bring on different infections, including strep throat, strep fever, scarlet fever and cellulitis — a relatively benign skin infection that’s usually treated with antibiotics.

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While Group A strep rarely results in necrotizing fasciitis, Morris points out, “if someone for whatever reason is genetically predisposed to get necrotizing fasciitis and they’re carrying the group A strep on their skin and then their skin in some way gets injured, they’re at risk.”

He also says that most cases happen randomly and very rarely spread from person to person. It’s also challenging to diagnose because patients first complain of pain in an arm or leg and they’re often sent home with anti-inflammatories for muscle injury. Then a rash appears on the limb and people develop a fever, chills, sweats and start feeling awful.

Depending on the patient, prompt treatment requires surgery, antibiotics and, in cases caused by group A strep, intravenous immunoglobulin therapy is administered to control immune reaction to the bacteria. 

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To keep yourself safe from a bacterial skin infection, frequent handwashing is recommended along with cleaning all minor cuts and injuries that break the skin, including blisters and scrapes.

And if you have an open wound or skin infection, avoid hot tubs and swimming.

“When people are on vacation, they do things that they don’t normally do. They climb, they hike, they go into the water and get scratched on coral,” says Morris. “All those things just increase the likelihood,”

Common sense should prevail, so don’t let your guard down, Morris adds. “Be smart when you travel. If you have wounds, manage them and seek medical attention if things aren’t right.”

 Karen Hawthorne is a Toronto-based writer.


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