Updated July 1, 2019 – BRADENTON BEACH – Wade Fleming used to consider saltwater good medicine for cuts and other skin irritations, but not anymore.
His mom, Lynn Fleming, took a walk at Coquina Beach earlier this month, slipped and cut her leg, and died two weeks later from a flesh-eating bacterial infection, he says.
Fleming, 77, of Ellenton, was diagnosed with necrotizing fasciitis, caused by bacteria known as flesh-eating bacteria, he said. No death certificate stating an official cause of death had been issued by press time.
“When I was a kid, if I had poison ivy, I’d scratch it open and go to a pool or the ocean,” he said, adding that he was advised at Blake Medical Center – where his mother was treated after a stay at Manatee Memorial Hospital – that beachgoers should not go in the water if they have a cut, have just shaved, have a new tattoo or even have a fresh bruise.
Fleming, his wife, Traci, and his mom, Lynn, visited Coquina Beach one day last month, where Lynn went for a walk near the erosion control groins, Fleming said.
“She went below one of them and it was washed out below the surface,” he said. “She stumbled and fell and put a couple of nicks in her leg.”
A lifeguard cleaned and bandaged the wound and advised her to put ice on it, then said, “Enjoy the rest of your day,” Fleming recalls.
“He didn’t give us any warnings. We enjoyed the rest of the day at the beach and went to dinner that night,” he said.
The day after the couple returned home to Pennsylvania, friends came and found Lynn Fleming with a red, swollen infection, he said, and took her to an emergency care center, where she got a tetanus shot.
The center called in a prescription for antibiotics to a pharmacy that was not open that day, Sunday, he said. The friends came back the next morning to take her to the pharmacy but she did not answer the door. They got in through a sliding glass door, found her on the floor and called 911.
She was treated at Manatee Memorial Hospital, and Fleming booked a flight back to Manatee County, talking to her as he was driving to the airport.
“I said I loved her. That’s the last time I had a conversation with her,” he said.
After landing in Ft. Lauderdale and driving across Alligator Alley – the quickest way back to Bradenton considering layovers – Fleming was advised by the hospital not to visit until the morning because his mom had just gotten out of surgery. In the middle of the night, he got a phone call from the hospital advising him that they were taking her to Blake Medical Center, where she had another surgery, he said.
“She wasn’t waking up,” Fleming said. With one kidney, she was on dialysis and breathing tubes and was taking medication to control her blood pressure and fight the infection. “Her whole body was septic.”
A CAT scan showed she had suffered strokes, he said.
“She did come around and could nod ‘yes’ and squeeze our hand,” he said.
Due back at work, Fleming flew home, but after a third surgery, he came back two days later. The next day, it was determined that the toxin levels were continuing to rise, and hospice was called.
“We sat with her and held her hand,” he said.
Her death came less than two weeks after their day at the beach.
Lifeguards should tell people they treat not to go back in the water the rest of the day after being cut, and warn that signs like redness, swelling, fatigue and fever could necessitate a trip to the ER, he said, adding that urgent care facilities also should warn about the signs of possible infection by flesh-eating bacteria.
“It would have saved my mother’s life,” he said.
“This is a first,” Marine Rescue Chief Joe Westerman said Monday morning as he studied the case.
Lifeguards advise beachgoers who have been stung by stingrays or jellyfish to watch out for signs of infection, he said, but after Fleming’s experience, new procedures may be developed.
“I am going look at this aggressively,” he said, adding that he is also concerned about his lifeguard staff, who “get banged up” as part of the job and could be vulnerable to the bacteria.
A permanent health department sign on lifeguard stand No. 1 advises of health concerns at the beach, but no mention of Vibrio has ever been noted, he said.
Vibrio vulnificus is a naturally occurring bacteria found in warm salty waters such as the Gulf of Mexico and surrounding bays. Concentrations of this bacteria are higher when the water is warmer, according to the Florida Department of Health.
The ordinary presence of Vibrio in the water may be comparable to sharks, Westerman said. “They’re all over the state all the time, but you never know when they’re going to bite.”
Fleming’s death won’t keep her son and his family from the beach, he said.
“I own a timeshare. My wife wants to retire down here. We’re not telling people not to go the beach, just to be educated,” he said.
“We will be back to Anna Maria Island, there’s no doubt,” Fleming said. “Maybe not Coquina Beach.”
Health officials respond
The Florida Department of Health issued a statement Monday evening saying that the department has not been contacted by anyone who has contracted necrotizing fasciitis in Florida.
“At present, we do not have first-hand knowledge related to any case of necrotizing fasciitis reported in the media. Necrotizing fasciitis can be caused by a number of bacteria, including Vibrio vulnificus, staphylococcus (staph), and most commonly Group A strep,” according to the statement.
Five confirmed cases of infection with Vibrio vulnificus have been reported in Manatee County in 2016-18, none of them fatal, according to the Florida Department of Health.
Statewide, 30 Vibrio-related deaths over the same period were reported.
Fleming’s death occurred the same month that an Indiana family blamed flesh-eating bacteria for their 12-year-old daughter’s leg infection in Destin. The girl survived.
Vibrio vulnificus bloodstream infections are fatal about 50 percent of the time, according to the health department.
In addition to exposure in seawater, people can get infected with Vibrio when they eat raw shellfish, particularly oysters, according to the health department.
People with compromised immune systems, liver disease, kidney disease and other conditions are more vulnerable to the infection, and should wear proper foot protection to prevent cuts and injury caused by rocks and shells on the beach, according to the health department, which notes, “If you are healthy with a strong immune system, your chances of developing or having complications due to this condition are extremely low.”
Necrotizing fasciitis is rare, spreads quickly in the body and can cause death, according to the Centers for Disease Control and Prevention (CDC).
Accurate diagnosis, rapid antibiotic treatment and prompt surgery are important to stopping the infection, according to the CDC, which recommends seeing a doctor right away if you have a fever, dizziness, or nausea soon after an injury, including cuts and scrapes, burns, insect bites, puncture wounds (including those due to intravenous or IV drug use) or surgery.
People also can get necrotizing fasciitis after an injury that does not break the skin (blunt trauma), according to the CDC.
Symptoms can include:
- A red or swollen area of skin that spreads quickly
- Severe pain, including pain beyond the area of the skin that is red or swollen
- Avoid walking, sitting, or swimming in Gulf or bay waters with open wounds
- Properly clean and treat wounds after:
- Accidentally exposing a wound to Gulf or bay waters
- Getting an injury while in the water
- Getting an injury while cleaning or handling seafood
- Seek medical treatment immediately if you develop signs or symptoms of an infection (redness, swelling, fever, severe pain in area of red or swollen skin) near or around a wound. Let the doctor know of recent exposure to Gulf or bay waters, pools or hot tubs.
The Florida Healthy Beaches Program lists good water quality in Manatee County except for Palma Sola Bay (south side) on May 13 and June 11, due to enterococcus bacteria, the only bacteria the tests are designed to detect.