Feeding on fear

When word spread last month about Aimee Copeland, the beautiful young Georgia woman who contracted necrotizing fasciitis, the world watched in horror as she lost several limbs to the disease and nearly died. Necrotizing fasciitis is more commonly known as flesh-eating bacteria, an illness whose name alone is enough to inspire fear in the strongest among us.

Despite the recent media hoopla surrounding the disease, however, there is little to fear, says Dr. Mark Lundberg, health officer with Butte County Public Health. Necrotizing fasciitis, NF for short, is indeed deadly, but the likelihood of catching it is extremely small, he said. And aside from normal advice about hand-washing and general sanitation, there’s not much one can do to steer clear of it. In fact, NF is most often caused by something we associate with strep throat—group A streptococcus.

“There are millions of cases of group A streptococcus in our country each year, and several million of those are strep throat,” Lundberg said during a recent phone interview. “When the bacteria is in the wrong place at the wrong time a person gets necrotizing fasciitis.”

The fact of the matter is, according to the Centers for Disease Control and Prevention (CDC), the strep A bacterium often exists in our bodies without any symptoms. It’s present all over the world, including right here in Butte County.

“The bacteria is here—it’s the same bacteria that can cause skin infections, strep throat infections. The bacteria is in our county,” Lundberg confirmed. But he cautioned that Butte County is not in the minority and in no way should people be afraid of catching the flesh-eating bacteria.

For those unfamiliar with the story, Copeland, a 24-year-old University of West Georgia student, was spending a weekend with friends and, in a zip-line adventure gone wrong, the line snapped. She fell into the Little Tallapoosa River, gashing her leg on a rock in the process.

In the days that followed the accident Copeland’s health rapidly declined. Her flesh wound had turned into something much worse, the entry point for deadly bacteria. A website was created and Copeland’s father started a blog (go to www.aimeecopeland.com to see both) chronicling his daughter’s condition. Immediately following the accident, the site reports, she was taken to the hospital, where they stapled a large gash in her leg closed. She was given pain medication and antibiotics and sent home. Within days she’d worsened and, after several more trips to the hospital, was finally diagnosed with NF. She’s since had her leg amputated to the thigh and her other foot and both hands removed.

“I was watching her case for a while and it makes me nervous because I know it could happen to anyone,” Lundberg said. “It happens more often in someone who has a reason to be immune-compromised. But even healthy people under certain circumstances can have this terrible infectious disease occur.”

Copeland, by most standards, was not someone who ordinarily should be concerned about getting seriously ill from strep A. And that’s precisely why her story has inspired so much public interest—and fear.

That, coupled with the scary-sounding term “flesh-eating bacteria,” has resulted in media outlets around the world reporting about the unusual disease. Necrotizing fasciitis, which spreads rapidly, kills soft tissue in the process, earning it the “flesh-eating” moniker.

“We all feel a little vulnerability when we see a healthy young woman hanging on to her life by a thread,” offered Lundberg.

In Copeland’s case, she actually contracted NF through a bacterium found in the water called Aeromonas hydrophila that entered her body through the gash in her leg. While similar cases have been reported, the majority of NF infections are caused by group A streptococcus.

According to the CDC, NF is one of the most severe but least common “invasive” strep A diseases (strep throat is considered noninvasive). In all, there are between 9,000 and 11,500 invasive strep A cases in the United States each year and, of those, only about 6.5 percent are NF. Of NF cases, about 20 percent result in death.

“Invasive [strep A] infections occur when the bacteria get past the defenses of the person who is infected,” the CDC reports on its website. “This may occur when a person has sores or other breaks in the skin that allow the bacteria to get into the tissue, or when the person’s ability to fight off the infection is decreased because of chronic illness or an illness that affects the immune system.”

Because NF comes on quickly, it can be difficult to diagnose and catch early. When it attacks from the inside, like it did in Copeland’s case, it can lead to sudden gangrene, and amputation becomes necessary.

Fortunately, Copeland’s condition was upgraded last week from critical to serious.

When stories like Copeland’s put a pretty face on such a devastating disease, it’s only natural for people to get scared. In many ways, seeing a smart, healthy young woman face the possibility of death and ultimately lose her limbs reminds people of their own mortality. But just because it could happen to anybody is no reason to put life on hold, Lundberg says.

“Don’t change your life regarding this infection,” he advised. “Enjoy the outdoors. Do things that make you healthy and happy. The only thing you can do is be reasonable about how you address symptoms. People should be active but vigilant about signs of disease that are progressing. That woman [Copeland] did the right thing—she kept going back [to the hospital]. Keep going back if the treatment isn’t working.

“I really don’t think we can be petrified by fear,” Lundberg concluded. “Sometimes fear is more of a disease and causes more harm than the disease itself.”