From the Research
Healthcare providers treating Hurricane Katrina survivors should be vigilant for Vibrio vulnificus infections, which can cause severe sepsis and skin and soft-tissue infections with mortality rates exceeding 50% in high-risk individuals, and treat promptly with doxycycline in combination with third-generation cephalosporins 1.
Infection Prevention and Treatment
When treating Hurricane Katrina survivors, it is essential to consider the risk of various infections, including:
- Wound infections from contaminated floodwater exposure, which require prompt cleaning, debridement of necrotic tissue, and appropriate antibiotics
- Respiratory infections, including pneumonia and tuberculosis, which may increase due to crowded shelter conditions
- Gastrointestinal infections from contaminated water, which necessitate fluid replacement and may require antibiotics
- Vector-borne diseases like West Nile virus, which may emerge in standing water environments
- Skin infections, including cellulitis, MRSA, and fungal infections, which are common in humid, crowded conditions
Vibrio Vulnificus Infections
Vibrio vulnificus is a halophilic Gram-negative bacillus that can cause severe infections, including:
- Gastroenteritis
- Necrotizing fasciitis
- Sepsis
- Septicemia, which is the most common presentation and accounts for the most fatalities The mortality rate for Vibrio vulnificus infections is high, exceeding 50% in most reported series, especially in high-risk individuals with underlying conditions such as chronic liver disease, diabetes, or immunosuppression 2, 1.
Treatment and Prevention
Treatment of Vibrio vulnificus infections typically involves the use of doxycycline in combination with third-generation cephalosporins, although the emergence of multidrug-resistant strains is an escalating concern 1. Prompt diagnosis and treatment are vital to prevent mortality, and it is essential to keep Vibrio vulnificus on the differential diagnosis when a patient presents with bullae or cellulitis or has a history of raw seafood consumption or exposure to brackish water 3. Tetanus prophylaxis is also essential, and healthcare providers should administer Td/Tdap to those without a booster in the past 10 years [@Example@].