Hospital study finds link between La Niña events and spread of deadly Vibrio vulnificus infection
Two men in three days had presented to the emergency department with baffling similarities.
Both men, aged around 80, had cuts that had rapidly progressed to grotesque infections, with their skin sloughing away to reveal gaping wounds.
Both had been crabbing in the muddy estuaries of rivers swollen by floodwater that had devastated the Wide Bay region just weeks before.
And to the despair of Dr Ganju and her colleagues, both men were unresponsive to the standard antibiotics used to treat bacterial infections.
"It is pretty devastating," Dr Ganju said.
"You're like, 'Why is this patient so sick? What am I missing? He shouldn't be so sick … with [the] signs and symptoms I'm seeing, they should start getting better."
Analysis of decaying tissue from one of the patients in March 2022 showed it was teeming with Vibrio vulnificus — a flesh-eating bacteria rare enough in the tropical north of Queensland, but almost unheard of in the Fraser Coast region about three hours' drive north of Brisbane.
Vibrio vulnificus was known to thrive on the additional nutrients brought by floodwaters, but Dr Ganju said the scarcity of the infection in the hospital's sub-tropical location meant it was not initially considered a likely diagnosis.
"To be honest, in my career — I've been doing this for 25 years — I had not seen a Vibrio [case] before this," Dr Ganju said.
The medical team pivoted to use ciprofloxacin, an antibiotic known to target Vibrio vulnificus, and both patients underwent operations to remove and replace the decaying flesh.
Three more fishermen presented to the hospital with bacterial infections over the next six months and, by then, the team was on high alert.
Source: Queensland Health
"We would always ask whether there was exposure to … marine water or were they in a boat, and if we got that history we would start the ciprofloxacin [immediately]," Dr Ganju said.
More than one in four patients can die once the infection takes hold, but all five men survived.
The third patient, Hervey Bay fisherman Rodney Drier, required 18 operations and after contracting a fungal infection had his left hand amputated.
He rues the slip of a knife while cutting up a catfish to use as crab bait which had life-changing consequences.
"It ruined my lifestyle … took my life away from me," the disability pensioner said.
Once all patients were discharged in 2022, Dr Ganju and her colleagues recorded their experience in a clinical case report published today in the Rural and Remote Health Journal.
By analysing the frequency of Vibrio vulnificus infections in Queensland, lead author and senior pharmacist Daniel Bermingham found spikes of infections over the past 25 years corresponded with La Niña weather events.
While there were only 86 cases of Vibrio vulnificus infections in Queensland between 1998 and 2023, the number of cases increased nearly fivefold during a La Niña event.
With carbon emissions known to contribute to more frequent and extreme La Niña events, Mr Bermingham said his research showed climate change increased the risk of Vibrio vulnificus infections.
The researchers hope the findings will result in a public awareness campaign of the potentially fatal risks and best practice if the infection is acquired.
"The first aid care that you can provide to yourself … is to get the first aid kit out, give [the wound] a good wash and make sure that you can clean the wound from injury," Mr Bermingham said.
"Get some chlorhexidine or some betadine and put it onto the actual wound and go see the GP or ED if it does tend to get worse."
Allen Cheng, the director of Monash Infectious Diseases at Monash Health in Victoria, was not involved in the clinical case report and does not believe "major changes" to public health messaging are warranted.
However, he agreed the epidemiology, or distribution, of Vibrio vulnificus was becoming more common in subtropical regions due to global warming.
"The case report … is at least a very good reminder to physicians that this [infection] does exist and we may be seeing changes in the epidemiology."
In a statement, Queensland Health says the department issues public health advice about the risks of exposure to floodwaters, particularly around severe weather events.
The Queensland Health guidelines prescribing antibiotics in cases of severe infections were last reviewed in 2024, the spokesperson said.
The guidelines now advise using ciprofloxacin — the antibiotic targeting Vibrio vulnificus — if the patient is exposed to water, including in subtropical regions like Hervey Bay.
As he tends to his orchids, Mr Drier is emphatic that there needs to be improved public awareness of the infection.
"Especially when you see people walking in floodwaters in the streets," he said.
"I think, 'You stupid fools, if only you knew'. One scratch and you've got a bug."
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
ABC News
2 hours ago
- ABC News
Police raids find trend of larger volumes of illegal tobacco in country stores
On today's show: Police in South Australia's Riverland have seized more than 1,000 illegal cigarettes, 500 vapes and 15 kilograms of loose tobacco. Multiple businesses received 28-day closure notices and on-the-spot fines as a result. The SA Minister for Consumer and Business Affairs says the illicit tobacco task force will continue to adjust their tactics to adapt to new organised crime gang models. Reporter: Amelia Walters (Renmark) Demolition of a popular lookout in Lancelin has begun due to the risk of it crumbling into the ocean. Local governments in Western Australia's Midwest are fighting coastal erosion as it eats away at public infrastructure. A coastal engineering lecturer Arnold Van Rooijen says governments need to tailor erosion management programs for individual towns. Reporter: Chris Lewis (Geraldton) A coroner has ruled a dementia patient who disappeared from a regional Queensland hospital in 2023, never to be seen again, died from dehydration. Major changes to the hospital's security followed but they have not stopped similar incidents occurring. It has prompted calls for change from the man's family and advocacy groups. Reporter: Katrina Beavan (Rockhampton) A Busselton widow has shared her experience of WA's struggling public health system. Jenny Cross says her husband Kevin was left bleeding while ramped in an ambulance and moved between hospital beds prior to his death in July. AMA president Kyle Hoath wants the state government to acknowledge problems with the system. Reporter: Pip Waller (Bunbury)
ABC News
3 hours ago
- ABC News
Dr Vahid Reza Adib gives evidence at first day of inquest into the death of his patient Rosemarie Campbell
A surgeon who performed weight loss surgery on a woman three days before she died from complications has been grilled at an inquest into the 62-year-old's death. Rosemarie Campbell died at her Gold Coast home in February 2022 in the days following a gastric bypass surgery at The Wesley Hospital in Brisbane. The operation was carried out by Dr Vahid Reza Adib, the partner of former Queensland premier Annastacia Palaszczuk. She also had an earlier gastric sleeve procedure carried out by Dr Adib in 2020, and her treatment by him and other healthcare staff is being examined at a coronial inquiry in Brisbane. A coroner will also look at the appropriateness of the second surgery offered to Ms Campbell and the circumstances of her discharge from hospital. During a preliminary inquest conference earlier this year, the court heard Ms Campbell died from sepsis after acquiring acute bacterial peritonitis from a strangulated hernia and pneumonia, however on Monday a forensic pathologist amended his statement. Dr Isaac Han told the court via video link that on review of an initial report there was "not sufficient" evidence there was movement of bacteria from her bowel into her blood stream, which is what causes sepsis. "We were unable to show that in the autopsy," he said. Dr Adib also gave evidence and was questioned at length about his treatment of Ms Campbell for both surgeries, including a lack of records of his consultations with her after the 2020 procedure. He told the court he would have had a post-operative review with her in the first two weeks, alongside a dietician, but accepted there were no clinical notes from the time made by him. "It's usually a joint consultation and I am always present," he said. "I regularly, without fail send a letter to the general practitioner (GP) [after] that visit." When asked why there was no separate entry in his medical system, he told the court "[the letter] is my record". Dr Adib was also asked about prescription repeats he wrote for Ms Campbell for medication to treat reflux, after an initial one-month supply ran out. He told the court he could not recall when a further script was issued but believed it would have followed either a telehealth or phone consultation as it was during the COVID-19 pandemic. "We did not have a lot of access direct face-to-face, and we were learning how to adopt our medical records to telehealth or phone consultations," he said. He told the court, reflux was a "very common" symptom in sleeve gastrectomy patients and some required medication for six to 12 months after the procedure. The court heard in January 2022 Ms Campbell had complained to her GP about ongoing reflux and this was raised with Dr Adib. However, Dr Adib told the court prior to this, it had not been raised by a dietician at her 12 month post operative review. "If there are areas of concern … [the dietician] would raise it with me and I would arrange a personal review," he said. Mr Adib accepted there were "shortcomings" with the medical record keeping system he used, and that some things were not being included in patient files or inaccurate things were being recorded. However, he was adamant if Ms Campbell made complaints about ongoing reflux at the 12-month review or after this, he would have been made aware regardless of the record keeping. After the GP contacted him in January 2022, the court heard Dr Adib had a consultation with Ms Campbell to discuss the ongoing reflux. During this consult he said she had also complained that her weight loss had stabilised and her weight had stared to increase, and she wished to lose further weight. "We had a good chat about her symptoms, I asked her certain questions," he said. He told the court he discussed options with her including general advice to assist with improving her reflux, as well as a possible endoscopy procedure. The court heard a further weight loss procedure was ultimately decided and a gastric bypass was booked for the following month. Following this, Dr Adib accepted he signed a letter to support the release of part of Ms Campbell's superannuation to fund the second surgery. The court heard that letter contained incorrect information about Ms Campbell including inaccurate BMI and current comorbidities and that her current condition was life threatening. Dr Adib told the court this was the result of a "clerical error". "This is a template generated by my front desk, I accept full responsibility," he said. "Unfortunately, I did not update the template." Dr Adib told the court in 2020 Ms Campbell's BMI had initially been at more than a "class 3" obesity level, and after her first surgery it had dropped to the "overweight" range. At the time of her second surgery, the court heard she was back to "class 1" obesity. Dr Adib told the court this alone was not the only reason for suggesting the second surgery. He said she was suffering a "very poor quality of life" due to the ongoing reflux, and a gastric bypass procedure was "gold standard" in treating that condition. "That is not readily available in the public system … this was the only way to help her out of her situation," he said. Dr Adib was also asked about a letter he submitted about Ms Campbell's treatment to the coroner's office in the months after her death. It was put to Dr Adib this letter was inaccurate, as it said her treatment had been prepared by a "team" of dieticians and psychologists, and she had been seen by a nurse practitioner. "That statement is not false," he said. Dr Adib told the court she had access to multiple dieticians he worked with, had been given details for psychologists which she chose not to engage in, and had seen a nurse practitioner when she was being prepped for surgery. He also denied it was false to state in that same letter that her choice of foods had caused her weight gain. Dr Adib was asked what he was told by nursing staff at hospital on the day he approved Ms Campbell's discharge. He said they told him over the phone she vomited a couple of times, and they were initially worried she had thrown up her medication but was "otherwise stable". "They said she was overall feeling better and was very keen to get home because of the Brisbane floods," he said. "I said, 'If she's meeting the discharge criteria and the [clinical] pathways, she can go.'" When asked if he queried specifically about her vitals or pain, he said no, and that it was "routine practice" that nursing staff should be reporting any concerns to him, particularly if her deterioration score was listed as a zero. "I am supposed to be told," he said. "I was not asked about any deterioration, there was no deterioration recorded. "Had that alarm had been made with me I would have definitely and immediately seen that patient." Under cross examination by lawyers for the nurses on staff that day, it was put to Dr Adib there was no "discharge criteria" in place at the hospital at the time, and he was being called because there was a concern about Ms Campbell. "What I was told is she is feeling slightly better … and her observations were stable and she's keen to get out," he said. "If I was aware of her deterioration, accurately, I would not be happy for the discharge." The court heard he wrote a prescription for her for anti-nausea medication before she left hospital. The inquest continues on Tuesday.
News.com.au
15 hours ago
- News.com.au
Content creator reveals life with consuming skin condition
A 25-year-old woman has revealed why she chose to go topless in order to help other people just like her who suffer with an all-consuming skin condition. Rosie Daniels, who is one half of content creator couple Rosie and Harry, first found signs of psoriasis on her scalp when she was between 10 and 12 years old. From the moment she was diagnosed, an overwhelming feeling of shame and self consciousness clouded her every thought. 'I think my first ever memories of having psoriasis was always being super self conscious if I had to tie my hair up at school,' Rosie told 'I'd always go to school with my hair down just to be able to cover it up. As soon as I had to tie it up for cooking or P.E. I'd be very hesitant and embarrassed. 'I remember saying to my mum that I was so scared that if I found a boyfriend, I don't think I could tell him I had psoriasis on my scalp. I always used to ask her how I was supposed to cover it up for the rest of my life.' As Rosie got older, the psoriasis began to appear in patches on her arms, stomach and legs. But it was so small that it took her a while to even notice. From that point, it just kept spreading. The 25-year-old said her psoriasis is one of the most chronic and severe types, and will always be present in some form on her body. She said the last five years have been dominated by the skin condition. 'It ruined my life completely,' she said. The young woman explained that at one point, she didn't understand how she could ever feel positive in her body. She'd compare herself to other women with clear, tanned skin and felt 'unworthy of love'. 'I thought that Harry shouldn't be with me, and I should be alone until I was able to look a certain way,' she said. 'It was horrible. I felt like the most unattractive person in the entire world, and everybody else was above me. I thought I was disgusting.' Rosie said she couldn't get past the way it looked, revealing she didn't want to leave the house or wear certain types of clothing that didn't cover up the auto-immune condition. She couldn't go to the gym, sleep properly or ever feel comfortable being naked in front of her fiance, Harry. It also had an impact on her mental health, making her feel incredibly low. But, over the last year, Rosie has been able to look at her skin in a new light — something she never thought was possible. She is now proud of how unique she is, saying she now focuses on how she is physically feeling within her body — rather than how her body appears to others. 'It just got to the point where I had looked at it in a certain way for so long that I had reached a point of acceptance,' she said. 'I genuinely think that it's just about time, surrounding yourself with the right people and looking at the right things on social media.' Rosie said even now, she avoids watching shows such as Love Island. She said even though she loves the series, and admires the way the women look, and she compares herself to them. 'That's why Harry and I produce content that is so real and relatable, because it's what I wish I could have consumed five years ago because it would have made my journey a million times easier,' she said. Rosie and Harry met seven years ago, at a pub in London, and she said she doesn't remember having a conversation with Harry about the fact she had psoriasis, adding it was like it was 'accepted and known from day one'. During their relationship, Harry has been a huge support system for Rosie, helping to wash her hair, making sure their house was filled with non-toxic products and helping her maintain a diet that didn't anger her skin. However, the main thing Harry has done is constantly reassure Rosie that she always has his support. The pair have a public platform — boasting 712,000 followers on their joint Instagram account — and Rosie said Harry was the one who helped encourage her to show her skin on social media. 'Back in 2020, I would post photos on Instagram and use Face Tune to edit out psoriasis patches on my stomach. If I was wearing jeans and a top, I would zoom in and actually edit out the patches and recover them with 'normal colour skin',' she said. 'And I remember one day Harry saw me doing it, and he was like 'Why don't you not edit it out one day and post it, and see what happens'.' He said he didn't think anyone would say anything, so Rosie trusted him completely and posted an unedited bikini picture. Positive support from fans instantly flooded in, ultimately encouraging the young social media star to use her platform to speak about psoriasis. This includes a recent Instagram video, posted on @rosieandharry, featuring Rosie having every patch of psoriasis on her back turned into a flower to prove that it was always a 'masterpiece' and never something to be ashamed of. For others out there who may be going through the same thing, Rosie said the way that you look doesn't determine your life path or how people view you — it's the person who you are underneath that does that. She said confidence isn't something that people are born with but a skill that you need to spend time learning. Rosie is sharing her story as part of Psoriasis Awareness Month. 'I genuinely feel from the bottom of my heart that my purpose and calling in life is to help other people learn to love the body and skin their in,' she said. 'Whether they have a skin condition or struggle with something else, I feel like my purpose is to help people love the skin their in so with every video I put out or interview I do, I hope it helps one person feel better and what they have is completely normal.'
