Update: A fourth case of Vibrio virus has been reported in Mobile. You can read more about the latest case here.

The Alabama Department of Public Health is warning people with cuts, abrasions and certain health conditions to avoid the water after reports of three cases of flesh-eating bacteria.

The bacteria – known as Vibrio – is found in lakes, rivers, along the coast and in other warm, brackish bodies of water. The bacteria can lead to destructive soft-tissue infections and other illnesses.

“Most soft-tissue infections occur with either injury or with conditions such as poorly controlled diabetes or low immunity. However, sometimes otherwise healthy people can develop a skin infection after skin injury and being exposed to natural bodies of water. Some bacteria can cause more severe infections than others,” said Dr. Karen Landers, Assistant State Health Officer, ADPH.

Three cases of flesh-eating bacteria have been reported in Alabama since March. One case involved the consumption of raw oysters from another state, the other two people – both of whom had open wounds – contracted the bacteria in water near Mobile Bay, the Mississippi sound and Dauphin Island areas. All of the victims have recovered from their illnesses.

How do you contract Vibrio?

Vibrio vulnificus is a naturally occurring organism that is found in warm brackish waters, such as bays or gulfs, particularly during summer months. Infection can come through exposure to water containing Vibrio or eating raw or under-cooked seafood from those areas.

According to the Centers for Disease Control, there are roughly 80,000 Vibrio infections each year, 100 of which are fatal. In the past year, there have been 30 Vibriosis cases in Alabama.

Can people spread Vibrio to each other?

No. It comes from contaminated water and undercooked seafood. There is no evidence of person-to-person transmission of Vibrio vulnificus.

What are the symptoms?

Symptoms from Vibrio can include diarrhea, vomiting, abdominal pain, chills, fever, shock, skin lesions and wound infections. Infections can be particularly dangerous for those with a compromised immune system, including those with liver disease or cancer.

The bacteria is typically referred to as “flesh eating” due to its destruction of soft tissues in the infected area.

Illness typically begins within three days of exposure, but it can take as long as a week for symptoms to appear.

What are the treatments?

Depending on the type of Vibrio, treatment can vary between monitoring and administering fluids to replace those lost from diarrhea to aggressive antibiotics and treatment of wound sites. In severe cases, the bacteria can lead to the amputation of infected limbs. Vibrio vulnificus bloodstream infections are fatal about 50 percent of the time.

How can you prevent Vibrio?

One of the primary ways to prevent Vibrio is to avoid exposure to water if you have open wounds or sores.

“If you have open wounds, cuts, abrasions and sores, stay out of the water. Persons with low immune systems, cancer, diabetes, liver disease, and other chronic conditions should avoid eating raw or undercooked seafood, especially oysters,” Dr. Landers said.

The CDC recommends:

• Stay out of brackish or salt water if you have a wound (including cuts and scrapes), or cover your wound with a waterproof bandage if there’s a possibility it could come into contact with brackish or salt water
• Wash wounds and cuts thoroughly with soap and water if they have been exposed to seawater
• If you develop a skin infection, tell your medical provider if your skin has come into contact with brackish or salt water
• Wear clothes and shoes that can protect you from cuts and scrapes when in brackish or salt water.

What else?

• Thoroughly cook seafood, especially oysters
• Do not eat raw oysters or other raw shellfish.
• Do not eat those shellfish that do not open during cooking.
• Avoid cross-contamination of cooked seafood and other foods with raw seafood and juices from raw seafood.
• Wear protective gloves when handling raw seafood.