Professor of the Practice of Health Services, Policy and Practice, Associate Director of the Accelerated Master of Public Health Program, Vice Chair of Health Services, Policy and Practice at the Brown University School of Public Health
Dr. Rivkees is a pediatric endocrinologist and physician-scientist who served as Florida’s State Surgeon General and Secretary of Health from June 2019 to September 2021, on the front lines of the state’s response through some of the most difficult days and months of the COVID-19 pandemic. As State Surgeon General, Dr. Rivkees also served as State Health Officer for the Florida Department of Health. Dr. Rivkees’ experience and leadership protecting lives and improving public health during emergencies, brings to the Pandemic Center a unique understanding of front-line decision-making to drive effective policy and practice, in the face of public and political obstacles. His background and skills are an asset to understanding pandemic preparedness and response.
The Florida Department of Health is warning people to avoid contact with floodwaters from Hurricane Milton to prevent exposure to a flesh-eating bacteria that causes life-threatening infections.
Vibrio vulnificus, a bacteria commonly found in warm coastal waters, can cause illness when open wounds are exposed to contaminated water, the Florida Department of Health said in a statement. After heavy rain and flooding, the concentration of this bacteria can rise, especially in brackish (salty) water.[1]
“Because of flooding and storm surges associated with hurricanes, there is a big increase in people who tend to be exposed to floodwaters after these events,” says Craig Baker-Austin, PhD, a senior research scientist at the Centre for Environment, Fisheries, and Aquaculture Sciences in the United Kingdom.
There have been spikes in vibrio infections, called vibriosis, in the wake of several major hurricanes that made landfall in the United States, including Katrina in 2005 and Ian in 2022, Dr. Baker-Austin says. “Milton and Hurricane Helene this year are no different, and I imagine there will be an increase in infections because of people coming into contact with floodwaters.”
How Common Are Vibrio Infections?
Even amid the increased risk posed by hurricanes, vibrio infections are quite rare, says Scott Rivkees, MD, a professor of public health at Brown University in Providence, Rhode Island, and a former state surgeon general and secretary of health in Florida. “Each year in Florida there are millions of people who swim recreationally, and the number of cases per year ranges from 20 to 40.”
Nationwide, there are about 150 to 200 vibrio infections a year, and about 1 in 5 cases are fatal, according to the U.S. Centers for Disease Control and Prevention.[2]
People who have compromised immune systems, liver disease, or open wounds are at higher risk of vibrio infections from exposure to floodwaters.[3]
What Are the Symptoms of Vibrio Infection?
Symptoms of vibrio infection can include:[1]
Diarrhea
Vomiting
Abdominal pain
Fever or chills
Fast or high heart rate
Confusion or disorientation
Anyone with symptoms, especially after exposure to floodwaters, should seek immediate medical attention.
The Florida Health Department offers the following tips to minimize the risk of exposure to vibrio:
Avoid swimming or wading in floodwaters, standing water, seawater, and brackish water, if possible.
Cover open cuts or wounds with waterproof bandages if they could come in contact with floodwaters, standing water, seawater, or brackish water.
Wash skin and any open cuts or wounds thoroughly with soap and clean water after any contact with floodwaters.
The most important thing is to monitor wounds for any sign of inflammation or infection in the first 24 hours after exposure to seawater or floodwaters that may have been contaminated, says Lisa Waidner, PhD, an assistant professor of biology at the University of West Florida in Pensacola.
“Immediate attention is necessary, and it is particularly important to notify the medical provider of the exposure to seawater that may contain vibrio,” Dr. Waidner says. “Medical professionals on the Gulf Coast are generally more aware of the danger of contracting vibriosis, but it is essential for the person who seeks medical attention to make it very clear that they suspect they may have come in contact with seawater, and to mention vibrio as a possible bacterium that they were exposed to before the inflammation began.”
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Sources
FDOH Urges Floridians to Avoid Floodwaters and Prevent Exposure to Vibrio Vulnificus. Florida Department of Health. October 8, 2024.
Hughes M et al. Notes From the Field: Severe Vibrio vulnificus Infections During Heat Waves — Three Eastern U.S. States, July–August 2023. Morbidity and Mortality Weekly Report. February 1, 2024.
FDOH Urges Floridians to Avoid Floodwaters and Prevent Exposure to Vibrio Vulnificus. Florida Department of Health. October 8, 2024.