Authorities on alert for flesh-eating bug

Health authorities were on high alert last night after the discovery of a rare flesh-eating superbug which has already claimed three lives and left several other patients in isolation until tests come back tomorrow.

An elderly patient at Christchurch's Princess Margaret Hospital died on Friday from necrotizing fasciitis, the third death in a fortnight from what is the first outbreak in New Zealand of the streptococcal superbug.

Patients and families were being informed of the issue, but the hospital said there were no plans to transfer patients to other hospitals or to rest homes.

Dr Alan Pithie, an infectious-diseases physician at Canterbury District Health Board, said it was doubtful whether they would be able to pinpoint the source of the infection, which meant there was a chance - albeit a slim one - that it could spread beyond Princess Margaret Hospital.

Normally spread by contact with infected mucus or open wounds, the toxic shock disease almost killed television celebrity Lana Coc-Kroft after she stepped on a coral reef in Fiji last year.

The flesh-eating superbug can destroy muscle, fat and skin in less than a day after the first symptoms are shown in a patient.

The first death was on September 29, the second death three days later and the most recent one on Friday.

Dr Pithie confirmed yesterday that on Friday the hospital had realised the deaths were linked and had immediately held an emergency meeting.

The ward was shut, and all patients and staff were screened and prescribed a course of preventative antibiotics yesterday to halt the possible spread of the bacteria.

So far, no one had shown any early symptoms of the disease, which include fever, redness and severe pain - but the first results of the screening swabs will not be known until tomorrow afternoon.

Necrotizing fasciitis is rare, diagnosed perhaps two or three times a year, but it has a mortality rate of more than 50 per cent, Dr Pithie said.

Dr Pithie said the illness was difficult to detect early, as it was extremely aggressive and could progress from a rash or swelling, to blistering, and then death very quickly.

While streptococcal infections are common, for example, sore "strep" throats, the bacteria can absorb virulence from other organisms which makes them superbugs.

Streptococci can pick up the killer quality from absorbing the genes of normally harmless organisms that produce toxins.

The toxins aren't normally dangerous, unless they attach themselves to an invasive bacteria - like streptococcus A - which then carry the toxins through the bloodstream.

"That's when it becomes a superbug and there's risk of a serious illness," Dr Pithie said. He said there had been outbreaks of flesh-eating disease overseas, but he was not aware of any other outbreaks in New Zealand.

He was unsure whether the investigation would be able to pinpoint the source of the infection.

"One of the problems is that quite a high proportion of the population can be carriers of streptococci, but not necessarily the right strain."

Many people may be exposed to them but never become sick, but the elderly and debilitated are more susceptible.

Streptococci bacteria are spread from the mucus of infected noses or throats or from direct contact with open wounds or skin sores.

Although this is not the first superbug to strike in a New Zealand hospital, the figures show that up to 10 per cent of all patients will suffer a hospital-acquired infection which could be prevented by simply washing hands.

An Auditor-General report in 2003 found that at least 11 people had died in New Zealand hospitals from hospital-acquired infections and questioned whether enough was done to prevent them.

A study tabled at Parliament's health committee in July reported that hospital-acquired infections, drug error and staff mistakes cost the country around $870 million a year - swallowing 30c of every $1 spent on health.

- HERALD ON SUNDAY