The beach is beautiful. The water, maybe not so much. | ET REALITY

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On a warm day in early July, Ed Houlihan led kayakers on a four-mile trip on Cape Cod from Popponesset Bay up the Mashpee River to a freshwater pond. It was a three-hour round trip paddling, but afterward Houlihan, 83, didn’t feel any worse… at first.

Five days later, his left shin was red and sore, his body ached, and he had a fever and chills. Doctors diagnosed him with an infection from Shewanella algae, a bacteria that thrives in brackish water.

“Everyone worries about sharks in the water, and what got me was this little microorganism,” Houlihan said.

Waterborne pathogens such as S. algae appear to be appearing more frequently in the Northeast. Another serious infection, the flesh-eating bacteria Vibrio vulnificus, killed three people in the New York area this summer. The bacteria enters the body through scrapes or cuts; It can also be ingested by eating raw seafood.

While once seen primarily in Florida and the Gulf of Mexico, V. vulnificus appears to be colonizing new waters. “It used to be very unusual north of the Carolinas,” said Jim Oliver, a microbiologist at the University of North Carolina at Charlotte. “Now it’s pretty routine.”

He is the author of a recent study that found that V. vulnificus wound infections increased eight-fold in the eastern United States between 1988 and 2018. from 10 to 80 infections per year. Cases were identified an average of 30 miles further north each year, according to the study, published in the journal Scientific Reports.

In 2018, infections caused by various species of Vibrio (there are at least a dozen) were regularly reported as far north as Philadelphia. There were more than 1,100 Vibrio wound infections between 1988 and 2018, and 159 deaths. According to the article, infections have become a “microbial barometer of climate change.”

Earlier this month, officials at the Centers for Disease Control and Prevention urged medical providers to consider V. vulnificus a possible culprit if they see an infection in the wound of someone who has been in coastal waters, and immediately start aggressive antibiotic treatment. The infection can kill in just one day.

“Many bacteria, including Vibrio, are more abundant in warm waters, and we know that water temperatures are rising, and this summer we had unprecedented heat waves,” said Joan Brunkard, an epidemiologist at the CDC.

A recent study that tracked Vibrio and Shewanella infections Between 2010 and 2018 in Denmark they found that most cases occurred in years when seawater temperatures were high.

These infections are rarely acquired domestically in northern European countries because mostly coastal seawater is too cold to support high bacterial levels. But warming of low-salinity coastal waters in the Baltic Sea has fueled the growth of the bacteria, increasing the risk of human infections, the authors said.

The researchers found that the number of infections was higher during warmer summers, compared to colder summers. Vibrio and Shewanella infections increased each summer during the study period, the article reported. The summers of 2014 and 2018, which saw very high sea surface temperatures, coincided with a higher number of infections.

The study found that older people, men and children were at higher risk; children probably because they were more likely to get scratches or wounds while doing activities like fishing or rowing, and bacteria only need a small entry point to enter. in the body.

Ear infections, many caused by S. algae, were more common than wound infections, according to the Danish study, which was published in the journal Emerging Infectious Diseases. But V. vulnificus most often causes sepsis, a life-threatening condition that occurs when the body’s defenses damage its own tissues and organs. (Sometimes limb amputations are necessary.)

The problem is not just that waterborne pathogens may be heading to new waters. The populations of the United States and Europe are also aging. Older people, immunocompromised people, people with diabetes, and those with liver disease are particularly vulnerable.

For them, “it’s not a good idea to wade in brackish water in very hot weather,” Dr. Brunkard said.

People who are older or have chronic illnesses should avoid swimming at any time if they have even a small cut or opening in their skin, the CDC says. Even a small puncture point, such as a piercing or a recent tattoo, can open the door to a pathogen.

Houlihan believes the broken toenail was all Shewanella needed. Since his leg became infected, he has been hospitalized three times, for a total of 26 days.

During the first hospitalization he developed high fever and sepsis. Although the fever subsided and Mr. Houlihan was sent home, his pain was intense and he had to return to the hospital on two more occasions.

Large blisters developed on her lower leg and she had to undergo surgery to remove the damaged tissue, leaving a marked crater wrapping around the bottom of her shin.

He now has an open wound on his leg. The bandages must be changed daily and, although she can walk, she does so with some difficulty. Treatment isn’t over yet: He’s scheduled for more surgeries and a skin graft later this month, and will then begin a physical therapy regimen.

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