The old saying is wrong. You CAN be too careful. Somewhere on the globe, probably in the state of Georgia, USA—but today's wired world it could even be in the Republic of Georgia—there are people who heard or read what happened to Aimee Copeland and immediately vowed to themselves that they will never, ever take a kayaking trip, never enjoy larking about a riverbank, never glide along a zip line or venture near the rocks along a stream. Perhaps never leave the house.
And that's the wrong lesson to take from this tragedy. Copeland, 24, has lost her left leg, amputated at the hip. Doctors have been working to save as much as possible of her other extremities, but as of May 21, reports said that she already had lost or was about to lose both hands and the other foot to amputation as well--surgeries necessitated by a freak infection.
Emphasis on the word freak. What happened to Copeland is rare, very rare, even though the microorganism that caused it is common. The bacterium lives in ponds, slow-moving streams, anywhere the water can be a little brackish. In a freshwater river like the one that Copeland was enjoying when her accident happened, however, it's not that common. That adds to the freakishness of what befell her.
On May 1, the lively, athletic, fun-loving graduate student was enjoying a kayaking trip with friends along the Tallapoosa River near Carollton, Georgia. The paddlers stopped to try out a homemade zip line set up on the riverbank. Copeland took a tumble and cut her leg—either on the snapped cable or on a rock (accounts vary). Her friends got her to an emergency room where a doctor closed up the gash with staples and sent her home to heal.
And that should have been the end of the story, except for a return visit to a doctor to get the staples removed from a successfully healed wound. In a vast majority of such incidents, she would have been fine. In this one, she wasn't. The leg hurt terribly. She was prescribed painkillers. It still hurt; she grew weak and pale. Back to the emergency room. By the time a doctor realized what was going on, opened up the wound and confirmed his worst suspicions, it was too late. The leg had to go, along with some soft flesh from her torso. Bacteria had invaded her body and she was in dire danger of death.
The culprit is Aeromonas hydrophila. When this water-dwelling bacterium gets into an environment with little oxygen, as in a closed-up wound in human flesh, it has the terrifying ability to switch gears, as it were, into a rapid anaerobic growth mode, traveling through the bloodstream, attacking the organs and extremities.
The resulting disease, called necrotizing fasciitis, is simply awful and is, of course, to be avoided. But anyone who thinks that staying away from rivers, kayaks, rocks, and fun in the great outdoors is a good idea in light of what happened to Copeland should think again.
Necrotizing fasciitis, often referred to by the horrifying term "flesh-eating disease" is not only rare; it is even more rarely caused by Aeromonal hydrophila from water. The disease is far more likely to be triggered by other kinds of bacteria, most notably antibiotic-resistant strains of staphylococcus or streptococcus.
Where can you hide to avoid those? Virtually nowhere. These bacteria live on the skin of city dwellers who never venture near a swimmin' hole. They lurk in hospitals, despite rigorous cleaning and sanitizing. They get into wounds during surgery in a supposedly sterile operating room. Not often, but it happens.
Reason for terror? No. But a reason for caution. In another reported case of necrotizing fasciitis, a New Orleans woman contracted the disease by injecting a recreational drug called "bath salts" (not the kind you dissolve in the tub) into her forearm. She lost that arm, a shoulder, and breast. By no means should you do what she did. Another drug user, this one a Mississippi woman, lost both legs after injecting drugs. Don't do it.
What else can you do to stay safe from the flesh-eating disease? Pay attention. If a simple spider bite turns color, becomes very painful, or blisters, get medical attention immediately. Jeff Hanneman, guitarist for the thrash-metal band Slayer waited a little too long to get what he thought was a minor infection checked out and almost lost an arm. He is recovering from multiple skin grafts.
There are reasons why strains of staphylococcus, streptococcus and other microorganisms aren't killed by common antibiotics, and thus are able to run amok when they get into a wound. Those include the way these drugs have been overprescribed and misused. Antibiotics don't work on viruses. They won't help when you have a cold. If you use penicillin, Amoxicillin Ampicillin, or any other antibiotic when you don't need it, you risk contributing to the problem of antibiotic-resistant bacteria. For the same reason, you should never stop taking a prescribed antibiotic as soon as you feel better, before using up the prescription. The bacteria that were causing your illness have been killed back enough to relieve your symptoms, but the ones surviving are the ones that stood up best to the medicine, which you quit taking before its job was done. Those surviving bacteria are left to reproduce, and to pass along to subsequent generations of bacteria whatever trait it was that made them tough to kill.
So, not misusing antibiotics is another thing you can do to avoid flesh-eating bacteria. And, just as importantly, to make it less likely that others get the rare disease. Beyond that, wash your hands—always after you use the bathroom, always before you handle food. Yes, it's common sense. Yes, it's what your mother nagged you to do. And yes, it's important. Use soap.
But don't, whatever you do, look at the case of Aimee Copeland and decide not to go outside, not to enjoy nature, not to be active and take a few physical risks. Okay, trying out the home-made zip line probably wasn't a great idea. But what Copeland and her friends were doing—playing, using their bodies, their muscles, having adventures—is far more likely to result in good health than sickness.
The World Health Organization reports that seventeen million people die of cardiovascular disease—especially heart attacks and strokes—every year. What contributes to heart attacks and strokes? Poor diet and lack of exercise. Especially lack of exercise. Recent studies have found that the simple act of sitting, especially sitting for long hours, as in front of a computer screen, actually damages a person's health. When you sit, your muscles aren't regularly performing the contractions needed to clear dangerous levels of glucose and fats from the blood stream. That's a far greater risk than any kayak trip.
According to the Centers for Disease Control and Prevention, almost 600,000 Americans died in 2010 of heart disease alone and nearly 130,000 of strokes. Add to that the number of people disabled by these and other cardiovascular diseases. Then consider the thousands who die or suffer as a result of diabetes and other lifestyle-related illnesses. It should become apparent to even the most germaphobic that everyone is better off getting out and getting active. Hiding away won't protect you. Sitting around could actually kill you.
So how to be safe? You can't be completely safe. Life involves risks. Cars crash. Earthquakes and tornadoes happen. The best advice is to use common sense. Eat sensibly. Drive carefully. Wear a helmet. All that stuff. Observe common safety practices. Learn first aid. When you venture on a strenuous hike or rafting trip, carry a rudimentary first-aid kit. And if you or a friend are injured in or near water—pond, stream, or even a rushing river—make sure you tell the doctor where it happened. (An alert physician should be aware of any risks.)
Beyond that, have fun. It's good for you.