Since today is All Hallows’ Eve, commonly called Halloween, I thought a little bit of horror was in order.  I won’t bore you with what you already know: that it’s the eve of All Saints’ Day in some Christian religions and historically is the Festival of the Dead with deep pagan roots.

In modern times, Halloween has evolved into a day and night of fun and festivities in which the more outrageous and ridiculous wins over anything normal and real.  Most popular in recent years are zombie festivals to celebrate Halloween with a healthy dose of flesh-eating creatures, and the costumes are enough to scare the most jaded.

But with a medical background and having dealt with many unusual bacterial infections in my career, I know there are real flesh-eating creatures out there that can put a zombie wannabe to shame.

The real horror story is that flesh-eating bacteria exist and cases are definitely on the rise.  Medical professionals attribute the increased incidence to two important reasons: better diagnostic tools that more accurately identify the culprits before they kill and the failure of standard antibiotic therapies due to resistant strains (more on that in a minute).

About 750 people each year suffer from such infectious attacks and one in five die as a result.  That’s a 20% death rate!  The odds that you could outrun a zombie would be better than escaping these deadly bacteria once they get under your skin.

So what are flesh-eating bacteria and how do they attack us?  Medically, the disease is known as Necrotizing Fasciitis, a relatively rare infection of the deeper layers of skin and the tissue that lies under skin (the hypodermis or subcutaneous tissue).  Once the offending bacteria invade subcutaneous tissue, they spread easily within the hypodermal layers and cause irreversible tissue damage.

But the term “flesh-eating” is a misnomer since bacteria don’t actually eat flesh.  Instead, they cause destruction of skin and muscle tissue by releasing toxins that destroy muscle.  The bacteria attack the underlying tissue by entering the skin through a scratch or cut.  Without an entry into the subcutaneous tissue, any of these bacteria usually remain relatively harmless; but give them an opening to underlying muscle tissue and they can be deadly.

Patients often experience flu-like symptoms initially, and this can delay proper diagnosis.  Initial symptoms include nausea, vomiting and dizziness.  Progression to localized pain, swelling, a purplish discoloration, scaling and peeling of skin usually signal the patient and caregiver that something more serious is going on; but that’s when it’s almost too late.

Early initiation of specific antibiotic therapy is crucial to prevent the spread of infection to surrounding tissue, but it can take less than 24 hours for these bacteria to invade and produce destructive toxins that destroy tissue.  So vital muscle is often lost well before the disease is identified.

At that point, the only sure treatment is removal of the infected area to prevent toxin migration into surrounding skin and muscle.  Skin and muscle grafts are then utilized to replace removed tissue.  When the infection has spread to large muscle areas, amputation is sometimes the last treatment option remaining to prevent further disease from spreading into healthy tissue.

Several types of bacteria are considered flesh-eating entities.  Surprisingly, the most common are those that are literally the most common, and that is where the horror lies.

Staphylococcus aureus—the simple bacterium that causes pimples, boils and abscesses—can be quite aggressive and deadly.  It’s the bacterium behind many pneumonias and toxic shock syndrome.  The medical community is becoming more and more concerned about these bacteria because a certain type, the Methicillin-resistant Staph A (MRSA), is resistant to most antibiotics and few new antibiotics are effective against this strain.

Group A Streptococcus, the bacteria that causes strep throat, and Clostridium perfringens, the bacteria from marine sediment and decaying vegetation that results in gangrene, are the next most common flesh-eating bacteria and they can be as deadly as Staph aureus.

So when you’re thinking about all the ghouls and goblins that show up on Halloween, you might think about taking a microscopic look at your skin to see the real ghouls of nature and, like a vampire, don’t invite them in.

Thoughts?  Comments?  I’d love to hear them!