Since Friday October 31^st is All Hallows’ Eve, commonly call Halloween, I thought some extra horror was in order today. I won’t bore you with what you already know about Halloween: that it’s the eve of All Saints’ Day in many Christian religions and historically is the Festival of the Dead with deep pagan roots.

In modern times, however, 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 clinical pharmacy background and having dealt with many unusual bacterial infections in my career, I know that 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 increase to two important issues: better diagnostic tools that more accurately identify the culprits and the failure of standard antibiotic therapies due to resistant strains.

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? Medically, the disease is known as necrotizing fasciitis, a relatively rare infection of the deeper layers of skin and the tissue that lies underneath (the subcutaneous tissue).

Once the offending bacteria invade subcutaneous tissue, they spread easily throughout the layers and cause irreversible tissue damage.

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

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

Early initiation of potent 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 deadly toxins. So vital muscle tissue is often destroyed well before the disease is even identified.

When the infectious process gets to that point, the only sure treatment is removal of the infected area to prevent toxin migration into surrounding skin and muscle. When the infection spreads to large muscle areas, amputation is sometimes the only option remaining to prevent further spreading into healthy tissue.

Several types of bacteria are considered flesh-eating entities. Surprisingly, the most common are those that ARE the most common, and that’s where the real horror lies.

Staphylococcus aureus—the simple bacterium that causes pimples, boils and abscesses—can be quite aggressive and deadly. 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 cause strep throat are the next most common flesh-eating bacteria and they can be as deadly as Staph aureus.

So when we’re thinking of all the ghouls and goblins that show up on Halloween, you might think about taking a closer 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!