A description of necrotizing fasciitis, sometimes called flesh eating disease, reads like a horror novel.

Powerful bacteria storm a person’s body, releasing toxins, destroying tissue and eventually triggering organ failure unless doctors can stop the rampage.

In January, Liam Flanagan from Pilot Rock died after he wrecked his bike and cut his leg. A doctor sutured the wound with seven stitches. He seemed on the mend — until an infection started to rage. Over the next days, surgeons were forced to amputate parts of the second grader’s body. He died on Jan. 21 at age 8.

The story prompted a lot of angst from parents on social media about risk to their own children. But, should they worry?

Dr. Paul Cieslak, medical director for communicable diseases and immunizations with the Oregon Health Authority, cautions against overreacting.

“The fact is, it is very, very uncommon,” he said. “Those most at risk have underlying immune system problems such as diabetes, liver disease or AIDS.”

According to the Centers for Disease Control and Prevention, between 700 and 1,100 cases were reported each year since 2010 in the United States. In 2016, in Portland’s tri-county area of 1.8 million people, there were five cases of necrotizing fasciitis.

The culprit is most often is a bacterium called group A streptococcus.

“It lives in the pharynx (throat) in a certain percentage of the population,” Cieslak said. “It causes strep throat in children.”

The bacteria is common, but occasionally it can go on the attack, entering a break in the skin and wreaking havoc.

“People often fail to realize the pathogenic potential of the bacterium,” Cieslak said. “It gets my vote for the nastiest bacterium out there.”

“Necrotizing” means “killing,” he said. The bacteria gets into the fascii, the connective tissue under the skin that stabilizes muscles and other organs, and begins to kill tissue.

“Once the bacteria gets into the fascial layer, the main thing needed is surgery to scoop out the dead tissue,” he said. “Without that, it can kill you within hours. It moves very rapidly.”

Parents should be on the lookout for four important indicators: pain, redness, heat and swelling.

Since the bacteria does its work deep under the skin, sometimes pain is the most prominent sign that something is seriously wrong.

“The pain,” Cieslak said, “is out of proportion to what you see.”

He’s seen more than one case. Once an infection gets past a certain tipping point, he said, all you can do is call the surgeon.

His advice? Don’t waste time worrying, but stay vigilant when signs of infection appear.


Contact Kathy Aney at kaney@eastoregonian.com or 541-966-0810.

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