July record-breaking for Vibrio infection deaths in NC; 1 confirmed on Outer Banks

Three North Carolina residents — including one from the Outer Banks — died from Vibrio vulnificus infections in July 2023. That is a monthly record, according to a North Carolina Department of Health and Human Services spokesperson.

Vibrio is naturally occurring in warm seawater and in brackish water — a mix of fresh and salt water, such as in estuaries and salt marshes — according to a July 28 state health department news release announcing the deaths and urging caution when entering North Carolina or other East Coast waters.

Two of the three deaths followed scratches exposed to brackish water in North Carolina and another East Coast state, the release said. The third case also had brackish water exposure in North Carolina, and that individual also consumed personally-caught seafood that was not shared nor commercially distributed, according to the release.

“No links have been identified between the cases or the areas where they were likely exposed to Vibrio, and public health investigations are ongoing,” the release said.

“Three deaths in one month had not been previously reported,” state Health and Human Services spokesperson Kelly Haight Connor said in an Aug. 1 email.

The department is not releasing further information about the people who died due to privacy concerns, Connor said.

Four days before the state’s press release, the Dare County Department of Health and Human Services confirmed the death of an Outer Banks resident from Vibrio, the county’s first reported Vibrio death since July 1, 2017.

The county department was notified of a confirmed Vibrio case July 20 and learned of that person’s death July 24, Dare County Director of Public Health Sheila Davies said in a July 24 email.

Family members of Nags Head resident Michael “Mike” Gard, 71, believe he was Dare County’s Vibrio death, but they do not yet have confirmation or a death certificate for him.

Davies in her email would neither confirm nor deny that it was Gard, since names are protected health information.

“It has to be, because of the timing,” opined Gard’s niece, Michelle Halfin. “I pray to God that it is him. I don’t want another family to have to go through this.”

Gard died the afternoon of Friday, July 21, after his girlfriend, Elaine Piddington, said he scratched himself Sunday, July 16, on a crab pot he was moving with her by boat south of Colington Island in Buzzard Bay, which is part of the Albemarle Sound — a body of brackish water.

A retired paramedic of almost 15 years, Halfin said the way the infection on his leg looked just one day after he scratched it and how quickly “something was attacking his body to make him shut down that fast” also leads her to think Vibrio took her uncle.

According to a 2015 article on Vibrio vulnificus published online on the National Institutes of Health’s National Library of Medicine, the “pervasive” and “opportunistic” bacterium can metabolize in oxygenated or nonoxygenated environments and can cause “rapid septicemia,” which is poisoning of the blood.

Halfin said Gard called her Monday evening after having scratched himself 24 hours prior, and she advised him to go to the hospital immediately for a tetanus shot. He went to Outer Banks Health in Nags Head and was discharged that night with a diagnosis of “cellulitis” after receiving a tetanus shot, oral pain medicine and antibiotics. Just 36 hours after his wound, he was “septic” and had to be flown by helicopter to the hospital in Greenville, North Carolina, she said.

“He was in multisystem organ failure when he got there Tuesday,” Halfin said.

She said the family has Gard’s ashes but not his medical records nor his most recent testing results. She and her uncle, Gard’s older brother, JT Gard, each said on Aug. 7 that the family is still waiting on the state medical examiner, with an unspecified timeline, for his death certificate.

They were informed the state was taking over, and “instead of the doctor signing the death certificate, the examiner’s going to do it,” JT Gard said.

Since 2019, eight of the 47 reported Vibrio vulnificus cases in North Carolina residents have been fatal, including the three this July, according to the state health agency’s news release.

While the release called Vibrio cases “rare,” with most reported in the warmest months of June through September, it noted that reports of Vibrio infections associated with brackish water contact have been increasing over the past few decades.

The geographic range of waters associated with infection is “spreading north along the East Coast of the U.S. due to increasing water temperatures,” and more Vibrio cases are expected “as climate change increases water temperatures,” according to the release.

Recommendations to help reduce people’s chances of exposure and infection include staying out of seawater and brackish water, including wading at the beach, if one has a wound, including from a recent surgery, piercing or tattoo.

The health agency also recommends covering wounds with waterproof bandages if they could come in contact with saltwater, brackish water or raw or undercooked seafood; getting out of the water if any wound is sustained; thoroughly washing wounds with soap and water after contact with saltwater, brackish water or raw seafood; and cooking all shellfish to an internal temperature of at least 145 degrees Fahrenheit for 15 seconds.

Vibrio is “the leading cause of seafood-related deaths in the United States,” according to the 2015 National Library of Medicine article on the bacterium.

Connor stressed that “all warm brackish and salt water poses a risk of infection” and said that people should contact a health care provider if they see signs of a skin infection or other symptoms, such as diarrhea, stomach pain, vomiting, nausea, fever or chills, after contact with brackish water or seawater.