What to know before the next time you go for a dip. 

By Christina Oehler
August 27, 2019

A man from Orlando, Florida, is currently in critical condition after doctors were forced to remove 25% of the skin on his body due to a flesh-eating bacteria—and the news is raising some questions about just how you can develop the infection in the first place.

David Ireland, 50, was diagnosed with necrotizing fasciitis in group A Streptococcus (group A strep) after being admitted to the emergency room—and eventually the intensive care unit (ICU)—at a Florida hospital after showing flu-like symptoms, according to a GoFundMe page set up by his brother, Daniel Ireland.

Since being admitted to the hospital, David has undergone three separate surgeries to remove a quarter of the skin on his body. According to the GoFundMe page, David's kidneys have also failed, but his "blood pressure and acid numbers from his liver are starting to level off, showing a hopeful sign of recovery."

It’s unclear exactly how David picked up the infection, but Daniel told the Miami Herald, that David, a father of two, swims in the pool at his condo, but does not go in lakes or the ocean. That bit of information begs the question: Can you only get flesh-eating bacteria from natural bodies of water (lakes, rivers, oceans)—or can you also get it from pools and hot tubs? 

RELATED: A Hiker Developed a Near-Fatal Infection With Flesh-Eating Bacteria. Here's How to Make Sure This Doesn’t Happen to You

Well, can you get flesh-eating bacteria from a pool? 

Unfortunately, yes. Typically, these flesh-eating bacteria can be found in both fresh and saltwater, says Vanessa Raabe, MD, assistant professor and infectious disease specialist at NYU Langone Health. While the bacteria is less common in pools and hot tubs because of their chlorine content (which is meant to kill any harmful bacteria), it's only a lesser risk, "but doesn't completely eliminate it," she says. (Just FYI: The CDC recommends a pH 7.2–7.8 and a free chlorine concentration of at least 1 ppm in pools and at least 3 ppm in hot tubs/spas). 

The specific type of bacteria that commonly causes necrotizing fasciitis (or flesh-eating bacteria), a strain of group A strep, can be extremely aggressive, says Dr. Raabe. According to the CDC, the bacteria typically enter the body through a break in the skin, like a cut, burn, rash, or even an insect bite. Once in the body, the bacteria are very fast-acting: "They can get in and set up shop within a matter of hours," says Dr. Raabe—which can lead to symptoms like red or swollen skin in the affected area, severe pain, and fever. As the infection progresses, it can cause oozing pus, color changes on the skin, and skin ulcers.

In the earlier stages, antibiotics are used to treat the infection. However, if the bacteria have destroyed too much tissue, doctors may need to remove the dead tissue to prevent the spread of the infection, states the CDC. In some cases, necrotizing fasciitis can cause sepsis, organ failure, and death. 

While contracting flesh-eating bacteria is extremely rare, you should still have it on your radar and know how to protect yourself. Staying out of the water if you have a cut, scrape, or any kind of break in your skin is your best option, says Dr. Raabe. "If you are going to go in the water, the best thing you can do is cover [the damaged] skin with a waterproof dressing." It's also smart to check any body of water you're going to for any recent advisories or issues. 

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