Doctors puzzled as bacterium turns killer

Two people are dead and three others recovering after what is believed to be the first outbreak of a rare infection that can kill within hours. Doctors in Gloucestershire are being warned to watch for symptoms of the infection, which can start in minor wounds such as insect bites or an in-growing toe-nail.

Immediate surgery is needed to remove the infected tissue because of gangrene, followed by intensive antibiotics.

The bacterium, haemolytic streptococcus Group A, is carried by about 10 per cent of people, living harmlessly in the throat and nasal passages and sometimes on the skin. Very rarely it can get below the skin and infect muscle and fat, 'liquefying fat cells with frightening speed and killing tissue', according to Dr Keith Cartwright, director of the Gloucester public health laboratory. A cluster of five such cases is unheard of. The Public Health Laboratory Service in London, monitoring the outbreak, said an average of 10 cases would be expected each year, but in individuals in different parts of the country.

Dr Cartwright said last night: 'I can't find (reports of) any other clusters in the literature I've looked at so far.'

Why the bacterium should become so virulent is 'puzzling', he said. One theory is that it has become infected with a virus which has 'switched on' genes that make the microbe more dangerous.

The first cases occurred in February in two patients, Les Christie and Helen Sackett, who had been operated on at Stroud General Hospital. They developed serious infections in their wounds, needing emergency surgery, and later received skin grafts.

Mr Christie, who was admitted to Stroud General for a hernia operation, said last night: 'It was a terrifying thing. The infection eats away at the fat under the skin at the rate of several inches an hour. It is like something from a science fiction film . . . . I have been told that if they had not operated on me to remove the affected skin within eight hours I would have been wheeled out in a coffin.'

No common source of infection has been identified, and three of the patients - who lived up to 30 miles apart - were infected with non-related sub-groups of the bacterium.

Public health officials feared the operating theatre at Stroud General was the source of infection and it was closed for a week for biological cleansing. However, further investigations identified three more people infected with the bacterium, who were admitted to Gloucestershire Royal Hospital as emergency cases.

Two, a man in his 50s from Gloucester and a woman in her 60s from the Forest of Dean, died in mid-April. Irwin Wilson, manager of the hospital, said last night that the infection was the main cause of the woman's death and a contributory factor to the man's death.

Toxins produced by the bacteria can cause nausea and diarrhoea, breathing problems and kidney failure. Elderly people and diabetics are at greatest risk.