The convergence of climate, recreation and health: La Niña, crab catching and necrotising fasciitis, a case series

Early Abstract:

Context: Necrotising fasciitis is a rapidly progressing, life-threatening soft tissue infection that carries a high morbidity and mortality, especially in susceptible populations.
Issue: During the La Niña Spring–Summer–Autumn of 2021/2022, five male patients aged between 59 to 86 were admitted into the Hervey Bay Hospital (Queensland, Australia) intensive care unit (ICU) with necrotising fasciitis and multiorgan failure. All five patients had been in saltwater rivers within the local Fraser Coast area and either hunting for the Scylla serrata (commonly known as green mud crabs), or descaling barnacles from their vessels. Following rapid and extensive surgical intervention and aggressive antibiotic and supportive treatment, all five patients were either discharged home or are currently in rehabilitation.
Lessons learned: With a strong possibility of future floods due to climate change and the cyclic return of the La Niña in the future, this article highlights a potential public health issue. This case series demonstrates the importance of increased vigilance for necrotising fasciitis by frontline healthcare staff post-flooding waters. Identification and escalation of a potential public health warning about the need for vigilance by people experiencing even the smallest of injury by green mud crabs or barnacles post-flood event may need to be considered.
Keywords: barnacles, flood waters, green mud crabs, necrotising fasciitis, La Niña, Scylla serrata.