EAST LANSING, Mich. — In the largest study of its kind, Michigan State University researchers have found that the prevalence of necrotizing fasciitis (NF), or more commonly known as “flesh-eating disease,” is quite rare among children, despite many reports to the contrary.
Published in a recent issue of The Journal of Pediatrics, the work of Dele Davies, chairperson of MSU’s Department of Pediatrics and Human Development, and former MSU faculty member Ihuoma Eneli, found that among children under the age of 16, statistically fewer than three in 1million get the disease.
“In context,” Davies said, “one has a better chance of getting struck by lightning.”
However, the research was necessary because it marked the first time a larger-scale study was conducted on the prevalence of NF. Until now, all reports on children with NF had been anecdotal at best.
“What we wanted to do over a period of time was track a whole population, trying to identify the cases, so we could see just how common it is,” Davies said. “We also wanted to establish how the cases were managed, what the outcomes were and just get a sense of the burden of the disease.
“This also gives us a better sense of how to counsel families and to give them a better idea of what to expect.”
In this study, Davies and colleagues found 36 cases involving children less than 16 years of age during a two-year period. They found that the incidence of the disease was greatest during the first five years of life with an overall annual incidence of 5.9 per million in that age group.
They also determined that about 5 percent of children who contract the disease die from it.
“Children don’t seem to die as much from this disease,” Davies said, “but they do get awfully sick. All of the kids in our survey had surgeries and one had an amputation. Virtually all had some long-term complication.”
The work also helped researchers validate some research findings related to NF, in particular the association of the disease to chickenpox.
“We wanted to do this around the time the chickenpox vaccine was being introduced in Canada,” Davies said. “There is an association between flesh-eating disease and chickenpox. In fact, the rate of risk is about 50 times higher with kids who have had chickenpox.”
The chickenpox vaccine was introduced in the United States in the mid-1990s. It was introduced in Canada around 2000.
Davies said the most prevalent symptom of NF is pain, often excruciating pain.
“This is an infection of the tissue just beneath the skin,” he said. “Then it can spread to other areas – fat or muscle – and is in this closed area. It can then stretch the fibers and cause awful pain.”
He noted that the disease is very treatable, if detected early.
Davies and Eneli gathered their data from the Canadian Paediatric Surveillance Program, a joint project of the Center for Infectious Disease Prevention and Control of Health Canada and the Canadian Paediatric Society.
The work was funded by a grant from the Canadian Paediatric Society and Health Canada.
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