Rare Bacteria Infects Leg of Triathlete, 35

A 35-year-old Santa Barbara triathlete stricken with a rare and virulent streptococcus infection--which has become notorious as the “flesh-eating” bacteria--was better Thursday afternoon, but remained in critical condition at the Sherman Oaks Hospital burn center.

The infection--the same type that set off alarming news reports when a cluster of seven cases was reported in Gloucestershire, England, this spring--apparently entered the man’s system through a shaving cut on his leg during a bicycle ride Sunday afternoon and spread rapidly, doctors said.

Bernie Donner, a Santa Barbara lifeguard and a popular swim camp counselor has already lost half the muscle tissue in his left leg to the infection known as “necrotizing fasciitis”, physicians said.

But doctors are hopeful they have stopped the infection from spreading to Donner’s abdomen, which almost certainly would be fatal, said Dr. A. Richard Grossman, the burn center’s medical director, who is attending Donner.

Donner spent most of Thursday in the hospital’s pressurized hyperbaric chamber, which forces more oxygen into the blood, in the battle against the necrotizing fasciitis, a deadly strain of a common and ordinarily much weaker germ, Group A streptococcus. Sherman Oaks is one of the few hospitals with such a chamber.

Necrotizing fasciitis bacteria thrive in “an anaerobic environment,” places where there is little oxygen, Grossman said. “They love dark, dank places.”

Donner was taken by helicopter to the burn center Wednesday night, after initially being treated by doctors at Santa Barbara Cottage Hospital.

Donner will undergo surgery today to remove dead tissue from his ravaged leg. Doctors will close the wound, which extends from Donner’s groin to his ankle, with skin from a cadaver, Grossman said.

“We will begin to graft that wound with his own skin” on Monday, Grossman said.

Donner is lucky to be in excellent physical condition, Grossman added. Triathletes compete in arduous, and often long, swimming, bicycling and running events.

When Group A strep invades the softer tissue of the abdomen, Grossman said, it “literally ends up eating a hole in the belly from the inside out.”

In Donner’s case, “Fortunately, it stopped at his pelvis,” Grossman said. “If we can get through the next four days, pumping him full of antibiotics, plasma, and getting him through the next two operations, he might be out of the woods.”

Donner is also lucky his mother is a retired nurse.

When he became sick with nausea and vomiting Sunday night, she insisted over his objections on rushing him to Santa Barbara Cottage Hospital. He was admitted there about 11 p.m.

Besides the toxic strep infection, Donner was also suffering from toxic shock caused by a staphylococcus bacteria and his condition rapidly worsened, Grossman said, until by 1:30 a.m., “his blood pressure was 70 over nothing,” he said.

Most Group A infections cause nothing more than strep throat, but over the last five years, scientists have tracked the spotty re-emergence of a highly virulent strain that had been dormant for a half century or more and was nearly nonexistent in the late 1970s and early 1980s. British health officials say the lethal organisms have caused more than a dozen deaths in their country this year.

Tabloid newspapers have had a field day with “the flesh-eating bacteria”--a catchy phrase that is technically inaccurate but catapulted Group A strep from scientific curiosity to headline disease.

U.S. statistics are incomplete. Only 22 states require doctors to report Group A strep infections to health officials, although the recent furor has caused an upsurge in reporting. In fact, Group A was blamed for the death four years ago of Jim Henson, creator of the Muppets.

The federal Centers for Disease Control and Prevention estimates that in 1990, the last year for which it gathered figures, there were 10,000 to 15,000 severe cases of Group A strep in the United States, resulting in 2,000 to 3,000 deaths.

Of those, 500 to 1,500 included necrotizing fasciitis, so called because it causes the death of the fascia, the tissue that binds skin to muscle.

Although the incidence of the infection is up from the early 1980s, the numbers are minuscule compared to the many thousands of routine strep throat infections reported each year. The organism is so common it has been called “an occupational disease of schoolchildren.” Experts estimate that 10% to 15% of all pupils are infected at any given time.

Grossman said Donner apparently acquired the airborne toxic strain of the infection through a small cut he received while shaving his legs--a common practice among competitive bicyclists and triathletes--before going out for a 35-mile ride Sunday near Santa Barbara.

Grossman said he did not know the exact route Donner took on that ride, but said he could have picked up the bacteria “just riding along Pacific Coast Highway.”

On Wednesday, Donner underwent five hours of surgery to remove dead tissue from the infection site, his left leg from thigh to ankle. Samples of that tissue revealed that he had raging infections from both the Group A strep and staph bacteria.

Donner has been a well-liked summer staff member of the Santa Barbara Parks and Recreation Department for the past five years, said Joan Russell, the department’s recreation programs manager.

“He’s great stuff and we’re concerned about him,” she said. “He works very well with kids and he’s very responsible.”

Russell said that during the rest of the year Donner, a trained private investigator, works for his father, who is also an investigator.

Donner is a Santa Barbara native, she said. His wife, Laura, is a fellow swimmer he met two years ago, when both worked as counselors at a summer swim camp sponsored by the parks department, Russell said.

Both Donner’s wife and his sister have remained by his side, staying in an nearby apartment owned by Sherman Oaks Hospital.

Donner’s family, through a Sherman Oaks Hospital spokesman, declined to be interviewed.