{
  "slug": "vibrio-vulnificus-wound",
  "question": "What are the odds a US adult contracts a flesh-eating Vibrio vulnificus infection after warm-coastal-water exposure?",
  "category": "health",
  "tags": [
    "travel"
  ],
  "no_reliable_estimate": false,
  "perceived": {
    "description": "The 'flesh-eating bacteria' headline cycle that recurs every Gulf-Coast summer makes the infection feel like a routine hazard of going in the water. No published survey measures how Americans rate their own odds, so the perception here is inferred from media salience rather than polled. The felt risk is plausibly orders of magnitude above the reported incidence: a few dozen severe cases a year across the entire US, concentrated in older men with liver disease, set against tens of millions of beach visits.",
    "rough_estimate": "Many coastal swimmers treat any cut plus seawater as a live flesh-eating-bacteria threat; the reported population rate is roughly 1 in 30,000 over a lifetime.",
    "kind": "intuition"
  },
  "native": {
    "display": "about 150 to 200 reported infections a year in a country of ~335 million",
    "numerator": 175,
    "denominator": 335000000,
    "unit": "reported V. vulnificus infections per person per year (all exposure routes, US)",
    "population": "US general population, all ages"
  },
  "normalized": {
    "lifetime_us_adult": 0.0000312,
    "display": "about 1 in 32,000 over a lifetime (US adult, all routes)",
    "log_value": -4.505,
    "assumptions": "CDC reports 150-200 V. vulnificus infections nationally each year (all exposure routes; wound contact with warm salt/brackish water is the predominant non-foodborne route). Midpoint 175 cases over a US population of ~335,000,000 gives an annual incidence of 175 / 335,000,000 = 5.22e-7 per person-year. Applying the site's 59-year remaining-life horizon for a US adult (age 18 onward): 5.22e-7 x 59 = 3.08e-5, rounded to 3.12e-5 (~1 in 32,000). This is a population average across the entire US, including landlocked residents who are effectively at zero exposure; the conditional risk for someone wading in warm Gulf water with an open wound is materially higher (see regional_breakdown and personal_factor_multipliers). The uncertainty band (1.5e-5 to 7e-5) is wide and asymmetric upward because (1) surveillance under-ascertains mild, unconfirmed wound infections and state reportability varies, and (2) the rate is non-stationary: East-Coast wound infections rose roughly eightfold from 1988 to 2018 and the northern range edge has moved ~48 km/year, so a lifetime spanning the coming decades likely sees a higher integrated incidence than the back-cast 2024 baseline.",
    "uncertainty": {
      "low": 0.000015,
      "high": 0.00007
    },
    "scope": "us_adult_lifetime"
  },
  "sources": [
    {
      "url": "https://www.cdc.gov/mmwr/volumes/73/wr/mm7304a3.htm",
      "title": "Notes from the Field: Severe Vibrio vulnificus Infections During Heat Waves — Three Eastern U.S. States, July–August 2023",
      "publisher": "CDC MMWR",
      "source_type": "govt_report",
      "statistic": "150-200 V. vulnificus infections reported to CDC annually; ~20% fatal; wound contact with salt/brackish water is a transmission route",
      "excerpt": "In the United States, 150–200 V. vulnificus infections are reported to CDC annually, approximately 20% of which are fatal. V. vulnificus can infect open wounds through contact with salt water, brackish water, or raw seafood.",
      "source_date": "2024-01-25",
      "source_accessed": "2026-06-13",
      "calculation_notes": "Supplies the national numerator (175 midpoint) and the all-route framing. 175 / 335,000,000 US population = 5.22e-7/year; x59-year horizon = 3.08e-5 lifetime.",
      "independence_note": "Federal surveillance source (COVIS); independent of the FL/LA state reports and the climate-projection study."
    },
    {
      "url": "https://www.floridahealth.gov/diseases-and-conditions/vibrio-infections/vibrio-vulnificus/index.html",
      "title": "Vibrio Vulnificus",
      "publisher": "Florida Department of Health",
      "source_type": "govt_report",
      "statistic": "Florida 2024: 82 cases, 19 deaths (record); 2023: 46/11; 2025: 33/5; hurricane-linked spike",
      "excerpt": "In 2024 Citrus, Hernando, Hillsborough, Lee, Pasco, Pinellas, and Sarasota counties experiences unusual increase due to the impacts of Hurricane Helene.",
      "source_date": "2026-06-13",
      "source_accessed": "2026-06-13",
      "calculation_notes": "FL record year 82 cases / ~22.6M residents = 3.63e-6/yr; x59 = 2.1e-4. Typical ~45 cases/yr -> 1.2e-4 lifetime for a FL resident. Used for regional_breakdown.",
      "independence_note": "State surveillance, independent of CDC national tally and the LA report."
    },
    {
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10036314/",
      "title": "Climate warming and increasing Vibrio vulnificus infections in North America",
      "publisher": "Scientific Reports (Nature Portfolio)",
      "source_type": "peer_reviewed",
      "statistic": "Northern range edge moved ~48 km/year; total reported cases rose from ~10/yr (1988) to ~80/yr (2018); projected doubling by 2041-2060",
      "excerpt": "The total reported V. vulnificus cases has increased, from around 10 p.a. in 1988 to around 80 p.a. by 2018.",
      "source_date": "2023-03-23",
      "source_accessed": "2026-06-13",
      "calculation_notes": "Establishes non-stationarity. The ~8x rise over 30 years and ~48 km/yr northward migration (0.43 deg p.a.) justify the upward-skewed uncertainty band and the rising-trend caveat.",
      "independence_note": "Independent academic modeling study (UEA/NOAA), separate from CDC/state surveillance press releases."
    },
    {
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4598054/",
      "title": "Pre-existing medical conditions associated with Vibrio vulnificus septicaemia",
      "publisher": "Epidemiology & Infection (Cambridge University Press)",
      "source_type": "peer_reviewed",
      "statistic": "86% of 1,212 US cases male; liver disease aOR 4.1 for septicemia after non-foodborne (wound) exposure, 5.1 after foodborne",
      "excerpt": "A total of 1212 patients with Vv infection were reported; 86% were male.",
      "source_date": "2015-04-13",
      "source_accessed": "2026-06-13",
      "calculation_notes": "86% male over ~50% population share -> male incidence ~1.72x, female ~0.28x population average. Liver-disease aOR 4.1 (wound route) used as the severity/septicemia multiplier with an explicit pathway caveat.",
      "independence_note": "Peer-reviewed analysis of CDC COVIS data; demographic and comorbidity figures independent of the climate study."
    },
    {
      "url": "https://www.wafb.com/2025/09/16/fifth-louisiana-death-confirmed-vibrio-surge-continues-across-gulf-coast/",
      "title": "Fifth Louisiana death confirmed as Vibrio surge continues across Gulf Coast",
      "publisher": "WAFB / Louisiana Department of Health",
      "source_type": "news_article",
      "statistic": "Louisiana 2025: 26 cases, 5 deaths by mid-September vs 10-year average of ~10 cases/1 death; 85% wound/seawater exposure",
      "excerpt": "an average of 10 Vibrio vulnificus cases and one death have been reported annually in Louisiana",
      "source_date": "2025-09-16",
      "source_accessed": "2026-06-13",
      "calculation_notes": "LA decade average 10 cases / ~4.6M = 2.17e-6/yr; x59 = 1.3e-4 lifetime for a LA resident. 2025 surge (26 cases) used to illustrate upper-tail year. News article relays LDH figures (LDH page itself returns 403 to automated fetch).",
      "independence_note": "Relays Louisiana Department of Health surveillance numbers; corroborates the Gulf-state regional incidence independently of Florida DOH."
    }
  ],
  "comparison_anchors": [
    {
      "label": "Lightning strike (lifetime, US)",
      "lifetime_us_adult": 0.00000478
    },
    {
      "label": "Plane crash death (lifetime)",
      "lifetime_us_adult": 0.000017
    },
    {
      "label": "Drowning (lifetime, US)",
      "lifetime_us_adult": 0.000725
    },
    {
      "label": "Food poisoning death (lifetime)",
      "lifetime_us_adult": 0.000537
    }
  ],
  "regional_breakdown": [
    {
      "region": "United States (population average)",
      "probability": 0.0000312,
      "notes": "150-200 reported cases/year over ~335M population, x59-year horizon. Includes interior states with negligible exposure, which pulls the average down."
    },
    {
      "region": "Florida (Gulf/Atlantic coastal state)",
      "probability": 0.00012,
      "notes": "Typical recent years run ~40-50 cases over ~22.6M residents; (45/22.6M)x59 = 1.2e-4. The 2024 record of 82 cases / 19 deaths followed back-to-back hurricanes Helene and Milton and represents an upper-tail, flood-driven year (82/22.6M x59 = 2.1e-4)."
    },
    {
      "region": "Louisiana (Gulf coastal state)",
      "probability": 0.00013,
      "notes": "10-year average ~10 cases/year over ~4.6M residents; (10/4.6M)x59 = 1.3e-4. 2025 was an outlier surge: 26 cases and 5 deaths by mid-September, ~2.6x the decade average, with 85% reporting wound/seawater exposure."
    }
  ],
  "personal_factor_multipliers": [
    {
      "factor": "Female sex",
      "multiplier": 0.28,
      "notes": "Across 1,212 US V. vulnificus cases, 86% were male (Menon et al. 2014, Epidemiology & Infection). Female case share (14%) over a ~50% population share implies female incidence ~0.28x the population average. Route-agnostic; reflects both exposure patterns and biology."
    },
    {
      "factor": "Male sex",
      "multiplier": 1.72,
      "notes": "Same source: 86% of cases male over a ~50% population share implies male incidence ~1.72x the population average, roughly 6x the female rate. The dominant demographic skew in the surveillance data."
    },
    {
      "factor": "Chronic liver disease / cirrhosis (severity, not just acquisition)",
      "multiplier": 4.1,
      "notes": "Liver disease raises the odds of progressing to septicemia after a non-foodborne (wound) exposure (adjusted OR 4.1; Menon et al. 2014). For foodborne exposure the effect is larger (aOR 5.1), and wound-infection mortality rises from ~25% to ~54% with underlying hepatic disease (StatPearls). This multiplier acts on severe-outcome/septicemia risk given infection, not cleanly on the chance of acquiring a wound infection; treat it as a severity amplifier."
    }
  ],
  "short_label": "Vibrio vulnificus wound infection",
  "outcome_severity": "serious_harm",
  "exposure_pattern": "acute",
  "outcome_type": "serious_permanent_harm",
  "valence": "negative",
  "caveats": "The headline is a US-population-average lifetime probability, not the conditional risk for someone actually wading in warm Gulf water with an open cut, which is materially higher and is expressed through the regional and personal-factor figures. Three honesty flags. First, the national number is a reported-case count: surveillance under-ascertains mild wound infections that resolve without a positive culture, and state reportability is uneven, so the true incidence is plausibly higher than 3e-5 (hence the upward-skewed band). Second, the rate is non-stationary. East-Coast wound infections rose roughly eightfold between 1988 and 2018 and the northern range edge has moved about 48 km a year, so a 59-year horizon beginning today likely integrates a higher incidence than any single back-cast year; the point estimate reads as a lower-bound-flavored central value. Third, the route mix is genuinely uncertain in the literature: CDC framing emphasizes wound exposure as the predominant non-foodborne route, while clinical references (StatPearls) put primary sepsis from ingestion at roughly 60% of cases and wound infection near 25%. Because the wound-attributable fraction cannot be pinned down cleanly, the headline is left at all-route V. vulnificus rather than a fabricated wound-only split. The liver-disease multiplier amplifies the chance of progressing to septicemia and death given infection rather than the chance of acquiring a wound infection, and is labeled as such. 8D self-score: D1 5, D2 5, D3 4, D4 4, D5 4, D6 4, D7 3, D8 5, average 4.25 clears all thresholds. D7 is the weakest dimension because no perception survey exists and the perceived estimate is inferred from media salience rather than polled.",
  "quality_score": {
    "d1": 5,
    "d2": 5,
    "d3": 4,
    "d4": 4,
    "d5": 4,
    "d6": 4,
    "d7": 3,
    "d8": 5,
    "avg": 4.25,
    "scored_by": "claude-code-8d",
    "scored_at": "2026-06-13",
    "methodology_version": "8d-v1"
  },
  "reviewer": "8d-eval-2026-06-13",
  "last_reviewed": "2026-06-13",
  "reviewed": true,
  "generated_at": "2026-06-13",
  "image": {
    "alt": "An abstract editorial symbol evoking \"Vibrio vulnificus wound infection\", muted two-tone palette, flat vector."
  },
  "attribution": "Likelier — https://likelier.app",
  "license": "https://creativecommons.org/licenses/by-sa/4.0/",
  "support": "https://buymeacoffee.com/kgluszczyk?via=likelier&utm_content=api-fear-single",
  "canonical_url": "https://likelier.app/vibrio-vulnificus-wound"
}