Couple's happy reunion cut short by killer disease

PUBLISHED : Sunday, 19 August, 2012, 12:00am
UPDATED : Sunday, 19 August, 2012, 10:01am


Ronald Ancheta counted the days until he would join his wife in Hong Kong so they could live together for the first time in their nine-year marriage. Their dream lasted just one week, cut short by something they could never have imagined.

For years the 45-year-old pastry chef had missed his wife Delma desperately and begged her to return to their home in Marikina City, Manila, but her domestic helper job was here.

So her Discovery Bay employers solved the problem by giving Ronald a job too: "Delma is part of our family, so Ronald was too," said his employer.

Ronald lived for just a week on Lantau. "For that one week together, we were so very happy," said Delma, 46, a helper for 23 years. The couple had no children.

She had never heard of the disease necrotising fasciitis, but it struck suddenly and without warning. Although he had mild type two diabetes, Ronald was slim, fit and active and cooked dinner on Thursday August 9, his wife recalls.

The next day, Friday, he complained of leg muscle pain and his face was pale and his legs red. Excruciating pain kept him awake all Friday night and he was taken by ambulance to Princess Margaret Hospital early next morning.

Pain relief did not work and doctors told his wife they had found "bad bacteria", and that two days on antibiotics should clear it up, but his condition worsened dramatically.

He had surgery that night to obtain tissue samples. On Sunday doctors warned his employer, who asked not to be named, that this particular strain of bacteria seemed resistant to antibiotics and the only thing left was amputation, but the bacteria might already have spread throughout his bloodstream and it might be too late.

Ronald never regained consciousness and despite his leg being amputated at the hip in a second operation on Sunday, he died on Monday night, August 13.

"The doctors told us it was necrotising fasciitis, the flesh-eating disease," said his employer. It had taken just three days to make Delma a widow.

"My understanding is that Ronald's case was a freak, but I have now heard there have been as many as five deaths from this in as many weeks. Something needs to be done in terms of awareness."

According to the Health Department, Ronald's death is the third from necrotising fasciitis they can officially confirm since July 1, with a surge to nine cases of the disease in the last six weeks.

This prompted an infectious disease expert and former lawmaker to call for a public campaign to warn people of the dangers.

Dr Lo Wing-lok said that although the Health Department issues regular warnings, people were not listening. "They should tell the public more about this."

Necrotising fasciitis, also known as flesh-eating disease, results from bacteria entering the body via a small wound, or a sore throat, said Lo.

The bacteria then produce toxins which rapidly consume, or "necrotise" soft tissues and fascia, the sheath which binds muscle. If intravenous antibiotics fail to stop the bacteria, two operations are needed - one to cut out necrotic tissue and, if that fails, amputation.

However, often the infection speedily spreads through the bloodstream, causing organ failure, shock and death. "Even if a person is cured there may be disfigurement and loss of muscle tissue," Dr Lo added.

The bacteria involved are commonly Vibrio vulnificus and Streptococcus A. The former is present in warm seawater and is usually caught from handling seafood kept in contaminated water.

The habit of restaurants and wet markets of keeping live fish in tanks of seawater is a big problem, said Dr Lo.

"People get a puncture wound from a crab claw or fish fin and the bacteria enter that way."

He also warned about body treatments. "Be careful in spas and massage places. I've seen cases where people got infected after receiving small cuts in these places."

Of the two bacteria strains, Streptococcus A is more threatening, since it is virtually impossible to avoid. " Streptococcus A is present everywhere in the environment," said necrotising fasciitis specialist Dr Josephine Ip, based at Queen Mary Hospital's department of orthopaedics sand traumatology. Most susceptible are the elderly and those with chronic illnesses such as cirrhosis, diabetes and renal failure which weaken their immune systems. Many, but not all, of the recent cases were in this category.

The eight recent Vibrio vulnificus cases included six people aged over 60. The two who died were an 85-year-old woman from Tai O, Lantau, who cut herself while preparing an uncooked fish and a 56- year-old Yuen Long man who visited the mainland. The three Kwun Tong cases were aged 80, 77 and 67.

The Health Department has confirmed Ronald Ancheta's case was caused by Streptococcus A.