Vibrio Vulnificus: Risk Factors, Symptoms, Treatment

Vibrio vulnificus can cause a terrible skin infection. It can cause bubbling skin infections called bullae (which can be filled with blood). What's more worrisome is that it can lead to a severe infection spreading in the blood.

Person walking on the beach leaving footprints behind
SensorSpot / Getty Images

Fortunately, it is quite rare. Every year in the US, people are infected along the East Coast and the Gulf Coast. In Florida in 2013, 31 were infected and 11 died.

Acquiring the disease, though rare, is unfortunately quite simple. A simple walk on the beach, a step on a sharp shell, and the bacteria in the warm seawater can enter.

The bacteria is found commonly in warm seawater. Warmer water increases the amount of vibrio vulnificus found. It is only found in saltwater.

What Kind of Disease Is Vulnificus?

The bacteria is a relative of cholera. Both cause vomiting and diarrhea. Cholera quickly spreads from person-to-person causing epidemics, while there is no evidence vulnificus ever spreads from person to person. Vulnificus can cause a severe and bubbling skin infection. It also can spread into the blood in those who are the most vulnerable; this can be rapidly fatal.

True flesh-eating bacteria are actually only strep A infections. Vulnificus infections look like strep but do not cause an infection that spreads in the skin as deeply as strep does.


  • Diarrhea, abdominal, abdominal pain
  • Low blood pressure
  • Bubbling and reddened skin near where the bacteria entered. There can be bleeding associated with these blistering bubbles.

Who Is at Risk?

  • Anyone who eats raw oysters or other shellfish
  • Anyone with a cut exposed to warm seawater, especially in the Gulf of Mexico, but also in other areas along the East Coast of the United States

Having any of the following conditions puts you at higher risk:

  • Liver disease
  • High iron levels
  • Alcoholism
  • Diabetes
  • Chronic kidney failure

The bacteria usually only causes severe disease — sepsis or infection in the blood — in those at most risk. The mortality risk for those who develop severe sepsis can be as high as 50%.

How You Become Infected

Infections can happen from a walk on the beach. The bacteria can enter open wounds, such as those from stepping on sharp shells or glass. It is particularly associated with alcohol use. The infection can spread from the skin into the blood, in those at risk.

Infection can also occur from eating raw or undercooked oysters from the Gulf Coast.  It can also be found in Atlantic and Pacific waters. The infection can spread from the intestines into the blood, in those at risk.


The bacteria can be found in stool, wound, or blood cultures, but requires labs to have a special medium — or plate — for the bacteria to grow and be identified.


Treatment for severe cases requires hospitalization. It is often with the IV antibiotic ceftazidime and the antibiotic doxycycline. It sometimes can be treated with fluoroquinolones. The skin infection can be so severe that surgery is needed to debride it or even an amputation may be required.


Even oysters that are legally harvested can have vibrio vulnificus. The FDA works with state officials to trace any infections to oyster beds. Work is being done to better identify what factors lead to growth and reduce the risk that those oysters that are harvested carry the bacteria.

Here are some ways to avoid infection:

  • Avoid eating raw or undercooked shellfish, particularly oysters (or avoid eating seafood altogether)
  • Do not expose wounds to salt water (ie go wading in ocean w/wounds on feet/legs) and do not handle shellfish if you have wounds on hands
  • Clean any wounds exposed to saltwater or shellfish thoroughly with soap and water
Was this page helpful?
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bross MH, Soch K, Morales R, Mitchell RB. Vibrio vulnificus infection: diagnosis and treatment. Am Fam Physician. 2007;76(4):539-44.

  2. Froelich BA, Noble RT. Vibrio bacteria in raw oysters: managing risks to human health. Philos Trans R Soc Lond, B, Biol Sci. 2016;371(1689) doi:10.1098/rstb.2015.0209

Additional Reading