The Florida county that was devastated by Hurricane Ian last month has seen a surge in cases of flesh-eating bacteria illnesses and deaths.
Officials say Lee County, where the category four storm made landfall on 28 September, has recorded 29 illnesses and four deaths owing to the bacteria.
All but two cases were diagnosed after the hurricane.
Vibrio vulnificus infections can be caused after bacteria enters the body through open cuts.
The bacteria live in warm brackish water, like standing flood-waters.
"The Florida Department of Health in Lee County is observing an abnormal increase in cases of Vibrio vulnificus infections as a result of exposure to the flood-waters and standing waters following Hurricane Ian," a spokesperson at the county health department said on Monday.
The statement called on residents to "always be aware of the potential risks associated when exposing open wounds, cuts, or scratches on the skin to warm, brackish, or salt water".
"Sewage spills, like those caused from Hurricane Ian, may increase bacteria levels," the statement continued. "As the post-storm situation evolves, individuals should take precautions against infection and illness caused by Vibrio vulnificus."
Collier County, just south of Lee County, has also recorded three confirmed cases that officials say are storm-related.
Across Florida, there have been a record 11 confirmed deaths attributed to the bacterium this year, and a total of 65 cases, according to state health data. Officials estimate that nearly half are related to Hurricane Ian.
In 2021, 10 deaths were recorded and 34 cases in Florida. Seven deaths were attributed to the bacteria in 2020.
Vibrio vulnificus is known as "flesh-eating" because it can develop into necrotising fasciitis, a condition that causes tissue to break down. It is not the only bacteria that can cause necrotising fasciitis.
According to the US Centers for Disease Control and Prevention, around one in five Vibrio vulnificus patients dies, sometimes within only a day or two of becoming ill.
It can cause sepsis if it enters the bloodstream, and can sometimes lead to amputations to prevent its spread to other parts of a patient's body.
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