A devastating “flesh-eating” bacterial infection killed one Texas resident after she fell in Harvey’s contaminated floodwater and injured herself. Another resident underwent surgery for the infection, and the Texas health department is watching a third suspected case near the area where Harvey made landfall.

The infections began in wounds and spread quickly. These cases of “necrotizing fasciitis” are called “flesh-eating” bacterial infections because of the way the bacterial toxins kill the body’s tissues and organs. A handful of species can cause the infections, and public health workers have warned residents that they can live in floodwater that’s been contaminated with sewage and chemical spills.

During Harvey, 33.9 million gallons of sewer overflows were reported to the Texas Commission on Environmental Quality.

Nancy Reed, 77, died at the hospital after falling and injuring herself in a flooded home during the storm. According to the Harris County Institute of Forensic Sciences, Reed was the 36th casualty of the storm in that county. The Houston Chronicle first reported this incident.

J.R. Atkins, a resident of Missouri City, Texas, told the local ABC News affiliate that he had also picked up the infection from stormwater in his neighborhood. Atkins survived, but was prescribed a course of four kinds of antibiotics and had three surgeries, he said.

According to the Texas Department of State Health Services, a third person is suspected to have contracted the condition in Aransas County, after an injury during the storm.