| Clinical
Features |
Wound or soft tissue infections.
In persons with underlying medical conditions, especially
liver disease, can cause bloodstream infections characterized
by fever, chills, decreased blood pressure, blistering skin
lesions, and often, death. In otherwise heathy persons, causes
diarrhea, vomiting, and abdominal pain. |
| Etiologic
Agent |
Vibrio vulnificus, a halophilic
(salt-requiring) gram-negative bacterium naturally and commonly
found in marine and estuarine environments. |
| Incidence |
An average of 40 culture-confirmed
cases, 35 hospitalizations, and 12 deaths are reported each
year from the Gulf Coast region (reporting states are Alabama,
Florida, Louisiana, Mississippi, and Texas). Nationwide, there
are as many as 95 cases (half of which are culture confirmed),
85 hospitalizations, and 35 deaths. |
| Sequelae |
Bloodstream infections in persons
with liver disease are fatal approximately 50% of the time.
Persons who recover suffer no long-term consequences. |
| Transmission |
Eating raw or undercooked shellfish,
particularly oysters harvested from warmer waters. Wound infections
may occur when wounds or soft tissues are exposed to warm
seawater. |
| Risk
Groups |
All persons. Persons with underlying
medical conditions, especially liver disease, may be at increased
risk of infection and serious complications. |
| Surveillance |
Twenty states require reporting
of Vibrio infections. Surveillance for culture-confirmed
infections has been conducted in the Gulf Coast states of
Alabama, Florida, Louisiana, Mississippi, and Texas since
1988, and expanded to include FoodNet states in 1996. |
| Trends |
Infections are seasonal; over 85%
occur between May and October. Environmental factors, such
as warm water and moderate salinity, can increase the number
of V. vulnificus organisms in shellfish. |
| Challenges |
Many persons prefer to consume oysters
raw. Many persons with liver disease are unaware of the hazards
of raw oyster consumption and exposure to warm seawater. |
| Opportunities |
Education focusing on the risks
associated with consumption of raw and undercooked shellfish,
especially in warm months. Implement refrigeration from harvesting
to consumption. Timely reporting of V. vulnificus infections.
Revision of the standards used for closing and re-opening
of oyster beds to take into account the role of environmental
factors. |
|
December 2000
|
