Aa
seafood/beach walks and Liver disease/ Vibrio vulnicus
here's more info on the reason raw seafood/shellfish and even ocean water can be dangerous to liver patients, especially those with high iron levels.
http://www.ebi.ac.uk/2can/genomes/bacteria/Vibrio_vulnificus.html
http://www.ebi.ac.uk/2can/genomes/bacteria/Vibrio_vulnificus.html
TX for 48 weeks relapser had hep C for 36yrs might TX again with the new drugs. So glad I did not read this before I went to Costa Rica,lived on the beach and in the water,ate lots of raw fresh fish. If I would have read this it would have been like going to see jaws.A very rare chance something would happen to me but would have been in the back of my mind.
I went in for my 6 month doc visit with a hep specialist at a teaching hospital and asked him about it he said not to worry about the only thing I might get is diirrea or hep A .been vaccanated for A so no worries. When I start worring about everything that could be bad for my hep c liver no matter how rare then the hep C has won the battle and I will just be it's slave host. Pass the fresh raw fish while I lay on the beach please.
I went in for my 6 month doc visit with a hep specialist at a teaching hospital and asked him about it he said not to worry about the only thing I might get is diirrea or hep A .been vaccanated for A so no worries. When I start worring about everything that could be bad for my hep c liver no matter how rare then the hep C has won the battle and I will just be it's slave host. Pass the fresh raw fish while I lay on the beach please.
As a liver TP patient one of our diet restrictions is no raw seafood, period. One may never recover from bacteria born or a parasitical infection.
Sushi is OK as long as its cooked thoroughly. The "maguro" served at a majority of mainland restaurants is Aku (skipjack tuna) which is loaded with parasites.
Sushi is OK as long as its cooked thoroughly. The "maguro" served at a majority of mainland restaurants is Aku (skipjack tuna) which is loaded with parasites.
So my question is why don't the doctor's tell us these things? I am going to the Hep specialist at Cedars Sinai and they have told me what to eat and what not to eat..... amazing...so I guess Sushi is out right? Boy this $%#%%^ disease sucks....now you can't even take a walk on the beach..... ok I will stop ranting now...but seriously no Sushi?
I live on the ocean and (hopefully) will be treating soon.
I know enuf to stay out of the sun and the water during tx, but in the title of this thread you included beachwalks. Is just being on the sand a risk factor?
Don't mean to sound dumb--but alarm bells went off seeing that and the link didn't mention that part.
Any input from anyone is appreciated.
Thanks-Izzy
I know enuf to stay out of the sun and the water during tx, but in the title of this thread you included beachwalks. Is just being on the sand a risk factor?
Don't mean to sound dumb--but alarm bells went off seeing that and the link didn't mention that part.
Any input from anyone is appreciated.
Thanks-Izzy
From the CDC...
What is Vibrio vulnificus?
Vibrio vulnificus is a bacterium in the same family as those that cause cholera. It normally lives in warm seawater and is part of a group of vibrios that are called "halophilic" because they require salt.
What type of illness does V. vulnificus cause?
V. vulnificus can cause disease in those who eat contaminated seafood or have an open wound that is exposed to seawater. Among healthy people, ingestion of V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In immunocompromised persons, particularly those with chronic liver disease, V. vulnificus can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock), and blistering skin lesions. V. vulnificus bloodstream infections are fatal about 50% of the time.
V. vulnificus can cause an infection of the skin when open wounds are exposed to warm seawater; these infections may lead to skin breakdown and ulceration. Persons who are immunocompromised are at higher risk for invasion of the organism into the bloodstream and potentially fatal complications.
How common is V. vulnificus infection?
V. vulnificus is a rare cause of disease, but it is also underreported. Between 1988 and 2006, CDC received reports of more than 900 V. vulnificus infections from the Gulf Coast states, where most cases occur. Before 2007, there was no national surveillance system for V. vulnificus, but CDC collaborated with the states of Alabama, Florida, Louisiana, Texas, and Mississippi to monitor the number of cases of V. vulnificus infection in the Gulf Coast region. In 2007, infections caused by V. vulnificus and other Vibrio species became nationally notifiable.
How do persons get infected with V. vulnificus?
Persons who are immunocompromised, especially those with chronic liver disease, are at risk for V. vulnificus when they eat raw seafood, particularly oysters. A recent study showed that people with these pre-existing medical conditions were 80 times more likely to develop V. vulnificus bloodstream infections than were healthy people. The bacterium is frequently isolated from oysters and other shellfish in warm coastal waters during the summer months. Since it is naturally found in warm marine waters, people with open wounds can be exposed to V. vulnificus through direct contact with seawater. There is no evidence for person-to-person transmission of V. vulnificus.
How can V. vulnificus infection be diagnosed?
V. vulnificus infection Is diagnosed by stool, wound, or blood cultures. Notifying the laboratory when this infection is suspected helps because a special growth medium should be used to increase the diagnostic yield. Doctors should have a high suspicion for this organism when patients present with gastrointestinal illness, fever, or shock following the ingestion of raw seafood, especially oysters, or with a wound infection after exposure to seawater.
How is V. vulnificus infection treated?
If V. vulnificus is suspected, treatment should be initiated immediately because antibiotics improve survival. Aggressive attention should be given to the wound site; amputation of the infected limb is sometimes necessary. Clinical trials for the management of V. vulnificus infection have not been conducted. The antibiotic recommendations below come from documents published by infectious disease experts; they are based on case reports and animal models.
Culture of wound or hemorrhagic bullae is recommended, and all V. vulnificus isolates should be forwarded to a public health laboratory
Blood cultures are recommended if the patient is febrile, has hemorrhagic bullae, or has any signs of sepsis
Antibiotic therapy:
Doxycycline (100 mg PO/IV twice a day for 7-14 days) and a third-generation cephalosporin (e.g.,ceftazidime 1-2 g IV/IM every eight hours) is generally recommended
A single agent regimen with a fluoroquinolone such as levofloxacin, ciprofloxacin or gatifloxacin, has been reported to be at least as effective in an animal model as combination drug regimens with doxycycline and a cephalosporin
Children, in whom doxycycline and fluoroquinolones are contraindicated, can be treated with trimethoprim-sulfamethoxazole plus an aminoglycoside
Necrotic tissue should be debrided; severe cases may require fasciotomy or limb amputation
------------------------------------------------------------------------------------------------------------------
The following groups are considered high-risk and should stringently adhere to the advisory: people with liver disease or liver involvement, such as diabetes mellitus, alcoholism, hemochromatosis (an iron metabolism disorder), or Thalassemia (a hereditary anemic condition); people with therapeutically-induced or naturally low gastric acid, such as those who have had gastric surgery or those using antacids on a routine basis; and persons with compromised immune systems, such as those individuals with AIDS or undergoing cancer treatment. The risk of death is almost 200 times greater in those with liver disease than those without liver disease, according to the FDA.
Hector
What is Vibrio vulnificus?
Vibrio vulnificus is a bacterium in the same family as those that cause cholera. It normally lives in warm seawater and is part of a group of vibrios that are called "halophilic" because they require salt.
What type of illness does V. vulnificus cause?
V. vulnificus can cause disease in those who eat contaminated seafood or have an open wound that is exposed to seawater. Among healthy people, ingestion of V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In immunocompromised persons, particularly those with chronic liver disease, V. vulnificus can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock), and blistering skin lesions. V. vulnificus bloodstream infections are fatal about 50% of the time.
V. vulnificus can cause an infection of the skin when open wounds are exposed to warm seawater; these infections may lead to skin breakdown and ulceration. Persons who are immunocompromised are at higher risk for invasion of the organism into the bloodstream and potentially fatal complications.
How common is V. vulnificus infection?
V. vulnificus is a rare cause of disease, but it is also underreported. Between 1988 and 2006, CDC received reports of more than 900 V. vulnificus infections from the Gulf Coast states, where most cases occur. Before 2007, there was no national surveillance system for V. vulnificus, but CDC collaborated with the states of Alabama, Florida, Louisiana, Texas, and Mississippi to monitor the number of cases of V. vulnificus infection in the Gulf Coast region. In 2007, infections caused by V. vulnificus and other Vibrio species became nationally notifiable.
How do persons get infected with V. vulnificus?
Persons who are immunocompromised, especially those with chronic liver disease, are at risk for V. vulnificus when they eat raw seafood, particularly oysters. A recent study showed that people with these pre-existing medical conditions were 80 times more likely to develop V. vulnificus bloodstream infections than were healthy people. The bacterium is frequently isolated from oysters and other shellfish in warm coastal waters during the summer months. Since it is naturally found in warm marine waters, people with open wounds can be exposed to V. vulnificus through direct contact with seawater. There is no evidence for person-to-person transmission of V. vulnificus.
How can V. vulnificus infection be diagnosed?
V. vulnificus infection Is diagnosed by stool, wound, or blood cultures. Notifying the laboratory when this infection is suspected helps because a special growth medium should be used to increase the diagnostic yield. Doctors should have a high suspicion for this organism when patients present with gastrointestinal illness, fever, or shock following the ingestion of raw seafood, especially oysters, or with a wound infection after exposure to seawater.
How is V. vulnificus infection treated?
If V. vulnificus is suspected, treatment should be initiated immediately because antibiotics improve survival. Aggressive attention should be given to the wound site; amputation of the infected limb is sometimes necessary. Clinical trials for the management of V. vulnificus infection have not been conducted. The antibiotic recommendations below come from documents published by infectious disease experts; they are based on case reports and animal models.
Culture of wound or hemorrhagic bullae is recommended, and all V. vulnificus isolates should be forwarded to a public health laboratory
Blood cultures are recommended if the patient is febrile, has hemorrhagic bullae, or has any signs of sepsis
Antibiotic therapy:
Doxycycline (100 mg PO/IV twice a day for 7-14 days) and a third-generation cephalosporin (e.g.,ceftazidime 1-2 g IV/IM every eight hours) is generally recommended
A single agent regimen with a fluoroquinolone such as levofloxacin, ciprofloxacin or gatifloxacin, has been reported to be at least as effective in an animal model as combination drug regimens with doxycycline and a cephalosporin
Children, in whom doxycycline and fluoroquinolones are contraindicated, can be treated with trimethoprim-sulfamethoxazole plus an aminoglycoside
Necrotic tissue should be debrided; severe cases may require fasciotomy or limb amputation
------------------------------------------------------------------------------------------------------------------
The following groups are considered high-risk and should stringently adhere to the advisory: people with liver disease or liver involvement, such as diabetes mellitus, alcoholism, hemochromatosis (an iron metabolism disorder), or Thalassemia (a hereditary anemic condition); people with therapeutically-induced or naturally low gastric acid, such as those who have had gastric surgery or those using antacids on a routine basis; and persons with compromised immune systems, such as those individuals with AIDS or undergoing cancer treatment. The risk of death is almost 200 times greater in those with liver disease than those without liver disease, according to the FDA.
Hector
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