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True Stories From The Disease Files

Think Before You Feast: Vibrio on a Half-shell

While out on the town, a group of Oklahomans decided to order some oysters to complement their meal.  A day later, one of the diners experienced symptoms of a fever and a sore on his right foot.  Throughout the day, he developed swelling, redness and pain that went up his whole right leg.  His sore developed into a large blister and the infection in his foot continued to worsen and progress to deeper layers of his skin.  That evening, he went to the hospital where some of the infected skin on his foot had to be surgically removed.  A sample from his skin tissue was tested and was found to be infected with Vibrio vulnificus (V. vulnificus).  While he was hospitalized, the doctors learned that he had a history of alcoholism and alcoholic liver disease.  He also told his doctors that he had eaten 24 raw oysters the night before he became sick while out with some friends.  Luckily, after being treated with antibiotics and spending a week in the hospital, he recovered and was able to go home.

V. vulnificus is a naturally occurring bacterium in marine and estuarine waters throughout the world.  Infection can occur after a wound is exposed to warm coastal waters where the V. vulnificus organism is growing.  Infection may also be acquired by eating raw or undercooked seafood from those waters.  V. vulnificus infections do not spread directly from one person to another.  The Center for Disease Control and Prevention receives reports of over 400 Vibrio illnesses each year.  Of those, about 90 per year are due to V. vulnificus.  Most Vibrio vulnificus ilness occurs during warm weather months.

V. vulnificus usually causes fever, chills, swelling and redness of the skin on the arms or legs, with blood-tinged blisters, and low blood pressure and shock.  If exposed by contamination of an open wound, increasing swelling, redness, and pain will occur at the site of the wound.  Illness typically begins within one to three days of exposure, but begins as late as seven days after exposure for a small percentage of cases.

Although raw shellfish may excite your palate, it is important to think before you feast.  Raw shellfish and inadequately cooked seafood may contain bacteria called Vibrio.  Several Vibrio species can cause disease in humans, which include V. vulnificus, V. cholerae O1/O139, V. cholerae non-O1/O139,and V. parahaemolyticus.

Although cases of Vibrio vulnificus are uncommon in inland areas, they do occur even in Oklahoma.  More than 90% of people infected with V. vulnificus with serious symptoms are infected by eating raw seafood within seven days before their illness onset.1 It is very important to remember if you have any type of liver disease, alcoholism, diabetes, cancer, or other conditions that affect the immune system to eat only cooked seafood and shellfish, especially oysters.  For your health, remember to think before you feast.

Reference
1Mandell GL, Bennett JE, Dolin R.  Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, Fifth Edition, 2000.  Churchill Livingstone.
 

Please visit the following links for more information regarding vibrio:

Vibrio Fact Sheets and Information:

Vibrio Vulnificus Fact Sheet (40k.pdf) 
   Vibrio Vulnificus Hoja Informativa (43k.pdf)

External Vibrio Resources:

Vibrio cholerae Infection (CDC)
Vibrio parahaemolyticus Infections (CDC)
Vibrio vulnificus Infections (CDC)

Vibrio Surveillance Data and Statistics:

Vibriosis 2006 Surveillance Summary (276k.pdf)

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