10 : Noncholera Vibrios

Abstract:

Noncholera vibrio infections have emerged as an important public health concern in the United States, Canada, Japan, Taiwan, and many other countries. The majority of noncholera vibrio infections are food-borne, and the major food vehicle is raw molluscan shellfish. Most noncholera vibrios are halophilic (or salt-requiring), and their growth is enhanced by specific ranges of salinity, water temperatures, and pH. The number of noncholera vibrio infections has increased over the past few years, after years of remaining relatively stable. Over the past 10 years, Vibrio parahaemolyticus and V. vulnificus have been the most commonly isolated noncholera Vibrio species. Among the 553 culture-confirmed v. vulnificus infections reported to CDC between 1988 and 1998 through the Vibrio Surveillance System, 44% were classified as primary septicemia, 43% as wound infections, and 7% as gastroenteritis, while 6% were from other or unknown sites of infection. Noncholera Vibrio strains that cause gastroenteritis are usually susceptible to antimicrobial agents used for enteric infections, although most cases of gastroenteritis are mild and self-limited, and they can effectively be treated with oral rehydration. On the other hand, wound and primary septicemia infections require antimicrobial treatment to improve the course of illness and prevent complications. The author recommends that consumers avoid eating raw or undercooked oysters, especially during the warmer months because illness is associated with consuming oysters harvested from warm water. Due to the recent increase in noncholera vibrio infections, all states should consider making infection with any Vibrio species reportable.