FW: PRO/EDR> Vibrio parahaemolyticus - USA (08)

[Maffei, Joanne]

Joanne T. Maffei, M.D.
Associate Professor
LSU Health Sciences Center
Department of Medicine
Section of Infectious Diseases/HIV
ILH Infection Prevention and Control Department Medical Director
Infection Control Office (504) 903-3578
Cell Phone (504) 452-6354



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Subject: PRO/EDR> Vibrio parahaemolyticus - USA (08)


VIBRIO PARAHAEMOLYTICUS - USA (08)
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Date: Mon 21 Oct 2013
Source: CDC [edited]
<http://www.cdc.gov/vibrio/investigations/index.html>


CDC and state and federal partners in 13 states are monitoring an increase in vibriosis since May 2013. As of 30 Sep 2013, 104 cases of a specific strain in 13 states with 6 hospitalizations and no deaths were reported to CDC.

Vibrio bacteria live in saltwater. People can get vibriosis after eating raw or undercooked shellfish, particularly oysters. Several species of _Vibrio_, including _Vibrio parahaemolyticus_, can cause illness, and there has been an increase in infections caused by a specific strain of _Vibrio parahaemolyticus_. These infections occurred among people who, in the week before they became ill, ate raw oysters or raw clams harvested along the Atlantic coast.

Before 2012, _V. parahaemolyticus_ infections of this strain were rarely associated with shellfish from the Atlantic coast.

Symptoms typically consist of mild to moderate diarrhea, but can sometimes be severe, especially if the bacteria enter the bloodstream.

Safe shellfish preparation is necessary to avoid illness, especially among high risk people. High risk groups include people with weakened immune systems or with chronic liver disease.

Public health investigators are using PulseNet, the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC, to identify additional cases. PulseNet matches DNA "fingerprints" of _V. parahaemolyticus_ bacteria submitted by several states.

Investigation as of 30 Sep 2013:
Public health investigators are using the national Cholera and Other Vibrio Infections Surveillance (COVIS) system to collect food histories. Food histories have been reported for 82 ill persons. Of these, 75 (91 percent) reported eating raw oysters or raw clams during the 7 days before their illness began. State health departments work with regulatory partners to trace the source of the shellfish. These efforts have determined that raw oysters and clams consumed by ill persons originated from shellfish harvest areas in Connecticut, Massachusetts, New York, and Virginia.

The Interstate Shellfish Sanitation Conference maintains a list of shellfish harvest area closures and recalls. Harvest areas to which illnesses were traced remain closed in Virginia (closed 12 Jul 2013) and Massachusetts (closed 30 Aug 2013). New York closed harvest areas which were associated with illnesses from 29 Jun 2013 to 14 Sep 2013, and Connecticut closed illness-associated harvest areas from 2 Aug
2013 to 17 Sep 2013. Massachusetts issued a recall of oysters originating from harvest areas associated with illness, and Connecticut issued a recall of oysters and clams originating from illness-associated harvest areas.

Illnesses are still being reported, but have decreased since the warmest months. It is unlikely that all harvest areas associated with illnesses have been identified. It is likely that many illnesses have occurred that were not detected through surveillance because some people do not seek medical care, diagnostic testing is not always performed, and some laboratories do not routinely use the specific culture plate necessary to test for _Vibrio_ bacteria. The investigation is ongoing.

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[Eating raw shellfish only during months containing an "r" in its name may decrease eating them during the warmer months (May, June, July, and August), but only in the Northern Hemisphere (it should be reversed below the equator). However, since global warming has occurred, and with the shellfish being shipped quickly from warmer to colder areas, the old adage is not very helpful anymore.

Successful isolation of _Vibrio parahaemolyticus_ from diarrheic stools must start with consideration of this particular organism, as _Vibrio_ spp. and a number of organisms, including the enteropaths of _E. coli_, require special media to either facilitate growth (_Vibrio_ spp. require higher salinity and are referred to as halophilic) or aid to identification (_E. coli_ O157 can be screened for using its lack of fermentation of sorbitol). - Mod.LL

A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/r/1hiS>.]

[See Also:
Vibrio parahaemolyticus - USA (07): (MA) 20130917.1947675 Vibrio parahaemolyticus - USA (06): (MA) 20130911.1938075 Vibrio parahaemolyticus - USA (05): (CT) 20130817.1886013 Vibrio parahaemolyticus - USA (04): (WA) 20130815.1882918 Vibrio parahaemolyticus - USA (03): (CT) shellfish recall
20130805.1865072
Vibrio parahaemolyticus - USA (02): (MA, MD) ex VA 20130716.1827539 Vibrio parahaemolyticus - USA: (TX) 20130605.1755987
2012
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Vibrio parahaemolyticus - USA (04): (MA) oysters 20121121.1415902 Vibrio parahaemolyticus - USA (03): (CA) raw oyster, recall
20120813.1241997
Vibrio parahaemolyticus, shellfish - Canada: (BC) 20120727.1217661 Vibrio parahaemolyticus - USA (02): NY shellfish source
20120714.1201574
Vibrio parahaemolyticus - USA: (MO) 20120701.1186448 Vibrio parahaemolyticus, oysters - USA: (MA), 2011 20120512.1131191
2011
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Vibrio parahaemolyticus, oysters - USA (04): (WA) expanded alert
20110927.2924
Vibrio parahaemolyticus, oysters - USA (03): (WA) alert 20110915.2820 Vibrio parahaemolyticus, oysters - USA (02): (CA) 20110913.2786 Vibrio parahaemolyticus, oysters - USA: (WA) 20110807.2394] .................................................sb/ll/je/lm
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