Vibrio vulnificus is an extremely virulent bacterium that can cause three types of infections: Acute gastroenteritis from eating raw or undercooked shellfish: V. vulnificus causes an infection often incurred after eating seafood, especially raw or undercooked oysters. Specific metabolic pathways can strip host transferrin of iron, triggering sepsis and elevating mortality. Liver disease (from hepatitis, cirrhosis, alcoholism, or cancer), Cancer (including lymphomas, leukemia, Hodgkins disease), Or any illness or medical treatment that weakens the bodys immune system, including HIV infection. Others who should avoid consuming raw shellfish are those with hemochromatosis (iron overload), diabetes, cancer, stomach disorders or any illness or treatment that weakens the immune system. Raw oysters are most commonly implicated in transmission of Vibrio vulnificus. Examine wounds for dirt and foreign objects. Among healthy people, ingestion of V. vulnificus can cause vomiting, diarrhea, and abdominal pain. Avoid swimming in treated water that is murky or has an odor. If you receive a puncture wound or a wound contaminated with feces, soil, or saliva, have a health care professional determine whether a tetanus booster is necessary based on individual records. The limbs are the most frequent anatomic location, but occasionally the perineum is involved. In 2007, infections caused byVibrio vulnificusand other vibrio species became nationally notifiable. If you have an open wound that becomes infected with Vibrio vulnificus bacteria symptoms may include: The infection may result in necrotising fasciitis (commonly known as flesh-eating disease). doi:10.1371/journal.pone.0136019 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4537211/, Newton A, Kendall M, Vugia DJ, Henao OL, Mahon BE. Necrotizing fasciitis is a severe life-threatening infection of the soft tissues, involving subcutaneous fat, contiguous fascial sheets, and potentially underlying musculature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681776/. People with chronic liver diseases including hepatitis, cirrhosis, haemochromatosis (iron storage disease), and liver cancer; and people with chronic diseases such as diabetes, chronic kidney disease, or conditions that impair the immune system, are at a higher risk of serious infection. In vitro and in vivo activities of newer fluoroquinolones against Vibrio vulnificus. Prevention However, unlike other species of this family, V. vulnificus can cause serious and fatal infections . Mar 8, 2023 Knowledge Article Vibrio vulnificus (V. vulnificus ) can cause disease in those who eat contaminated seafood or have an open wound that is exposed to seawater. Vibrio vulnificusis a rare cause of disease, but it is also underreported. A review of 459 U.S. cases reported by the U.S. Food and Drug Administration (FDA) between 1992 and 2007 revealed that 51.6% of the patients died 7). This disease is not transmitted from person to person. The spirochete can survive in water and soil for weeks to months without an animal host. Limb amputation is sometimes necessary to remove dead or infected tissue. Nonresponse to treatment should warrant further investigation and/or referral to a subspecialist. Marine debris is defined as anything man-made that is either intentionally or unintentionally abandoned in the marine environment, according to the National Oceanic and Atmospheric Administration. Common Signs and Symptoms of Vibrio Vulnificus. Vibrio vulnificus can also infect wounds sustained while in contact with coastal or estuarine waters (boating accidents, fisherman oyster shuckers) and can range from mild, self-limited lesions to rapidly progressive cellulites and myositis. Microbes Infect. Vibrio vulnificus is a bacterium that normally lives in warm seawater and is part of a group of vibrios that are called "halophilic" because they require salt. doi:10.1073/pnas.1609157113, Wong KC, Brown AM, Luscombe GM, Wong SJ, Mendis K. 2015. Consuming raw oysters that have undergone a post-harvest treatment process to eliminate the bacteria can also reduce the risk of illness. Capsular polysaccharides are also are implicated in neutrophil and macrophage dysfunction. New England Journal of Medicine July 26, 2018 379(4):375 https://www.nejm.org/doi/full/10.1056/NEJMicm1716464, Menon MP, Yu PA, Iwamoto M, Painter J. Consumption of seafood (primarily raw oysters) containing Vibrio vulnificus can result in a severe, fulminant systemic infection. Leave a comment. Exposure to chemicals used in pool maintenance is another source of upper respiratory symptoms; these symptoms are usually self-limited.21. Bowdre, J. H., J. H. Hull, and D. M. Cocchetto. Signs and symptoms of Vibrio vulnificus infection can include: Watery diarrhea, often accompanied by stomach cramping, nausea, vomiting, and fever; For bloodstream infection: fever, chills, dangerously low blood pressure, and blistering skin lesions Before 2007, there was no national surveillance system forVibrio vulnificus, but CDC collaborated with Alabama, Florida, Louisiana, Texas and Mississippi to monitor the number of cases in the Gulf Coast region. People with healing or open wounds should avoid contact with estuary waters. Do not eat those shellfish that do not open during cooking. Those months overlap with the time when hurricanes and tropical storms are more likely to affect the U.S. mainland and many U.S. territories. Infection can result in mild to severe illness.22,23 Mild illness (Pontiac fever) presents as an influenza-like syndrome and is self-limited. Exp. A large number of oocysts (1 108 daily) are excreted by infected persons.14 Transmission through accidental ingestion can occur if a water source has been contaminated with feces from an infected person. Management is primarily symptomatic; with fluid and electrolyte replacement the mainstay of therapy. There is a foreign object (soil, wood, metal, or other objects) embedded in the wound; A wound is a result of a puncture by a dirty object; The wound is infected (pain and soreness, swelling, redness, draining, or you develop a fever); You have signs of sepsis such as confusion or disorientation, shortness of breath, high heart rate, fever or shivering, extreme pain or discomfort or clammy or sweaty skin. General recommendations for avoiding Vibrio vulnificus gastrointestinal illness and severe infection in susceptible individuals: General recommendations for avoiding wound infections: Recent Texas Trends Recreational fishing licenses, hunting licenses, and vessel registrations will be unavailable for purchase from 5 p.m. Tuesday, June 27 to 8 a.m. Saturday, July 1. VISIT FLORIDA is accredited by the Destination Marketing Accreditation Program (DMAP) of Destinations International. Giardiasis is diagnosed via stool microscopy or antigen detection immunoassays. Climate influence on Vibrio and associated human diseases during the past half-century in the coastal North Atlantic. Furthermore, warming ocean patterns have coincided with the emergence of Vibrio vulnificus infections along the northern U.S. Atlantic coast and Baltic Sea 18). Nausea, vomiting, diarrhea, and stomach pain may occur 12 - 72 hours after eating . These waters include bays, estuaries, and rivers close to the ocean. Cover clean, open wounds with a waterproof bandage to reduce chance of infection. Symptoms of vibrio vulnificus are similar but also include: Infection is diagnosed when vibrio bacteria are found in the stool, wound or blood of a patient who has symptoms of vibriosis. While not potentially life-threatening to most healthy people, symptoms of V. vulnificus infection may occur within 24 to 48 hours of ingestion and may include sudden chills, fever, nausea, vomiting, diarrhea, shock, and skin lesions. According to FoodNet, an active surveillance network of foodborne diseases in the United States, the annual incidence of Vibrio vulnificus per 100,000 population increased from 0.01 to 0.05 between 1996 and 2010 17). Centers for Disease Control and Prevention, Vibrio vulnificus (Warm Seawater Bacteria Infection). Thoroughly wash hands, utensils, and surfaces after preparing or handling raw seafood. The symptoms are not specific to waterborne illnesses; waterborne pathogens should be suspected if symptoms coincide with water-based activity, especially in the summer.3 Table 1 identifies the most common symptoms of waterborne illness, initial management, and symptoms that require urgent disease-specific treatment in addition to supportive care.512, Common waterborne gastrointestinal illnesses are summarized in Table 2.1316 Cryptosporidiosis and giardiasis account for more than 50% of all reported recreational waterborne illnesses.3 Cryptosporidiosis is caused by the apicomplexan protozoan Cryptosporidium. Vibrio vulnificus is a bacterium that is a rare cause of illness in the United States. Eat shellfish promptly after cooking and refrigerate leftovers. Ingestion of a single oocyst can cause symptoms; conversely, about one-half of infected persons are asymptomatic.18 Symptoms, when present, occur within one to two weeks of exposure, are intermittent, and can recur after treatment. Persons with prolonged or recurrent diarrhea with potential exposure history should be tested for, Patients with open wounds, diabetes mellitus, or chronic liver conditions should avoid swimming in brackish water because of the high risk of, Acute febrile illness after swimming in endemic area, Yes, with doxycycline (outpatients) or ampicillin/sulbactam (Unasyn; inpatients), Cellulitis (rapidly progressing) after exposure to salt or brackish water, Yes, with tetracycline (plus third-generation cephalosporin for hospitalized patients), No, symptomatic and supportive treatment only, Meningeal signs after exposure to infested fresh water, Yes, with miltefosine (Impavido, available from the Centers for Disease Control and Prevention), Gastrointestinal symptoms, skin and lung irritation, Supportive treatment; avoid further exposure, Primarily diarrhea but may include abdominal pain, fever, nausea, vomiting, and weight loss, Supportive treatment (fluids); nitazoxanide (Alinia) for prolonged symptoms in immunocompetent patients, Abdominal cramps, arthralgias, diarrhea, hives, nausea, pruritus, and vomiting, Metronidazole (Flagyl), nitazoxanide, or tinidazole (Tindamax) for prolonged symptoms (alternatives include paromomycin or furazolidone), Bloody diarrhea, fever, vomiting; hemolytic uremic syndrome in severe cases, Supportive treatment; antibiotics and anti-diarrheals should be avoided, Adenovirus, hepatitis A, norovirus, rotavirus, Abdominal pain, diarrhea, nausea, and vomiting, Self-limiting; symptomatic treatment only (fluids), Rashes and/or symptoms of respiratory illness, Topical antibiotic and corticosteroid; systemic antibiotics for severe symptoms, Influenza-like illness, fever, headache, and muscle aches, Usually resolves after 24 hours; prolonged symptoms may require antibiotics, Doxycycline or quinolone antibiotic; biopsy if, Usually self-limiting; quinolone antibiotic if symptoms persist, Abdominal pain, diarrhea, sepsis, skin necrosis; if untreated, may be fatal, Doxycycline plus third-generation cephalosporin (alternatively, quinolone antibiotic), Children: trimethoprim/sulfamethoxazole plus aminoglycoside. 1999. What are some tips for preventing Vibrio vulnificus infections? Prolonged or unusual symptoms should prompt further investigation, including culture of the affected site. https://www.cdc.gov/disasters/vibriovulnificus.html. Most people with a mild case of vibriosis recover after about 3 days with no lasting effects. Edema and hemoconcentration in mice experimentally infected with Vibrio vulnificus. Shedding may last for several weeks, and symptoms may last for one to three weeks after infection. Capsular polysaccharides in the organisms capsule resist host gastric acid attack, and further trigger the release of host cytokines, such as tumor necrosis factor (TNF) and interleukins-8 and interleukin-6. 101 North Monroe Street
Learn more about Vibrio vulnificus. People with food-related V vulnificus usually have diarrhea for several days and may have nausea, vomiting, stomach cramping, fever, and chills. Preexposure prophylaxis is not effective for casual exposure, but if ongoing exposure is anticipated, pretreatment with 200 mg of doxycycline per week is safe and potentially effective.36,37 As of 2013, leptospirosis is a reportable disease in humans. Surface pili facilitate the attachment to host cells. Vibrio vulnificus is responsible for two major syndromes: primary septicemia and wound infection. Individuals with liver disease, including Hepatitis C and cirrhosis, are most at risk for developing serious illness from Vibrio vulnificus obtained from eating raw oysters. The infection is especially dangerous to people who have long-term (chronic) liver disease. chronic liver disease, kidney disease, or weakened immune system, should wear proper foot protection to prevent cuts and injury caused by rocks and shells on . For shellfish in the shell, either a) boil until the shells open and continue boiling for 5 more minutes or b) steam until the shells open and then continue cooking for 9 more minutes. People with a Vibrio vulnificus infection can get seriously ill and need intensive care or limb amputation. These bacteria live in coastal waters. The cure rate with treatment is 72%.13 Regardless of treatment, shedding continues after symptoms abate, so once asymptomatic, patients should continue to refrain from swimming for two weeks.18 Nitazoxanide is not effective in immunocompromised persons, such as those with poorly controlled human immunodeficiency virus infection, so prevention is key.13. Sargassum seaweed being seen in Florida. If you have one of the medical conditions listed above then you should take extra precautions to avoid exposure to coastal waters including water in bays and estuaries. Waterborne illnesses are underreported because most recreational activity occurs in unsupervised venues or on private property, and participants tend to disperse before illness occurs. Nitazoxanide (Alinia) may be used to treat severe or prolonged diarrhea. Wear protective clothing (ie. Certain Vibrio species, including Vibrio vulnificus, can also cause a skin infection when an open wound is exposed to brackish or salt water. A delay in proper medical treatment could lead to severe infection. Thoroughly cooking oysters, either by frying, stewing, or roasting eliminates harmful bacteria and viruses in the meat. 2002. People who develop wound infections generally do so following contamination of a pre-existing wound or through an injury acquired while exposed to brackish or salt water. These can include painful, rapidly progressive "hemorrhagic bullae" (blisters that appear when fluid is trapped under a thin layer of skin). There is no evidence of person-to-person transmission of Vibrio vulnificus. Symptoms and signs resemble those of food poisoning and include watery diarrhea, abdominal cramping, nausea, vomiting, fever, and chills. While not potentially life-threatening to most healthy people, symptoms of V. vulnificus infection may occur within 24 to 48 hours of ingestion and may include sudden chills, fever, nausea,. Fluoroquinolones were found to be equivalent in efficacy to combination therapy with cefotaxime and minocycline in wound infection models 24). Three-quarters of the patients develop bullous skin lesions, thrombocytopenia, and often disseminated intravascular coagulation. The bacterium can enter through the break in the skin and cause infection. Vibrio vulnificus can cause skin infections after wound exposure to contaminated seawater, as well as primary septicemia through the consumption of contaminated raw or undercooked seafood. doi:10.1017/S0950268813001593, Zhao H, Xu L, Dong H, Hu J, Gao H, Yang M, Zhang X, Chen X, Fan J, Ma W. 2015. Those numbers don't tell a complete story, however. Table 5 summarizes the recommendations that can be used to educate patients about prevention of recreational waterborne illnesses.38. Legionella is a bacteria found in treated fresh water that can infect humans exposed to the aerosolized mist of hot tubs and decorative fountains. On rare occasions, bacterial sinusitis or otitis externa related to Vibrio alginolyticus25 or other unusual marine pathogens can occur. State Government websites value user privacy. Additionally, individuals who are immunocompromised, e.g. Vibrio and Raw Oysters }); Are Vibrio vulnificus infections serious? How common is Vibrio vulnificus infection? Infection is diagnosed when Vibrio bacteria are found in the stool, wound, or blood of a patient who has symptoms of vibriosis. Eating raw or undercooked shellfish, particularly oysters, is the most common way of becoming infected, according to the CDC. That means that it can be found in clean coastal water, including waters that have been approved for shellfishing. Read the full outbreak investigation Seek immediate medical care if a wound develops redness, swelling, or oozing or other signs of working infection such as fever, increasing pain, shortness of breath, fast heart rate, or confusion or disorientation, high heart rate. In the United States, these diarrheagenic E. coli cause 10% of waterborne illnesses.6,7 Shiga toxinproducing E. coli, such as E. coli O157, is the most common pathotype and can make its way into recreational water via a person with diarrhea and incontinence (often a child) or into untreated water via livestock. Vibrio vulnificus is a bacterium that occurs naturally in marine and estuarine waters throughout the world. Vibrio vulnificus is an opportunistic human pathogen that is highly lethal and is responsible for the overwhelming majority of reported seafood-related deaths in the United States 1).