Vibrio parahaemolyticus infections are associated with consumption of raw or undercooked shellfish, contaminated food, and exposure of wounds to warm seawater. Foodborne outbreaks and sporadic infections from Vibrio species in 4 Gulf Coast states are reported routinely to the Centers for Disease Control and Prevention (CDC). Between 1988 and 1997, 345 sporadic V. parahaemolyticus infections were reported: 59% were gastroenteritis, 34% were wound infections, 5% were septicemia, and 2% were from other exposures. Forty-five percent of patients suffering from these conditions were hospitalized for their infections, and 88% of persons with acute gastroenteritis reported having eaten raw oysters during the week before their illness occurred. Between 1973 and 1998, 40 outbreaks of V. parahaemolyticus infections were reported to the CDC, and these outbreaks included >1000 illnesses. Most of these outbreaks occurred during the warmer months and were attributed to seafood, particularly shellfish. The median attack rate among persons who consumed the implicated seafood was 56%. To prevent V. parahaemolyticus infections, persons should avoid consumption of raw or undercooked shellfish and exposure of wounds to seawater.

Vibrio vulnificus infections are highly lethal and associated with consumption of raw shellfish and exposure of wounds to seawater. V. vulnificus infections were reported to the Centers for Disease Control and Prevention from 23 states. For primary septicemia infections, oyster trace-backs were performed and water temperature data obtained at harvesting sites. Between 1988 and 1996, 422 infections were reported; 45% were wound infections, 43% primary septicemia, 5% gastroenteritis, and 7% from undetermined exposure. Eighty-six percent of patients were male, and 96% with primary septicemia consumed raw oysters. Sixty-one percent with primary septicemia died; underlying liver disease was associated with fatal outcome. All trace-backs with complete information implicated oysters harvested in the Gulf of Mexico; 89% were harvested in water ú22ЊC, the mean annual temperature at the harvesting sites (P õ .0001). Control measures should focus on the increased risk from oysters harvested from the Gulf of Mexico during warm months as well as education about host susceptibility factors.Vibrio vulnificus is a gram-negative, halophilic bacterium to infections have not previously been studied, and a safe harvesting temperature has not been defined. that inhabits marine and estuarine environments and causes three syndromes of clinical illness in humans: gastroenteritis, Here we summarize data from the Centers for Disease Control and Prevention (CDC) Gulf Coast Surveillance System, wound infections, and primary septicemia [1]. Although gastroenteritis is self-limited and rarely reported, wound infections which has collected epidemiologic and clinical information about V. vulnificus infections in Florida, Alabama, Louisiana, and primary septicemia are highly lethal conditions that occur most often among persons with liver disease or other immunoand Texas since 1988. To assess the contribution of environmental factors in the epidemiology of V. vulnificus infections, compromising conditions [2 -4]. Primary septicemia with V. vulnificus is usually associated with the consumption of raw we also studied the association between reported infections and water temperature at oyster harvesting sites. The clinical and oysters; it is probably the leading cause of seafood-associated fatalities in the United States.environmental information described highlights potential control measures for reducing the number of V. vulnificus infecSince its first recognition as a pathogen in the 1970s [2,5], much has been learned about the effects of bacterial virulence, tions in the United States. host factors, and environmental conditions in the epidemiology of V. vulnificus infections. Vibrios proliferate in warm water Methods [6,7], and infections occur more commonly in warmer months [4,8]; however, the harvest site temperatures of oysters traced States participating in the Gulf Coast Vibrio Surveillance System were Florida, Alabama, Louisiana, and Texas; other states were also encouraged to report Vibrio infections to CDC. Investigators in state and c...

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We examined clinical and epidemiological features of 575 laboratory-confirmed cases of vibrio gastroenteritis in Alabama, Florida, Louisiana, and Texas from 1988 to 1997 (the US Gulf of Mexico Regional Vibrio Surveillance System). Illnesses occurred year round, with peaks in spring and autumn. Illnesses lasted a median of 7 days and included fever in half of patients and bloody stools in 25% of patients with relevant information. Seventy-two percent of patients reported no underlying illnesses. In the week before onset, 236 (53%) of 445 patients for whom data were available ate raw oysters, generally at a restaurant or bar. Educational efforts should address the risk of vibrio gastroenteritis for raw oyster consumers, including healthy individuals. Further studies should examine environmental conditions affecting vibrio counts on seafood and processing technologies to enhance the safety of raw oysters.

This outbreak was caused by contamination of oysters in the oyster bed, probably by stool from one or more ill harvesters. Education of oyster harvesters and enforcement of regulations governing waste disposal by oyster harvesting boats might prevent similar outbreaks.