Widespread Outbreaks of Clam- and Oyster-Associated Gastroenteritis

Abstract

Consumption of raw shellfish has long been known to be associated with individual cases and sporadic outbreaks of enteric illness. However, during 1982, outbreaks of gastroenteritis associated with eating raw shellfish reached epidemic proportions in New York State. Between May 1 and December 31, there were 103 well-documented outbreaks in which 1017 persons became ill: 813 cases were related to eating clams, and 204 to eating oysters. The most common symptoms were diarrhea, nausea, abdominal cramps, and vomiting. Incubation periods were generally 24 to 48 hours long, and the duration of illness was 24 to 48 hours. Bacteriologic analyses of stool and shellfish specimens did not reveal a causative agent. Norwalk virus was implicated as the predominant etiologic agent by clinical features of the illness and by seroconversion and the formation of IgM antibody to Norwalk virus in paired serum samples from persons in five (71 percent) of seven outbreaks in which testing was done. In addition, Norwalk virus was identified by radioimmunoassay in clam and oyster specimens from two of the outbreaks. Determining the source of the shellfish was not always possible, but northeastern coastal waters were implicated. The magnitude, persistence, and widespread nature of these outbreaks raise further questions about the safety of consuming raw shellfish.

Impact of climate change on waterborne diseases

“…One of the outbreaks was characterized by the high diversity of human enteric viruses (up to six different strains) detected both in patient stool and shellfish samples [51]. Other important outbreaks associated to contaminated oyster/clam consumption caused by sewage overflow and discharge into the aquatic environment during heavy rainfall events were reported as those that affected 2000 people in Australia, in summer 1978 [52], and 1000 people in New York State in 1982 [53].…”

Prevalence of Small Round Structured Virus Infections in Acute Gastroenteritis Outbreaks in Tokyo

“…Infection with SRSV, which occurred not only as sporadic cases and family clusters but also as large outbreaks, have been reported in the United States, Australia, United Kingdom, and other countries (3,5,8,11,12). Viruses with characteristics of SRSV have also been detected in sporadic cases and outbreaks of acute gastroenteritis in several parts of Japan (10,(13)(14)(15).…”

Genogroup II Noroviruses Efficiently Bind to Heparan Sulfate Proteoglycan Associated with the Cellular Membrane

“…Norovirus (NV), a member of the family Caliciviridae, is a causative agent of acute gastroenteritis, and NV is known to have been responsible for both sporadic cases and epidemic outbreaks of the disease in both developing and developed countries (23,55). As many as 95% of nonbacterial gastroenteritis outbreaks in the world are reported to be caused by this agent (20).…”

“…As many as 95% of nonbacterial gastroenteritis outbreaks in the world are reported to be caused by this agent (20). Most of the outbreaks are associated with the ingestion of contaminated food, in particular raw shellfish, or contaminated drinking water (24,39,55). The predominant clinical manifestations are nausea, vomiting, and diarrhea (38).…”