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Vibrio vulnificus is a bacterium that occurs naturally in estuarine and
coastal waters, residing in high numbers in filter-feeding shellfish (oysters, clams, mussels). The organism is able to cause infection in people through ingestion (typically eating raw oysters) or through a wound (typically a cut or puncture acquired while shucking oysters, peeling shrimp, cleaning fish, etc.). Fortunately, most healthy people are resistant to infection with this bacterium. Those who are at risk, and who should avoid consuming raw or undercooked seafood, are persons with certain underlying diseases. Foremost of these are certain liver diseases (especially cirrhosis and hepatitis),
and certain blood disorders (hemochromatosis, thalassemia major), diabetes, cancer, and gastric disease, among others. For such individuals,
V. vulnificus is one of the most invasive and rapidly fatal human pathogens known. Symptoms following ingestion generally occur within 16-38 hours, and include fever, chills, a decrease in blood pressure, and the development of secondary lesions, typically on the legs. These lesions begin as fluid-filled blisters which progress to result in extensive destruction of muscle tissue, frequently requiring amputation of the affected limb. Continued progression of the infection leads to death in
50% of the cases, with the time to death often only a matter of hours or days. Prompt administration of antibiotics and intensive medical treatment on several fronts is
critical. Infections with
V. vulnificus are seen primarily in males over the age of 40, and generally occur between the months of May and October.
Patients developing wound infections develop fever and chills, with redness, swelling, pain, and tissue destruction at the site of the wound, but do not develop the secondary lesions typical of ingestion cases. The fatality rate for wound infections is approximately 25%, with deaths occurring primarily in persons with the underlying diseases listed above. Of all food-borne diseases, V. vulnificus is the most serious in the United States, with 95% of all seafood-related deaths being due to this one bacterium. The Centers for Disease Control estimates that there are 50 food-borne cases each year serious enough to require hospitalization (although estimates as high as 41,000 total cases have been reported). For a recent review of V. vulnificus and other pathogenic vibrios, the reader is referred to one of the following recent publications: Vibrio species. Oliver, J.D. and J.B. Kaper. pp 263-300, In: Food Microbiology. Fundamentals and Frontiers. 2001. M.P. Doyle, L.R. Beuchat, and T.J. Montville (eds.). American Society for Microbiology Press, Washington, D.C. Vibrio vulnificus. 2006. Oliver, J.D. In: Oceans and Health: Pathogens in the Marine Environment. (pp. 253-276). S. Belkin and R.R. Colwell (eds.). Springer Science, New York. Vibrio vulnificus. 2006. Oliver, J.D. pp. 349-366 In: Biology of Vibrios. F.L. Thompson, B. Austin, and J. Swing. (eds.). American Society for Microbiology Press, Washington, D.C. Wound infections caused by Vibrio vulnificus and other marine bacteria. “Special Article”. Oliver, J.D. 2005. Epidemiology and Infection 133:383-391.
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