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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...

A novel water quality intervention that consists of point-of-use water disinfection, safe storage and community education was field tested in Bolivia. A total of 127 households in two periurban communities were randomized into intervention and control groups, surveyed and the intervention was distributed. Monthly water quality testing and weekly diarrhoea surveillance were conducted. Over a 5-month period, intervention households had 44% fewer diarrhoea episodes than control households (P = 0.002). Infants < 1 year old (P = 0.05) and children 5-14 years old (P = 0.01) in intervention households had significantly less diarrhoea than control children. Campylobacter was less commonly isolated from intervention than control patients (P = 0.02). Stored water in intervention households was less contaminated with Escherichia coli than stored water in control households (P < 0.0001). Intervention households exhibited less E. coli contamination of stored water and less diarrhoea than control households. This promising new strategy may have broad applicability for waterborne disease prevention.