Cholera and Other Vibrioses in the United States

Abstract

Wales or one in Tasmania. Although subsequent testing of several samples of oysters from both suppliers failed to isolate V. cholerae, additional cases of V. cholerae infection have been reported. One, in Victoria, was associated with seafood consumption, while the infective source for another case, in Tasmania, was less certain (Dr Kath Taylor, Department of Human Services, Victoria, personal communication). This case highlights the potential of V. cholerae to cause serious illness in immunocompromised patients, and the potential risks to such patients of eating uncooked seafood. Other Vibrio species, such as V. vulnijicus and V.parahaemolyticus, can cause a similar clinical illness. V.vulnijicus, in particular, can cause primary septicaemia, predominantly after the ingestion of uncooked seafood by patients who have an underlying chronic disease. Diagnosis may be readily established in patients with bacteraemia, as all Vibrio species grow in routine blood culture media. However, unless selective media (such as thiosulfate citrate bile salt sucrose [TCBS] agar) are used for stool cultures, these pathogens may be missed.' In patients with underlying chronic illness, particularly chronic liver disease and haematological malignancy, one needs to have a high index of suspicion for Vibrio infections, particularly when patients have eaten uncooked seafood. 1 Guard RW, Brigden M, Desmarchelier P. Fulminating systemic infection caused by Vibrio ctioteree species which does not agglutinate with 0-1 V cholerae antiserum. Med J Aus! 1980; 1 659-661 2 Magmusson MR, Pegg SP. Vibrio cholerae non-01 primary septicaemia following a large thermal burn.

Analysis of some virulence factors ofVibrio vulnificusisolated from Rio de Janeiro, Brazil

“…It is found in high frequency in sea water and sea food, which contrasts with the small number of clinical cases reported worldwide. This indicates a large variation in the pattern of virulence among the strains; this is similar to V. parahaemolyticus, in which only 1 % of the strains found in the aquatic environment is pathogenic for man [3].…”

“…Patients with hepatic dysfunctions or other syndromes involving iron metabolism appear to be most susceptible to this type of infection [2]. The second, represented by cellulitis, results from the direct contact of wounds or skin lesions with sea ecosystem constituents in both apparently healthy and debilitated patients, and sometimes progresses into septicaemia [1,3]. The third form, seldom found, causes acute self-limited diarrhoea with a low mortality rate [4].…”

“…Other factors have also been reported including the presence of some siderophore-like proteins in the membrane [6], the production of enzymes that damage the surrounding tissues [7,8], and various toxins acting like invasive factors in acute infections [1,3]. An interesting point is that some factors were detected in environmental strains as well as in strains of human origin [9].…”

Seasonal variations in the occurrence of Vibriovulnificusalong the Dutch coast

“…Thirty-four Vibrio species are currently recognized in the genus, a third of which are known to be pathogenic for humans [1]. The halophilic Vibrio species, V. parahaemolyticuas, V. alginolyticus and V. vulnificus are known to be involved in intestinal as well as in extra-intestinal human infections [2]. V. parahaemolyticus and V. alginolyticus strains have been isolated from seawater samples and from brackish inshore water collected along the Dutch, the Belgian and the British coasts and a seasonal effect in their occurrence has been demonstrated [3][4][5].…”

Detection of Vibrio parahaemolyticus and Vibrio cholerae in oyster, Crassostrea rhizophorae, collected from a natural nursery in the Cocó river estuary, Fortaleza, Ceará, Brazil

“…Vibrio parahaemolyticus and Vibrio cholerae are pathogenic to humans. They are found in the marine and estuarine environments and may cause gastrointestinal illnesses, either in isolated cases or in the form of outbreaks 19,24 .…”