VIBRIO MIMICUS - USA: (WASHINGTON) CRAYFISH
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Date: Fri 29 Oct 2010
Source: CDC. MMWR Morb Mortal Wkly Rep 2010; 59(42): 1374 [edited] <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5942a5.htm?s_cid=mm5942a5_e>
On 24 Jun 2010, the Spokane (WA) Regional Health District (SRHD) was notified of 2 hospitalized patients under intensive care with severe dehydration whose stool specimens yielded _Vibrio mimicus_. CDC was asked to assist with the environmental and epidemiologic investigation. Investigators learned that both persons had consumed crayfish on 20 Jun 2010. The previous day, live crayfish obtained from an online seafood company had been boiled and served warm at a party. The chef reported that the boiled crayfish were served out of a cooler that had contained live crayfish, and the cooler had not been cleaned before being used to serve the cooked crayfish. After the party, the remaining crayfish were refrigerated overnight in different containers and served cold as leftovers the following evening on 20 Jun 2010.
Questionnaires were administered to 21 (95 percent) of 22 persons who had attended either the party on 19 Jun 2010 or the meal of leftovers on 20 Jun 2010. A case was defined as an illness in any person who had attended the party or the meal and experienced acute, watery diarrhea during 19-25 Jun 2010. 4 cases were identified. Consuming leftover crayfish was associated with illness. Of 8 persons who consumed leftover crayfish, 4 (50 percent) became ill compared with 0 of the 13 persons who did not consume leftover crayfish (relative risk = 14; Fisher's exact test p value = 0.007). No other food items or environmental exposures were associated with illness.
_V. mimicus_ was isolated from cultures of stool specimens, and genes encoding cholera toxin were identified by polymerase chain reaction
(PCR) in all 3 ill persons who submitted specimens. 2 persons were hospitalized in an intensive-care unit with severe dehydration, metabolic acidosis, and acute renal failure. The 2 patients received intravenous fluid rehydration, bicarbonate infusions, and antibiotics; they recovered fully. The other 2 persons had mild, self-limited diarrheal illness. Frozen leftover crayfish samples submitted to the FDA on 21 Jul 2010 for testing did not yield _V.
mimicus_ by culture, nor were cholera toxin genes detected using PCR.
_V. mimicus_ has been recognized as a cause of gastroenteritis transmitted by raw oysters, fish, turtle eggs, prawns, squid, and crayfish (1). _V. mimicus_, when carrying genes that encode cholera toxin, can cause severe watery diarrhea (2). Consumers and physicians should be aware that improperly handled marine and aquatic animal products can be a source of _V. mimicus_ infections. Consumers should avoid cross-contamination of cooked seafood and other foods with raw seafood and juices from raw seafood and should follow FDA recommendations for selecting seafood and preparing it safely (3).
[Reported by: MacEachern D, McCullough J, J Duchin J, et al]
References
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1. Oliver JD, Kaper JB: Vibrio species. In: Food microbiology:
fundamentals and frontiers. 2nd ed. MP Doyle, LR Beuchat, TJ Montville, eds. Washington, DC: ASM Press; 2001: 228-64.
2. Shandera WX, Johnston JM, Davis BR, Blake PA: Disease from infection with _Vibrio mimicus_, a newly recognized _Vibrio_ species.
Ann Intern Med 1983; 99(2): 169-171 [abstract available at <http://www.ncbi.nlm.nih.gov/pubmed/6881769>].
3. Food and Drug Administration: Fresh and frozen seafood: selecting and serving it safely. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2009. Available at <http://www.fda.gov/food/resourcesforyou/consumers/ucm077331.htm>.
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[Since 2000, at least 7 noncholeragenic _Vibrio_ species (_V.
vulnificus_, _V. parahaemolyticus_, nontoxigenic _V. cholerae_, _V.
alginolyticus_, _V. fluvialis_, _V. mimicus_, and _V. hollisae_) (ProMED-mail Vibrio vulnificus, post-hurricane - USA(04): Additional Vibrio species 20050915.2723) have been reported as causing illness each year in the USA. Although these organisms and those that cause cholera are grouped together under the genus _Vibrio_, they usually cause distinctly different illnesses.
In the USA, noncholeragenic _Vibrio_ usually are either foodborne, (such as, resulting from eating raw or undercooked shellfish, particularly oysters, or other contaminated foods) or wound-associated (such as, resulting from exposure to seawater or brackish waters where the organism naturally occurs). Non-cholera vibrios are not transmitted easily from person to person. Outbreaks, which are rare, usually are the result of consuming contaminated shellfish.
_V. mimicus_ seems appropriately named since genetically it is the _Vibrio_ species most similar to _V. cholerae_ (1). The organism was first proposed to define atypical non O1 _V. cholerae_ that could not utilize sucrose (2) but sucrose-negative strains of _V. cholerae_ do exist. _V. mimicus_ and _V. cholerae_ share almost 100 percent of 16S rRNA gene sequences and about 80 percent DNA-DNA relatedness and, as in this case, _V. mimicus_ can share important virulence factors.
Multilocus sequence analysis can distinguish the organisms (3).
Additionally, like the cholera bacillus, _V. mimicus_ strongly interacts with free living amoebae (4).
The largest reported foodborne outbreak associated with _V. mimicus_ occurred in 2004 in Thailand, involved at least 300 individuals and was associated with undercooked seafood.
This crayfish-associated outbreak could have been avoided by attention to good kitchen hygiene, that is, not placing cooked food in the same place where the uncooked food was.
A crayfish is a freshwater crustacean that looks like a small lobster to which it is related. A picture can be seen at <http://mindjourney1962.files.wordpress.com/2009/01/pond_crayfish2.jpg>.
References
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1. Thompson CC, Vicente ACP, Souza RC, et al: Genetic taxonomy of vibrios. BMC Evol Biology 2009; 9: 258; available at <http://www.biomedcentral.com/1471-2148/9/258>.
2. Davis BR, Fanning GR, Madden JM, et al: Characterization of biochemically atypical _Vibrio cholerae_ strains and designation of a new pathogenic species, _Vibrio mimicus_. J Clin Micriobiol 1981;
14(6): 631-9; available at
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC274012/pdf/jcm00161-0055.pdf>.
3. Thompson CC, Thompson FL, Vicente ACP: Identification of _Vibrio cholerae_ and _Vibrio mimicus_ by multilocus sequence analysis (MLSA). Int J Syst Evol Microbiol. 2008; 58 (pt 3): 617-21; available at <http://ijs.sgmjournals.org/cgi/content/full/58/3/617>.
4. Abd H, Valeru SP, Sami SM, et al: Interaction between _Vibrio mimicus_ and _Acanthamoeba castellanii_. Environ Microbiol Rep 2010;
2(1): 166-71; available at
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861843/>. - Mod.LL]
[Spokane can be located on the HealthMap/ProMED-mail interactive map at <http://healthmap.org/r/0eEk>. - Sr.Tech.Ed.MJ]
[see also:
Vibrio vulnificus, post-hurricane - USA(04): Additional Vibrio species 20050915.2723] ...................................mpp/ll/mj/dk
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