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International Society for Infectious Diseases <http://www.isid.org>

Date: Fri 29 Jun 2012
Source: Missouri Department of Health and Senior Services [edited] <http://health.mo.gov/emergencies/ert/alertsadvisories/pdf/advisory62912.pdf>

The Missouri Department of Health and Senior Services (DHSS) is investigating a cluster of cases of vibriosis in eastern Missouri which were identified 27-28 Jun 2012. 3 cases of _Vibrio parahaemolyticus_ [infection] have been identified during this time period. Typically, this infection is associated with eating raw or undercooked shellfish, particularly oysters. The investigation is ongoing. DHSS recommends that any person who has signs or symptoms of acute gastroenteritis after consuming raw or undercooked shellfish should seek medical care. Health care providers should consider obtaining stool cultures for Vibriosis in such patients.

Vibriosis is caused by _Vibrio_ bacteria, such as _V.
parahaemolyticus_ that grow
in coastal waters. Risk factors for acquiring gastrointestinal Vibrio infections
include: eating raw or undercooked shellfish (oysters, clams, mussels) or crabs; or cross-contamination of other foods and surfaces with raw shellfish or crabs during preparation.

Disease symptoms may include: nausea, vomiting, diarrhea, abdominal cramps, and in some cases, signs of severe infection (septicemia), including fever and low blood pressure.

Symptoms can start from 4 to 96 hours after eating contaminated food.
can be a mild to serious disease. People with weakened immune systems, especially those with liver disease, diabetes, and peptic ulcers, are at highest risk for serious disease. The infection is not normally communicable from person to person. Vibrio infections can be treated with antibiotics. Most episodes of diarrhea are mild and self-limited, and do not require treatment other than oral rehydration.

Communicated by:

[It is important to stress that _Vibrio parahaemolyticus_ is naturally
present in marine waters and does not imply sewage contamination, as
would be the case with _Salmonella_ sp. or _E. coli_. It is most
common in warmer waters such as those of the American Gulf Coast, but
warmer waters in more northern climates such as in Washington State
and Alaska, can also be associated with oyster-associated _V.

Most cases of _V. parahaemolyticus_ infection are reported from
coastal states where there is more exposure to the contaminated
(usually) oysters. Oysters, however, can be shipped to non-coastal
water states such as Missouri. Affected oysters are classically
harvested in the waters of the Gulf of Mexico or other warm water
areas but with global warming, the infection has been associated with
more northern climes such as Alaska, Washington State and Maine.

The source of the shellfish here is not state and it is certainly
possible for cases to be recognized in other states. - Mod. LL

A HealthMap/ProMED-mail map can be accessed at:

[see also:
Vibrio parahaemolyticus, oysters - USA: (MA), 2011 20120512.1131191
Vibrio parahaemolyticus, oysters - USA (04): (WA) expanded alert
Vibrio parahaemolyticus, oysters - USA (03): (WA) alert 20110915.2820
Vibrio parahaemolyticus, oysters - USA (02): (CA) 20110913.2786
Vibrio parahaemolyticus, oysters - USA: (WA) 20110807.2394
Vibrio parahaemolyticus, oysters - USA: (WA) 20100803.2604
Vibrio parahaemolyticus, seafood - Chile 20081223.4041
Vibrio parahaemolyticus, oysters - USA: (MD ex NJ) 20080821.2608
Vibrio parahaemolyticus, oysters - USA (WA): int'l alert
Vibrio parahaemolyticus, shellfish - Chile: 2005 20070321.0991
Vibrio parahaemolyticus, shellfish - Chile (San Antonio)
Vibrio parahaemolyticus, shellfish - USA (multistate) (03)
Vibrio parahaemolyticus, shellfish - USA (multistate) 20060807.2211
Vibrio parahaemolyticus, shellfish - USA (WA, NY) (05) 20060805.2175
Vibrio parahaemolyticus, shellfish - USA (WA, NY) 20060721.1999
Vibrio parahaemolyticus - North America: background 20060717.1963
Vibrio parahaemolyticus, oysters - North America: USA (OR, WA),
(BC) 20060716.1956
Vibrio parahaemolyticus, seafood - Chile (Puerto Montt) (03)
Vibrio parahaemolyticus, seafood - Chile (Puerto Montt) 20050118.0163
Food poisoning, birthday guests - USA (FL) (02): vibrio
parahaemolyticus 20040927.2664
Food poisoning, birthday guests - USA (FL) 20040922.2619
Vibrio parahaemolyticus, oysters - USA (AK) (02) 20040822.2335
Vibrio parahaemolyticus, oysters - USA (AK) 20040803.2113
Vibrio parahaemolyticus, shellfish - USA (NY): alert 20020822.5111
Vibrio parahaemolyticus, O3:K6 - USA, Asia 20020716.4770
Vibrio parahaemolyticus, oysters - USA (Texas) 20000928.1676
Vibrio parahaemolyticus, oysters - USA (multistate) 19990725.1252]
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