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Biological Health Hazard – Vibrio vulnificus infections: (Public Health Alert) Alabama

2017/07/11

VIBRIO VULNIFICUS – USA (05): (ALABAMA)
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Published Date: 2017-07-07 10:30:30
Subject: PRO/EDR> Vibrio vulnificus – USA (05): (AL)
Archive Number: 20170707.5157494


Related

Vibrio vulnificus: Mobile County reports 4th confirmed case
Alabama issues Vibrio warning: Don’t enter bodies of water if you have cuts or abrasions


Date: Thu 6 Jul 2017 4:43 PM EDT
Source: WALA [edited]

Barbara Gibbs with The Alabama Department of Health has confirmed 3 cases of flesh eating bacteria (_Vibrio vulnificus_) in Mobile County. Gibbs, who oversees the Infectious Disease and Control Department, said one case was from an individual who consumed raw oysters in another state and the other 2 cases were due to exposure to open wounds in area waters. Officials say the latter 2 cases happened during the month of June [2017]; one in the Mississippi Sound and the other was on Dauphin Island. They say all 3 cases are “mild cases.”

Earlier this week [week of 2-8 Jul 2017], the Gulf Coast News Today reported a 70-year-old Mississippi woman started getting symptoms after fishing off the Fairhope Pier [in Fairhope, AL). In the case of the unidentified Mississippi woman, we’re told she reached into the bait bucket, where a live shrimp pricked her. After returning home to Mississippi, her hand began to swell and she got a fever, chills, and headaches. We are told she was rushed to Forrest General Hospital in Hattiesburg, where she had several surgeries.

“This is not a common occurrence, and for that we are very grateful,” said Dr Karen Landers with the Alabama Department of Public Health. “I think there are about 1000 cases a year reported in the USA. It’s not common, but when people have it, it’s pretty severe.” Dr Landers says they are working with Mississippi health officials to investigate this case further. It is unclear right now whether the bacteria came from the water directly, or from the shrimp that pricked the woman’s hand.

[Byline: Cassandra McAboy, Alexa Knowles, Devan Coffaro]

Communicated by:
ProMED-mail
<promed@promedmail.org>

[The following is extracted from the “Bad Bug Book,” Center for Safety and Applied Nutrition, US FDA (Food and Drug Administration) at http://www.fda.gov/downloads/Food/FoodborneIllnessContaminants/UCM297627.pdf#page46:

_Vibrio vulnificus_, a lactose-fermenting, halophilic, Gram-negative, opportunistic pathogen, is found in estuarine environments and associated with various marine species such as plankton, shellfish (oysters, clams, and crabs), and finfish. Environmental factors responsible for controlling numbers of _V. vulnificus_ in seafood and in the environment include temperature, pH, salinity, and amounts of dissolved organics. It may be normal flora in salt water, and acquiring this organism from shellfish or water exposure does not imply that the water is contaminated by sewage.

Wound infections result either from contaminating an open wound with sea water harboring the organism, or by lacerating part of the body on coral, fish, etc., followed by contamination with the organism. The ingestion of _V. vulnificus_ by healthy individuals can result in gastroenteritis.

The “primary septicemia” form of the disease follows consumption of raw seafood containing the organism by individuals with underlying chronic disease, particularly liver disease. The organism can also enter through damaged skin. In these individuals, the microorganism enters the blood stream, resulting in septic shock, rapidly followed by death in many cases (about 50 percent). Over 70 percent of infected individuals have distinctive bullous skin lesions (shown at http://safeoysters.org/medical/diagnosis.html).

There are 2 points to be emphasized: that vibrios are normal flora in warm saltwater (not indicative of any sewage contamination) and that most of the life-threatening illnesses occur in individuals with underlying medical illnesses, including immunocompromised states, chronic liver disease, and diabetes. So-called normal individuals often just get gastroenteritis. The range of disease due to _V. vulnificus_ can involve more northern geographical areas if the area is affected by a substantial heat wave. – Mod.LL

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/8322.]

See Also

Vibrio vulnificus – USA (04): (TX) 20170703.5147295
Vibrio vulnificus – USA (03): (TX) fatal, tattoo site entry 20170606.5086970
Vibrio vulnificus – USA (02): (MS) 20170601.5076695
Vibrio vulnificus – USA: (FL) 2016 statistics 20170107.4748975

2016
—-
Vibrio vulnificus – USA (08): (MD) fatality 20161024.4581150
Vibrio vulnificus – USA (07): (AL) 20160915.4490920
Vibrio vulnificus – USA (06): (FL) 20160825.4441084
Vibrio vulnificus – USA (05): (FL) 20160807.4400519
Vibrio vulnificus – USA (04): (MS) 20160725.4367896
Vibrio vulnificus – USA (03): (FL) fatality 20160709.4335205
Vibrio vulnificus – USA (02): (MS) 20160706.4329031
Vibrio vulnificus – USA: (LA) 20160601.4259203
Vibrio vulnificus, Mycobacterium marinum – USA: (LA) 20160403.4136309

2015
—-
Vibrio vulnificus – USA (03): (FL) 20151117.3799041
Vibrio vulnificus – USA (02): (VA) fatality 20150806.3562336
Vibrio vulnificus – USA: (FL) 20150615.3437172
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Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


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