CASES/YEAR
8,320 (US); 166,400 (Global)
INCUBATION
4-96 hours; Usually about 24 hours; [CCDM]
INITIAL SYMPTOMS
Acute gastroenteritis usually resolving in 1-7 days with diarrhea, cramping and often nausea/vomiting; [CCDM]
PRECAUTIONS
Standard; "Use Contact Precautions for diapered or incontinent children for duration of illness and to control institutional outbreaks." [CDC 2007 Guideline for Isolation Precautions] Person-to-person transmission is not known to occur. [PPID, p. 2646]
COMMENTS
About 1/4 of patients have a dysentery-like illness with bloody or mucoid stools; Wound infections can occur. The organism lives in seawater and causes outbreaks of gastroenteritis associated with seafood and warmer months. Implicated are raw or inadequately cooked oysters and other seafood. [CCDM, p. 110] Hypotension and shock complicated 3 of 5 cases in a UK outbreak. [Guerrant, p. 160] V. parahemolyticus bacteria are prevalent in coastal seawater, especially in summer months. Contamination of shellfish is natural and may be enhanced by sewage. The bacteria are also known to cause wound infections and septicemia. Bloody diarrhea occurs in less than 15% of cases. Fecal leukocytes are common. Gastroenteritis is usually self-limited. [PPID, p. 2645-6] Wound infections are usually less severe than those caused by V. vulnificus. [Cecil, p. 1920] Sepsis is rare. Severe infections occur in patients with diabetes, liver disease, or immunosuppression. [Harrison ID, p. 558]
DIAGNOSTIC
Culture of stool, blood, or other clinical specimens; [CCDM]
SCOPE
Global (marine coastal environments in warm months); Most outbreaks have been reported in Japan, southeast Asia, and the USA; 1998 outbreaks in the USA were linked to raw oysters and this strain emerged in South America and Africa; [CCDM]
SIGNS & SYMPTOMS
-
>fatigue, weakness
-
>fever
-
G abdominal pain
-
G blood in stool
-
G diarrhea
-
G fecal leukocytes
-
G nausea, vomiting
-
N headache
-
S cellulitis or rash, circinate
-
*sepsis
-
*shock
SOURCE
Eating Contaminated Food, Eating Infected or Toxin-Containing Fish, Eating Contaminated Mollusks or Crustacean, Waterborne (Ingesting, Inhaling, or Swimming)
RESERVOIR
Fish and Shellfish
RISK FACTORS
- Eat undercooked meat or fish
- Ingest infectious agents in food/water
- Travel to endemic area
TREATMENT
Non-cholera Vibrio infection can be treated with a single dose of ciprofloxacin 1 g po or doxycycline 300 mg po. "However, generally, such treatment is not necessary because the infection is self-limited." [Merck Manual, p. 1583]
REFERENCES FOR CASES/YEAR
1. (US) Published in MMWR 2011 = 832 (includes V. parahaemolyticus, V. vulnificus, and V. alginolyticus); Use correction factor of 10 for reported diseases: 832 X 10 = 8320;
2. (Global) Guesstimate: Assume global rate = US rate; Calculate: 20 X 8320 = 166,400;