SafeOysters.org - Health Care Providers

A Publication of University of Georgia Marine Extension Service California Sea Grant Extension Program Georgia Sea Grant University of Georgia Public Service and Outreach UC Agriculture and Natural Resources Sponsored by National Sea Grant Acknowledgments

Intro

Diagnosis

High-risk Patients

Modes of Infection

Prevention

Public Health Impact

Resources

Symptoms

Treatment

Resources and References

Internet Resources

American Medical Association

• Diagnosis and Management of Foodborne Illnesses: A Primer for Physicians and Other Health Care Professionals
• Foodborne Illness Table: Bacterial Agents*

Centers for Disease Control and Prevention

• Centers for Disease Control and Prevention. Vibrio vulnificus infections associated with raw oyster consumption - Florida, 1981-1992. MMWR. 1993:42(21); 405-407.*
• Disaster Recovery Fact Sheet - Vibrio vulnificus
• Management of Vibrio vulnificus Wound Infections
• Vibrio vulnificus General Information
• Vibrio vulnificus Technical Information
• Vibrio vulnificus Additional Information

Interstate Shellfish Sanitation Conference (ISSC)

• Faxable Order Form for Physician and Patient Education Materials*

   Educational Resources for Physicians from ISSC

• Physician Internet Course: Diagnosis, Treatment and Prevention of Vibrio vulnificus Infection (one CME available to licensed physicians at no cost for a limited time only)
• Published Vibrio vulnificus Reference Materials (2004)*
• Review of Pathogenic VibrioInfections for Clinicians (2000 N.A. Daniels and A. Shafaie)*
• Vibrio vulnificus Fact Sheet for Health Care Providers*
• Vibrio vulnificus Hazard in Patients with Liver Disease (1994 K. W. Kizer)*

   Patient Education Materials from ISSC

• The Risk of Eating Raw Molluscan Shellfish Containing Vibrio vulnificus(English)*
• The Risk of Eating Raw Molluscan Shellfish Containing Vibrio vulnificus (Spanish)*
• Vibrio vulnificus and Diabetes*
• Vibrio vulnificus and Liver Disease*
• Vibrio vulnificus (For wider audience of immunocompromised individuals)*

U.S. Food and Drug Administration

• Bad Bug Book

University of California Food Safe Program

• "Fifty Ways to Eat Your Oysters" amusing food safety education song and lyrics by Carl K. Winter, Ph.D. (University of California Cooperative Extension Food Toxicology Specialist) - RealPlayer required.

University of Georgia

• Diagnosing and Treating Deadly Vibrio vulnficus Infection - (2008 T. Stivers)*
   

Additional References

1. Andrews, L.S. 2004. Strategies to control Vibrios in molluscan shellfish. Food Protection Trends 24(2): 70-76.
2. Smith, J.L. 2003. The role of gastric acid in preventing foodborne disease and how bacteria overcome acid conditions. Journal of Food Protection 66(7):1292-1303.
3. Weinberg, E.D. 2000. Microbial pathogens with impaired ability to acquire host iron. BioMetals 13(1):85-89.

References Cited Alphabetically

1. American Medical Association, Centers for Disease Control and Prevention, U.S. Food and Drug Administration. 2001. Diagnosis and management of foodborne illnesses, a primer for physicians.
2. Arias, C.R., M.C. Macian, R. Aznar, E. Garay, and M.J. Pujalte. 1999. Low incidence of Vibrio vulnificus among Vibrio isolates from sea water and shellfish of the western Mediterranean coast. Journal of Applied Microbiology. 86:125-134.
3. Bashin, M. 2004. Vibrio vulnificus Case Analysis 1993-2003. (unpublished report). Interstate Shellfish Sanitation Conference.
4. Blake, P.A, M.H. Merson, R.E. Weaver, D.G. Hollis, and P.C. Heublein. 1979. Disease caused by a marine Vibrio: clinical characteristics and epidemiology. N Engl J Med 300:1-5.
5. Cases of Vibrio vulnificus identified among Hurricane Katrina evacuees [Internet]. Atlanta (GA): Centers for Disease Control & Prevention, Health Advisory no. 233. [2005 September 7; cited 2005 September 10]. Available from: http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00233
6. Cavallo, R.A., and L. Stabili. 2002. Presence of vibrios in seawater and Mytilus galloprovincialis (Lam.) from the Mar Piccolo of Taranto (Ionian Sea). Water Research. 36:3719-3726.
7. Centers for Disease Control and Prevention. Vibrio vulnificus infections associated with raw oyster consumption - Florida, 1981-1992. MMWR. 1993:42(21); 405-407.*
8. Daniels, N.A. and A. Shafaie. A review of pathogenic Vibrio infections for clinicians. J Infect Med. 2000;17(10):665-685.*
9. Emergency wound management for healthcare professionals [Internet]. Atlanta (GA): Centers for Disease Control & Prevention. 2005. [modified 2005 September 9; cited 2005 September 10]. Available from: http://www.bt.cdc.gov/disasters/emergwoundhcp.asp
10. Flattery, J. and M. Bashin. 2003. A baseline survey of raw oyster consumers in four states. Interstate Shellfish Sanitation Conference.*
11. Hervio-Heath, D., R.R. Colwell, A. Derrien, A. Robert-Pillot, J.M. Fournier, and M. Pommepuy. 2002. Occurrence of pathogenic vibrios in coastal areas of France. Journal of Applied Microbiology. 92:1123-1135.
12. Hlady, W.G and K.C. Klontz. 1996. The epidemiology of Vibrio infections in Florida, 1981-1993. J Inf Dis 173:1176-83.
13. Hsueh, P.R., C.Y. Lin, H.J. Tang, H.C. Lee, J.W. Liu, Y.C. Liu, and Y.C. Chuang. 2004 Vibrio vulnificus in Taiwan. Emerg Infect Dis [serial on the Internet]. [cited March 28, 2005 ].
14. Interstate Shellfish Sanitation Conference. 2003.Vibrio vulnificus Fact Sheet for Health Care Providers*
15. Interstate Shellfish Sanitation Conference. 2003. The risk of eating raw molluscan shellfish containing Vibrio vulnificus (consumer brochure - English)*
16. Interstate Shellfish Sanitation Conference. 2003. The risk of eating raw molluscan shellfish containing Vibrio vulnificus (consumer brochure - Spanish)*
17. Jaksic, S., S. Uhitil, T. Petrak, D. Bazulic, and L. Gumhalter Karolyi. 2002. Occurrence of Vibrio spp. in sea fish, shrimps and bivalve molluscs harvested from Adriatic Sea. Food Control. 13:491-493.
18. Johnston J.M., S.F. Becker, and L.M. McFarland. 1985/ Vibrio vulnificus: man and the sea. JAMA 253:2850-3.
19. Kedzierska, K, R. Azzam, P. Ellery, J. Mak, A. Jaworowski, and S.M. Crowe. 2003. Defective phagocytosis by human monocyte/macrophages following HIV-1 infection: underlying mechanisms and modulation by adjunctive cytokine therapy. J Clin Virol. 26(2):247-63.
20. Kizer, K.W. 1994. Vibrio vulnificus hazard in patients with liver disease. Western Journal of Medicine. 161:65.*
21. Koo, J, D.L. Marshall, and A. DePaola. 2001. Antacid increases survival of Vibrio vulnificus and Vibrio vulnificus phage in a gastrointestinal model. Appl Envir Microbiol 67:2895-2902.
22. Kumamato, K.S., and D.J. Vukich. 1998. Clinical infections of Vibrio vulnificus: a case report and review of the literature. J Emerg Med. 16:61-66.
23. Marhoffer, W., M. Stein, E. Maeser, and K. Federlin. 1992. Impairment of polymorphonuclear leukocyte function and metabolic control of diabetes. Diabetes Care. 15(2):256-60.
24. Martin, G, A.M. Wright, and K.A. Banakaim. 2000. A case of fatal food-borne septicemia:can family physicians provide prevention? J Am Board Fam Pract. 13:197-200.
25. Mississippi Department of Marine Resources. 2004. Post-harvest oyster processing technologies fact sheet.
26. Morris, J.G. 2003. Vibrio vulnificus infections. UpToDate (www.uptodate.com).
27. Tacket, C.O, F. Brenner F, and P.A. Blake. 1984. Clinical features and an epidemiological study of Vibrio vulnificusinfections. J Inf Dis 149:558-561.
28. Tal, S, V. Guller, O. Zimhony, S. Levi, M. Greenshpun, and A. Gurevich. 2004. A "fishy remedy": an unusual transmission of Vibrio vulnificus infection. Southern Medical Journal 97(2): 205-207.
29. Tamplin, M., R. Hammond, P. Gulig, and R. Baker. 2001. Vibrio vulnificus, a hidden risk in raw oysters (video). A clinician's guide to V. vulnificus infection and treatment. (Request via Interstate Shellfish Sanitation Conference order form.)*
30. Thampuran, N., and P.K. Surendran. 1998. Occurrence and distribution of Vibrio vulnificus in tropical fish and shellfish from Cochin (India). Letters in Applied Microbiology 26(2):110-112.
31. Ulusarac, O and E. Carter. 2004. Varied clinical presentations of Vibrio vulnificus infections: a report of four unusual cases and review of the literature. Southern Medical Journal 97(2): 163-168.
32. Vibrio illnesses after Hurricane Katrina -- multiple states, August -- September 2005 [Internet]. Atlanta (GA): Centers for Disease Control and Prevention, MMWR 54 (Dispatch); 1-4 [2005 September 14; cited 2005 October 26]. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm54d914a1.htm
33. Volberg CM, and J.L Herrera. 1997. Vibrio vulnificus infection: an important cause of septicemia in patients with cirrhosis. South Med J. 90(10):1040-2.
34. Yoshida, S, M. Ogawa, and Y. Mizuguchi. 1985. Relation of capsular materials and colony opacity to virulence of Vibrio vulnificus. Infectious Immunity. 47:446-451.

List of References by Website Section

Diagnosis References

1. Daniels N.A., Shafaie A. 2000. A review of pathogenic Vibrio infections for clinicians. J Infect Med .17(10):665-685.*
2. Martin G, Wright A.M., Banakaim K. 2000. A case of fatal food-borne septicemia:can family physicians provide prevention? J Am Board Fam Pract. 13:197-200.
3. Morris, J.G. 2003. Vibrio vulnificus infections. UpToDate. (www.uptodate.com)
4. American Medical Association, Centers for Disease Control and Prevention, U.S. Food and Drug Administration. 2001.Diagnosis and management of foodborne illnesses, a primer for physicians.

High-Risk Patients References

1. Hlady W.G. and K.C. Klontz. 1996. The epidemiology of Vibrio infections in Florida, 1981-1993. J Inf Dis 173:1176-83.
2. Bashin, M. 2004. Vibrio vulnificus Case Analysis 1993-2003. (unpublished report). Interstate Shellfish Sanitation Conference.
3. Tacket C.O, F. Brenner F. and P.A. Blake. 1984. Clinical features and an epidemiological study of Vibrio vulnificus infections. J Inf Dis 149:558-561
4. Johnston J.M., S.F. Becker, and L.M. McFarland. 1985. Vibrio vulnificus: man and the sea. JAMA 253:2850-3.
5. Blake, PA, M.H. Merson, R. E. Weaver, D.G. Hollis and P.C. Heublein. 1979. Disease caused by a marine Vibrio: clinical characteristics and epidemiology. N Engl J Med 300:1-5.
6. Volberg C.M., and J.L. Herrera. 1997. Vibrio vulnificus infection: an important cause of septicemia in patients with cirrhosis. South Med J. 90(10):1040-2.
7. Hsueh, P.R., C.Y. Lin, H.J. Tang, H.C. Lee, J.W. Liu, Y.C. Liu, and Y.C. Chuang. 2004 Vibrio vulnificus in Taiwan. Emerg Infect Dis [serial on the Internet]. [cited March 28, 2005 ]
8. Marhoffer, W., M. Stein, E. Maeser, and K. Federlin. 1992. Impairment of polymorphonuclear leukocyte function and metabolic control of diabetes. Diabetes Care. 15(2):256-60.
9. Kedzierska, K., R. Azzam, P. Ellery, J. Mak, A. Jaworowski, and S.M. Crowe. 2003. Defective phagocytosis by human monocyte/macrophages following HIV-1 infection: underlying mechanisms and modulation by adjunctive cytokine therapy. J Clin Virol. 26(2):247-63.
10. Koo, J., D.L. Marshall, and A. DePaola. 2001. Antacid increases survival of Vibrio vulnificus and Vibrio vulnificus phage in a gastrointestinal model. Appl Envir Microbiol 67:2895-2902.

Modes of Infection References

1. Tamplin, M., R. Hammond, P. Gulig, and R. Baker. 2001. Vibrio vulnificus, a hidden risk in raw oysters (video). A clinician's guide to V. vulnificus infection and treatment. (Request via Interstate Shellfish Sanitation Conference order form.)*
2. Arias, C.R., M.C. Macian, R. Aznar, E. Garay, and M.J. Pujalte. 1999. Low incidence of Vibrio vulnificus among Vibrio isolates from sea water and shellfish of the western Mediterranean coast. Journal of Applied Microbiology. 86:125-134.
3. Cavallo, R.A., and L. Stabili. 2002. Presence of vibrios in seawater and Mytilus galloprovincialis (Lam.) from the Mar Piccolo of Taranto (Ionian Sea). Water Research. 36:3719-3726.
4. Hervio-Heath, D., R.R. Colwell, A. Derrien, A. Robert-Pillot, J.M. Fournier, and M. Pommepuy. 2002. Occurrence of pathogenic vibrios in coastal areas of France. Journal of Applied Microbiology. 92:1123-1135.
5. Jaksic, S., S. Uhitil, T. Petrak, D. Bazulic, and L. Gumhalter Karolyi. 2002. Occurrence of Vibrio spp. in sea fish, shrimps and bivalve molluscs harvested from Adriatic Sea. Food Control. 13:491-493.
6. Thampuran, N., P.K. Surendran. 1998. Occurrence and distribution of Vibrio vulnificus in tropical fish and shellfish from Cochin (India). Letters in Applied Microbiology 26(2):110-112.
7. Yoshida, S, M. Ogawa, Y. Mizuguchi. 1985. Relation of capsular materials and colony opacity to virulence of Vibrio vulnificus. Infectious Immunity. 47:446-451.
8. Bashin, M. 2004. Vibrio vulnificus Case Analysis 1993 - 2003 (unpublished report). Interstate Shellfish Sanitation Conference.
9. Vibrio illnesses after Hurricane Katrina -- multiple states, August -- September 2005 [Internet]. Atlanta (GA): Centers for Disease Control and Prevention, MMWR 54 (Dispatch); 1-4 [2005 September 14; cited 2005 October 26]. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm54d914a1.htm
10. Cases of Vibrio vulnificus identified among Hurricane Katrina evacuees [Internet]. Atlanta (GA): Centers for Disease Control & Prevention, Health Advisory no. 233. [2005 September 7; cited 2005 September 10]. Available from: http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00233
11. Emergency wound management for healthcare professionals [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. 2005. [modified 2005 September 9; cited 2005 September 10]. Available from: http://www.bt.cdc.gov/disasters/emergwoundhcp.asp
12. Tal, S, V. Guller, O. Zimhony, S. Levi, M. Greenshpun, A. Gurevich. 2004. A "fishy remedy": an unusual transmission of Vibrio vulnificus infection. Southern Medical Journal 97(2): 205-207.
13. Ulusarac, O and E. Carter. 2004. Varied clinical presentations of Vibrio vulnificus infections: a report of four unusual cases and review of the literature. Southern Medical Journal 97(2): 163-168.

Prevention References

1. Kizer, K.W. 1994. Vibrio vulnificus hazard in patients with liver disease. Western Journal of Medicine. 161:65.*
2. Flattery, J. and M. Bashin. 2003. A baseline survey of raw oyster consumers in four states. Interstate Shellfish Sanitation Conference.*
3. Interstate Shellfish Sanitation Conference. 2003. The risk of eating raw molluscan shellfish containing Vibrio vulnificus (consumer brochure - English).*
4. Interstate Shellfish Sanitation Conference. 2003. The risk of eating raw molluscan shellfish containing Vibrio vulnificus (consumer brochure - Spanish).*
5. Mississippi Department of Marine Resources. 2004. Post-harvest oyster processing technologies fact sheet.

Public Health Impact References

1. Bashin, M. 2004. Vibrio vulnificus Case Analysis 1993 - 2003 (unpublished report). Interstate Shellfish Sanitation Conference.
2. Interstate Shellfish Sanitation Conference. 2003.Vibrio vulnificus Fact Sheet for Health Care Providers*
3. Tamplin, M., R. Hammond, P. Gulig, R. Baker. 2001. Vibrio vulnificus, a hidden risk in raw oysters (video). A clinician's guide to V. vulnificus infection and treatment. (Request via Interstate Shellfish Sanitation Conference order form.)*

Symptoms References

1. American Medical Association, Centers for Disease Control and Prevention, U.S. Food and Drug Administration. 2001. Diagnosis and management of foodborne illnesses, a primer for physicians.
2. Centers for Disease Control and Prevention. Vibrio vulnificus infections associated with raw oyster consumption - Florida, 1981-1992. MMWR. 1993:42(21); 405-407.*
3. Daniels, N.A. and A. Shafaie. 2000. A review of pathogenic Vibrio infections for clinicians. J Infect Med. 17(10):665-685.*
4. Martin, G, A.M. Wright and K. Banakaim. 2000. A case of fatal food-borne septicemia:can family physicians provide prevention? J Am Board Fam Pract. 13:197-200.
5. Kumamato, K.S., and D. J. Vukich. 1998. Clinical infections of Vibrio vulnificus: a case report and review of the literature. J Emerg Med. 16:61-66.
6. Morris, J.G. 2003. Vibrio vulnificus infections. UpToDate. (www.uptodate.com)

Treatment References

1. Daniels, N.A., and A. Shafaie. 2000. A review of pathogenic Vibrio infections J Infect Med. 17(10):665-685.*
2. Morris, J.G. 2003. Vibrio vulnificus infections. UpToDate. (www.uptodate.com).

* Acrobat Reader required