Who would not love to feed on the delicious sea food? No matter where they are, sea food always has a special place in the menu of every hotel or home. There are numerous health benefits in eating sea food; they are very rich source of protein without or with less fat unlike other animal foods. Yet everyone consuming sea food should be a bit precautious, if they love to eat raw sea food. Every year millions of Americans consume molluscan seafood such as oysters and clams. Many consume them uncooked or undercooked unaware about the fact that they could bring serious illness and infection. One such serious infection caused by consuming raw or undercooked molluscan is Vibrio vulnificus infection.
About Vibrio vulnificus infection
Vibrio vulnificus infection is caused by the bacteria Vibrio vulnificus, a gram negative bacterium that commonly thrives in warm seawater with a temperature greater than 68°F. This bacterium is not associated with pollution or fecal contamination of the water, they naturally grows in warm coastal regions like Gulf of Mexico and coastal regions of America. There are number of other Vibrio bacterium causing many health hazards, among them Vibrio vulnificus is considered the most lethal bacterium inhibiting brackish waters and salt water. Even with prompt diagnosis and aggressive treatment the mortality rate is as high as 30-40%.
Mode of infection
Shell fishes such as oysters and clams gather Vibrio vulnificus bacteria in their tissue. When a person eats these shell fishes, either raw or undercooked, the bacteria gains direct entry into the digestive tract and starts multiplying rapidly. Apart from this mode of entry, the bacteria can also entry through cuts or burns, sores or bruises if they come into direct contact with sea water containing Vibrio vulnificus. The transmission of bacteria is very common during summer when the bacteria are at their highest levels. Vibrio vulnificus infection is not a very common infection and it is not contagious.
People at risk
Healthy individuals are not targeted by Vibrio vulnificus infection. People at risk are those who are suffering from previous medical conditions like
- Liver disease
- Hepatitis
- Liver cirrhosis (death of liver cells)
- Liver cancer
- Gastric disorder
- Hemochromatosis (increased iron content in blood)
- Diabetes
- HIV/AIDS
- Cancer
- Consuming alcohol
- Renal disease (kidney disease)
- Persons taking medications to reduce stomach acid levels and who had a gastric surgery are at high risk
- People who consume raw oysters
- Wound exposed to warm salt warm containing Vibrio vulnificus
Symptoms
Symptoms in individuals with Vibrio vulnificus infection include abdominal pain, cramps, vomiting, and diarrhea. Fever may be present in some. There could be development of blisters on skin which may erode into necrotic ulcers. In persons with other medical conditions the symptoms are severe and include – high fever, chills, decrease in blood pressure, redness, and swelling on the skin. In case of wound entry, the person may suffer from severe skin infection, painful skin lesions, redness, swelling, and intense pain around the infected region. In severe cases, the person may have altered mental status, and even death, if the infection spreads to the blood stream (sepsis). Contact the nearby physician in case any of these symptoms are experienced after consuming sea food.
Diagnosis
Diagnosis of Vibrio vulnificus infection is not usually based on symptoms because they exhibit quite vague symptoms that do not give a conclusive result. Prompt and quick diagnosis is critical as sepsis (bacteria in blood) occurs very rapidly in patients who are at high risk. One third of patients with sepsis develop hypotension or shock within 24 hours of infection. Patients, with alcoholic liver cirrhosis and immune-compromise disease such as HIV/AIDS, presenting hypotension or shock should be considered to have Vibrio vulnificus infection or septicemia. However, diagnosis is usually confirmed by stool, wound or blood cultures.
Treatment
The widely recommended treatment for Vibrio vulnificus infection is antibiotic doxycycline 100 mg, either intravenously or orally twice a day. Along with this ceftazidime 2g is given intravenously every 8 hours. Other alternative antibiotics prescribed may include cefotaxime or ciprofloxacin. In addition to antibiotic therapy, many patients require aggressive supportive care in the intensive care unit. Proper wound care is very essential. In many surgical debridements (the process of cleaning an open wound by removal of foreign material), draining out the fluid from the wound by incision, and amputation has shown to reduce mortality rate. Infection in healthy individuals is usually acute and those who recover should not have any long term consequences. Infection in high risk individuals usually has 50% fatality rate and those who recover from wound infection develop necrosis, which requires skin grafting or limb amputation.
Safety tips
Few safety tips that will help prevent Vibrio vulnificus infection are
- Avoid eating raw oysters or other shell fishes
- Eat shell fishes that are cooked thoroughly
- Avoid eating shell fishes that do not open during cooking
- Refrigerate the leftover cooked shellfish immediately
- Do not go in warm salt water or brackish water if wound or bruises are present
- If any cut or bruise in hand wear protective gloves during shell fish handling
- Limit oyster consumption during summer
- High risk patients should avoid or consume well cooked shell fish
- Wash hands thoroughly after handling shellfish
- Wash utensils, knife, and chopping plate thoroughly after use
Outlook
Vibrio vulnificus infection should be dealt seriously as any delay in diagnosis or treatment can result fatally. People who fall under high risk category should practice extra caution when consuming shell fishes. Being aware of such infections and following safety precautions while handling and consuming seafood can help prevent such serious infection. Eat healthy and stay healthy.
