ProMed- CHOLERA O75 - USA: (FLORIDA) RAW OYSTERS, WARNING
ProMed- CHOLERA O75 - USA: (FLORIDA) RAW OYSTERS, WARNING
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,88394
Archive Number 20110511.1443
Published Date 11-MAY-2011
Subject PRO/EDR> Cholera O75 - USA: (FL) raw oysters, warning
CHOLERA O75 - USA: (FLORIDA) RAW OYSTERS, WARNING
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Date: Tue 10 May 2011
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5gNbMYDzfbT7tbN118PgbtC2kRHYA?docId=CNG.60d5b39646e58529e4788d62cae3ee2e.431>
As many as 11 people have reported getting sick from eating raw
oysters contaminated with cholera bacteria in northern Florida,
officials said on Tuesday, 10 May 2011.
The oysters came from Apalachicola Bay, near Panama City in northern
Florida, about 300 miles (482 kilometers) from New Orleans along the
Gulf of Mexico coast, and the FDA issued a warning not to eat them.
"There is ongoing, collaborative discussions among all state and
federal partners as we look at this new pathogen to analyze the 1st
ever outbreak of this unique strain of _Vibrio cholerae_," Florida's
Department of Agriculture said in a statement.
State officials said 11 cases of illness were reported, while the FDA
said 8 of those have so far been confirmed as "caused by toxigenic
_Vibrio cholerae_ O75... No one was hospitalized or died."
The high number of cases is unusual, given that the Centers for
Disease Control typically logs 1 to 2 cases per year, an FDA spokesman
told AFP. "From 2000-2010, a total of 17 persons with toxigenic _V.
cholerae_ O75 infection were reported to CDC, the numbers are greatest
when the water is warm," spokesman Douglas Karas said in an email.
The FDA said the affected oysters were harvested from Area 1642 in
Apalachicola Bay between 21 Mar and 6 Apr 2011. The Florida Department
of Agriculture said it closed the area to oyster harvesting on 29 Apr
2011 and was investigating the cause of the outbreak. "To date, we
have learned of 2 events that may be the cause of the cholera related
illnesses. First, there was a dredging operation near the 1642
harvesting area that may have stirred up organisms on the floor of the
ocean," it said. "We have also learned there was a sewer break in East
Point and we are investigating whether it had any impact on oysters in
1642. The harvesting area will remain closed until our investigation
is complete."
Area 1642 is home to about 10 percent of the state's oyster harvest,
and oysters taken from there are mainly consumed in Florida, Georgia,
and Alabama.
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[A HealthMap/ProMED-mail interactive map of the Florida can be seen
at <http://healthmap.org/r/0PL7>. - Sr.Tech.Ed.MJ]
[In contrast to _V. cholerae_ serotype O1 and O139, the non-O1,
non-O139 _V. cholerae_ (NCV) are not associated with cholera epidemics
but with sporadic cases or small outbreaks of gastrointestinal
disease. Occasionally they can cause extraintestinal disease including
wound infections and septicemia. A few NCV strains produce cholera
enterotoxin, the toxin responsible for massive dehydrating diarrhea.
Some strains can have other virulence genes leading to less severe
intestinal symptoms. The presence of typical rice water stools and
dehydration are uncommon in NCV infection and suggest cholera
enterotoxin production.
The following is the citation that first described O75 as a cause of
a cluster of illness in the USA: Tobin-D'Angelo M, Smith AR, Bulens
SN: Severe diarrhea caused by cholera toxin-producing _Vibrio
cholerae_ serogroup O75 Infections Acquired in the Southeastern United
States.
Clin Infect Dis. (2008) 47(8): 1035-40 (available at
<http://cid.oxfordjournals.org/content/47/8/1035.long>):
Abstract
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Background: from 2003 through 2007, _Vibrio cholerae_ serogroup O75
strains possessing the cholera toxin gene were isolated from 6
patients with severe diarrhea, including 3 in Georgia, 2 in Alabama,
and 1 in South Carolina. These reports represent the 1st
identification of _V. cholerae_ O75 as a cause of illness in the USA.
_V. cholerae_ O75 was isolated from a water sample collected from a
pond in Louisiana in 2004. Subsequently, 3 _V. cholerae_ isolates from
Louisiana (2 from patients with diarrhea in 2000 and 1 from a water
sample collected in 1978) that had been previously reported as
serogroup O141 were also discovered to be serogroup O75.
Results: all 8 patients who were infected with _V. cholerae_ O75 were
adults who became ill after consuming seafood; 2 had eaten raw oysters
traced back to the Gulf Coast of the United States. All 10 isolates
possessed the cholera toxin gene and were susceptible to 10
antimicrobials. One clinical isolate and one environmental (water)
isolate had the same pulsed-field gel electrophoresis pattern; 4
clinical isolates shared a common pulsed-field gel electrophoresis
pattern.
Conclusions: the occurrence of these cases over many years and the
concurrent identification of _V. cholerae_ O75 in water from a Gulf
Coast state suggest that these strains may survive for long periods in
this environment. The patients' exposure histories suggest that
infection can be acquired from consumption of raw oysters from the
Gulf Coast. Clinicians and public health authorities should be
vigilant for the occurrence of new toxigenic serogroups of _V.
cholerae_ that are capable of causing severe diarrhea." - Mod.LL]
[see also:
2009
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Cholera, non-O1 - Netherlands ex Spain (02): (CN) 20090818.2931
Cholera, non-O1 - Netherlands ex Spain (CN) 20090803.2725
2006
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Cholera, non-O1, non-O139 - Poland 20061207.3450
Cholera, non-O1, non-O139 - Netherlands (North) 20060811.2255
Cholera, non-O1, non-O139 - Sweden (Blekinge): wound infection
20060804.2157
2005
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Vibrio vulnificus, post-hurricane - USA(04): Additional Vibrio
species 20050915.2723
2001
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Cholera O13 - China (Hainan): RFI 20010418.0768]
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