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Center for Food Safety & Applied Nutrition

Foodborne Pathogenic Microorganisms
and Natural Toxins Handbook
 

Vibrio cholerae Serogroup Non-O1
Morbidity and Mortality Weekly Reports on Vibrio cholerae Serogroup Non-O1 at Centers for Disease Control   NIH/PubMed: Current Research on Vibrio cholerae Serogroup Non-01   Agricola Advanced Keyword Search of Articles on Vibrio cholerae Non-01

1. Name of the Organism:
Vibrio cholerae Serogroup Non-Ol
This bacterium infects only humans and other primates. It is related to V. cholerae Serogroup O1, the organism that causes Asiatic or epidemic cholera, but causes a disease reported to be less severe than cholera. Both pathogenic and nonpathogenic strains of the organism are normal inhabitants of marine and estuarine environments of the United States. This organism has been referred to as non-cholera vibrio (NCV) and nonagglutinable vibrio (NAG) in the past, although at least 139 "O" serogroups have been identified. (Note: for V. cholerae O139, see Chapter 7).
   
2. Nature of Acute Disease: Non-Ol V. cholerae gastroenteritis is the name associated with this illness. Although rare, septicemic infections have been reported and deaths have resulted. Some cases are similar to the primary septicemia caused by V. vulnficus.
   
3. Nature of Disease: Diarrhea, abdominal cramps, and fever are the predominant symptoms associated with this illness, with vomiting and nausea occurring in approximately 25% of infected individuals. Approximately 25% of infected individuals will have blood and mucus in their stools. Diarrhea may, in some cases, be quite severe, lasting 6-7 days. Diarrhea will usually occur within 48 hours following ingestion of the organism. It is unknown how the organism causes the illness, although an enterotoxin is suspected as well as an invasive mechanism. Disease is caused when the organism attaches itself to the small intestine of infected individuals and perhaps subsequently invades.

Disease caused by V. cholerae O139 is indistinguishable from cholera caused by V. cholerae O1. See chapter 7.

Infective dose - It is suspected that large numbers (more than one million) of the organism must be ingested to cause illness.

   
4. Diagnosis of Human Illness: Diagnosis of a V. cholerae non-Ol infection is made by culturing the organism from an individual's diarrheic stool or from the blood of patients with septicemia.
   
5. Associated Foods: Shellfish harvested from U.S. coastal waters frequently contain V. cholerae serogroup non-Ol. Consumption of raw, improperly cooked or cooked, re-contaminated shellfish may lead to infection.
   
6. Relative Frequency of Disease: No major outbreaks of diarrhea have been attributed to this organism. Sporadic cases occur frequently mainly along the coasts of the U.S., and are usually associated with the consumption of raw oysters during the warmer months.
   
7. Course of Disease and Complications: Diarrhea resulting from ingestion of the organism usually lasts 7 days and is self-limiting. Antibiotics such as tetracycline shorten the severity and duration of the illness. Septicemia (bacteria gaining entry into the blood stream and multiplying therein) can occur. This complication is associated with individuals with cirrhosis of the liver, or who are immunosuppressed, but this is relatively rare. FDA has warned individuals with liver disease to refrain from consuming raw or improperly cooked shellfish.
   
8. Target Populations: All individuals who consume raw shellfish are susceptible to diarrhea caused by this organism. Cirrhotic or immunosuppressed individuals may develop severe complications such as septicemia.
   
9. Food Analysis: Methods used to isolate this organism from foods are similar to those used with diarrheic stools. Because many food isolates are nonpathogenic, pathogenicity of all food isolates must be demonstrated. All virulence mechanisms of this group have not been elucidated; therefore, pathogenicity testing must be performed in suitable animal models.
   
10. Selected Outbreaks: Literature references can be found at the links below.
  Sporadic cases continue to occur all year, increasing in frequency during the warmer months.
MMWR 44(11):1995 The cholera epidemic caused by Vibrio cholerae O1 that began in January 1991 has continued to spread in Central and South America. In southern Asia, the epidemic caused by the newly recognized strain V. cholerae O139 that began in late 1992 also has continued to spread. This report updates surveillance findings for both epidemics.
MMWR 42(26):1993 Epidemics of cholera-like illness caused by a previously unrecognized organism occurred recently in southern Asia. This report documents the first case of cholera imported into the United States that was caused by this organism, the newly described toxigenic Vibrio cholerae O139 strain.
MMWR 31(39):1982 In September 1981, an isolated case of non-O1 Vibrio cholerae gastroenteritis occurred in a Laconia, New Hampshire, resident following consumption of raw clams harvested from New England coastal waters. The patient was a previously healthy 40-year-old woman; her recent travel and personal-contact histories were unremarkable. Within 26 hours after eating the clams, she developed acute abdominal cramps, followed by fever and bloody diarrhea. She was treated symptomatically with rest and oral hydration and recovered without sequelae. Her stool culture grew V. cholerae (Smith serotype 361) and no other enteric pathogens.
Morbidity and Mortality Weekly Reports For more information on recent outbreaks see the CDC.
   
11. Education and Background Resources: Literature references can be found at the links below.
Loci index for genome Vibrio cholerae Available from the GenBank Taxonomy database, which contains the names of all organisms that are represented in the genetic databases with at least one nucleotide or protein sequence.
   
12. Molecular Structural Data: None currently available.

CDC/MMWR
The CDC/MMWR link will provide a list of Morbidity and Mortality Weekly Reports at CDC relating to this organism or toxin. The date shown is the date the item was posted on the Web, not the date of the MMWR. The summary statement shown are the initial words of the overall document. The specific article of interest may be just one article or item within the overall report.
NIH/PubMed
The NIH/PubMed button at the top of the page will provide a list of research abstracts contained in the National Library of Medicine's MEDLINE database for this organism or toxin.
AGRICOLA
The AGRICOLA button will provide a list of research abstracts contained in the National Agricultural Library database for this organism or toxin.

mow@cfsan.fda.gov
January 1992 with periodic updates


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