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U.S.
Food & Drug Administration Center for Food Safety & Applied Nutrition Foodborne Pathogenic Microorganisms and Natural Toxins Handbook |
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Vibrio vulnificus
| 1. Name of the Organism:
Vibrio vulnificus |
Vibrio vulnificus, a lactose-fermenting, halophilic, gram-negative, opportunistic pathogen, is found in estuarine environments and associated with various marine species such as plankton, shellfish (oysters, clams, and crabs), and finfish. It is found in all of the coastal waters of the United States. [Cases of illness have also been associated with brackish lakes in New Mexico and Oklahoma.] Environmental factors responsible for controlling members of V. vulnificus in seafood and in the environment include temperature, pH, salinity, and increased dissolved organics. |
| 2. Nature of Acute Disease: | This organism causes wound infections, gastroenteritis, or a syndrome known as "primary septicemia." |
| 3. Nature of Disease: | Wound infections result either from contaminating an
open wound with sea water harboring the organism, or by
lacerating part of the body on coral, fish, etc.,
followed by contamination with the organism. The
ingestion of V. vulnificus by healthy
individuals can result in gastroenteritis. The
"primary septicemia" form of the disease
follows consumption of raw seafood containing the
organism by individuals with underlying chronic disease,
particularly liver disease (see below). In these
individuals, the microorganism enters the blood stream,
resulting in septic shock, rapidly followed by death in
many cases (about 50%). Over 70% of infected individuals
have distinctive bulbous skin lesions. Infective dose -- The infective dose for gastrointestinal symptoms in healthy individuals is unknown but for predisposed persons, septicemia can presumably occur with doses of less than 100 total organisms. |
| 4. Diagnosis of Human Illness: | The culturing of the organism from wounds, diarrheic stools, or blood is diagnostic of this illness. |
| 5. Associated Foods: | This organism has been isolated from oysters, clams, and crabs. Consumption of these products raw or recontaminated may result in illness. |
| 6. Relative Frequency of Disease: | No major outbreaks of illness have been attributed to
this organism. Sporadic cases occur frequently, becoming
more prevalent during the warmer months. In a survey of cases of V. vulnificus infections in Florida from 1981 to 1987, Klontz et al. (Annals of Internal Medicine 109:318-23;1988) reported that 38 cases of primary septicemia (ingestion), 17 wound infections, and 7 cases gastroenteritis were associated with the organism. Mortality from infection varied from 55% for primary septicemia cases, to 24% with wound infections, to no deaths associated with gastroenteritis. Raw oyster consumption was a common feature of primary septicemia and gastroenteritis, and liver disease was a feature of primary septicemia. |
| 7. Course of Disease and Complications: | In healthy individuals, gastroenteritis usually occurs within 16 hours of ingesting the organism. Ingestion of the organism by individuals with some type of chronic underlying disease [such as diabetes, cirrhosis, leukemia , lung carcinoma, acquired immune deficiency syndrome (AIDS), AIDS- related complex (ARC), or asthma requiring the use of steroids] may cause the "primary septicemia" form of illness. The mortality rate for individuals with this form of the disease is over 50%. |
| 8. Target Populations: | All individuals who consume foods contaminated with this organism are susceptible to gastroenteritis. Individuals with diabetes, cirrhosis, or leukemia, or those who take immunosuppressive drugs or steroids are particularly susceptible to primary septicemia. These individuals should be strongly advised not to consume raw or inadequately cooked seafood, as should AIDS / ARC patients. |
| 9. Food Analysis: | Methods used to isolate this organism from foods are
similar to those used with diarrheic stools. To date, all
food isolates of this organism have been pathogenic in
animal models. FDA has a genetic probe for V. vulnificus; its target is a cytotoxin gene which appears not to correlate with the organism's virulence. |
| 10. Selected Outbreaks: | Sporadic cases continue to occur all year, increasing in frequency during the warmer months. |
| MMWR 45(29):1996 | Of all foodborne infectious diseases, infection with Vibrio vulnificus is one of the most severe; the case-fatality rate for V. vulnificus septicemia exceeds 50% (1,2). Cases are most commonly reported during warm-weather months (April-November), and often are associated with eating raw oysters. During April 1993-May 1996, a total of 16 cases of V. vulnificus infection were reported in Los Angeles County. |
| MMWR 42(21):1993 | Vibrio vulnificus is a gram-negative bacterium that can cause serious illness and death in persons with preexisting liver disease or compromised immune systems. From 1981 through 1992, 125 persons with V. vulnificus infections, of whom 44 (35%) died, were reported to the Florida Department of Health and Rehabilitative Services (HRS). This report summarizes data on these cases and presents estimates of the at-risk population in Florida. |
| 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. |
| Vibrio vulnificus FAQ's from the CDC. | What is Vibrio vulnificus? What sort of germ is it? How can an infection be diagnosed? How can the infections be treated? |
| Loci index for genome Vibrio vulnificus | 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. |
| If You Eat Raw Oysters, You Need to Know . . . | More information for consumers of raw shellfish is available at this FDA brochure. |
mow@cfsan.fda.gov
January 1992 with periodic updates
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