Vibrio v. Update

[MolarBoater]

Just recieved a Vibrio vulnificus (Vv) update from the ISSC orginally dated August 8, 2005. They est. 5,000 Americans die each year from food borne illness. With Vibrio, fatality rate is 53% with diagnosis and treatment within 48 hours crucial.
Vv is a gram neg bacterium and is the most lethal of that type which inhabits brackish to salt water. The shellfish in question are filter feeding fish most notable are raw oysters and clams.
Anyone with liver disorders, hemochromatosis, diabetes, immunocompromising conditions, cancer, past gastric surgery or on meds for stomach acid low levels. Heck, we might as well throw in the very old and very young to be safe. Infection enters via eating or when there is contact of organism with skin cuts, sores or burns in seawater caintaining Vv.

There are three clinical syndromes.

1. Primary Septicemia: fever, chills, nausia, possible vomiting and diarrhea.
Also, a sharp drop in blood pressure, with possible
intractable shock followed by death.
2 Gastroenteritis: usually due to healthy persons ingesting Vv. resulting in
milder amounts of stomach cramps, vomiting and
diarrhea. May require hospitalization w/o death.
3. Wound Infection: from skin lacerations with seawater coming direct
contact or from acute marine contact ie fish bite,
de-hooking injury, puncture by fin barb etc.
Usually, swelling, redness and intense pain with
possible blistering and tissue necrosis/gangrene.
50% require surgical debribement or amputation.
If infection enters bloodstream, death is common.

Diagnosis via blood, stool or wound sample and you should emphasis the potential for waterborne injury to speed diagnosis. Treatment is with oral and iv antibiotics, debribation of wounds or amputation. There should be state reporting mandates so check your state health dept. websites.
High risk folks would be best advised to eat no shellfish or if you are really, really adventuresome, the thoroughly cooked varieties only. Also high risk folks should avoid seawater (esp. bay waters) if they have unhealed lesions on the skin.
For more info, go to www.issc.org or call them 1-800-416-4772 or call your state health dept.
Always good to take hydrogen peroxide and alcohol on the boat to dowse wounds ASAP but be careful, I have had something leak out of a medical kit and melt (soften) Ropelene in the center console but didn't harm the gas tank!
Lastly, this is for information only and not medical advise, so go to the ER or physician immediately if you think you have an exposure, you may only have a few hours.
MolarBoater

[MolarBoater]

Took the physicians online course and can clarify a few things on the Vv. memorandum. First, it is mainly in warm brackish to salt water like bays. It is mainly (50%) in the Gulf of Mexico coastal areas with outbreaks from 1993-2003 rating as follows:
1: FL (99) 2: Tx (48) 3: CA (45) 4: LA (28) 5: GA (20) 6: AL (16) with California and Georgia being high importers of oysters. Worst month is August and least Jan/Feb but ALL months have been positive for infection. Typical Gulf Coast resident whom b/c's infected 84% are males with average age of 54. In CA, the average age is lower and still 90% male and hispanic.
Foodborne type has higher morbidity while the cut/wound type is most common. The infection is not normally found in routine lab testing, need to tell them to test using TCBS medium culture specific for Vv. Oral and IV antibiotics immediately with only 33% morbidity if begun within the first 24 hours, after that it gets bad quick.
Most at risk groups are liver disease patients and immunocompromised and really just should not eat oysters, clams or muscles, ie "filterfeeders" as well as no other "raw" animal protiens, sushi? Fresh caught tuna?
The problem is 94% oysters, 4%wounds, and 2%clams/muscles.
I didn't notice anything about horseradish, beer and hot sauce killing the bacterium and improving your chances but apparently, stomach acid in a healthy adult is pretty effective.
Now if I could only get Tulane University's(New Orleans) fax to work to mail in my CE cert. Guess I could try again in 6 months.
Molar

[Perdido Key]

Hey Molar
Thanks for the info.
I plan to post a copy in the condo.

[Fishin' DC's]

A lady in Jacksonville died from it earlier this summer. She had sustained a cut during an outing on the St. John's river. It's definitely bad stuff that you don't want any part of.

[MolarBoater]

Another interesting fact is that it is not related to pollution or unoff. Neither is it related to an "outbreak" of infection, it is just naturally out there and no known ways to test the food prior to consumption without destroying it and no way to know if the water you are in is effected.
I love raw oysters but also like fried ones too........and sushi....that is the original reason to use wasabi and horseradishes as well as alcohol with consumption of any raw animal food. I think white wine rated the most protective but who's gonna drink that with oysters on the half shell? haha

[k9reno]

WASABI you can never put on to much wasabi. especially if you have a sinus cold. heheee