Infection on the half shell

Jorge Serpa, a Portuguese national and old grad school friend, is enjoying a plate of cold Chesapeake oysters. He picks up another half shell, waves it in front of me, and asks, “Want some vibrios?” It’s an old joke. He knows I won’t eat raw shellfish; I know what might be lurking in some of them. He also knows I’m going to give him my stock speech about raw shellfish and vibrios. He’s been getting that same speech for years. It’s a speech that falls on ears suddenly deaf to English, but it’s a speech worth hearing. At least once. On August 4, two oyster beds near Seattle were closed after six people became ill from eating oysters harvested from nearby beds. Last April, three people became ill in Florida after eating raw shellfish. The Seattle incident was caused by Vibrio parahaemolyticus and the Florida cases were caused by Vibrio vulnificus. Both species of bacteria cause an infection generally known as vibriosis. Vibrio bacteria are found in warm saltwater. People typically encounter them while eating raw or undercooked shellfish. Symptoms occur several hours later in the form of vomiting, diarrhea, fever, chills, and abdominal pain. These gastrointestinal assaults are usually over in a few days, and tend to be seasonal. Most infections occur between May and October. More serious illnesses may occur among people with weakened immune systems or chronic liver disease. Then the bacteria may cause life-threatening bloodstream infections. Opens wounds and breaks in the skin exposed to contaminated saltwater also may allow vibrios to start serious skin infections.

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In August 2006, a man in Rhode Island was hospitalized after a wound on his leg became infected with Vibrio vulnificus. In the wake of Hurricane Katrina in 2005, there were 22 cases of vibriosis, including five deaths. Eighteen of those cases were wound infections probably acquired by people wading through the filthy floodwaters. It’s hard to know exactly how common vibrio infections are in the U.S. The Centers for Disease Control and Prevention (CDC) estimates there are 3000 annual cases of Vibrio parahaemolyticus infection that lead to 40 hospitalizations and seven deaths. For Vibrio vulnificus, the best annual estimates are 95 cases, 85 hospitalizations, and 35 deaths. Cases of gastrointestinal vibriosis in healthy people usually are brief and do not require specific medical treatment. However, Vibrio vulnificus infections in persons with weakened immune systems or other underlying illnesses may need immediate medical attention. Wound infections can lead to tissue necrosis, and limb amputations. Antibiotics, such as intravenous doxycycline and a cephalosporin, are usually given for seven to fourteen days. Both of the above mentioned vibrios are relatives of Vibrio cholerae, the waterborne agent of cholera. The cholera bacterium has caused seven pandemics since the early 19th century, and has been responsible for depopulating cities and decimating armies throughout recorded history. Interestingly, V. cholerae has been detected in Chesapeake Bay, but not the variant that causes epidemics and life-threatening illness. In 2003, Rita Colwell and her colleagues at the University of Maryland Biotechnology Institute in Baltimore reported finding V. cholerae in parts of the Bay where specific temperatures and salinity levels allowed the bacteria to survive. The

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researchers noted that, “under scenarios of global climate change, increased climate variability, accompanied by higher stream flow rates and warmer temperatures, could favor conditions that increase the occurrence of V. cholerae in Chesapeake Bay.” That probably would not be good news for Jorge Serpa’s oysters on the half shell. He may be forced to switch to another Annapolis specialty—the oyster shooter—on the theory that enough vodka will kill any vibrio. In the interest of public health, local business, and long friendship, I might join him.

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