2011 Georgia data summary: Vibrio infections [Oct. 2013]

2011 Georgia Data Summary
Vibrio Infections
Georgia Department of Public Health
VIbrio Quick Fact: Vibrio Infections are often transmitted through ingestion of raw or undercooked seafood.

OVERVIEW

SURVEILLANCE

Infections caused by Vibrio species are largely classified into 2 distinct groups: Vibrio cholerae infection and noncholera Vibrio infections. The clinical and epidemiologic characteristics of the diverse species can vary dramatically from one species to another.
Noncholera Vibrio Infections:
Vibrio infections typically manifests as a gastrointestinal illness characterized by watery diarrhea , nausea , vomiting , abdominal cramping , fever and headache. In immunocompromised patients and persons with liver disease, infections of the gastrointestinal tract or contaminated wounds (causing tissue necrosis) with V. vulnificus can result in septicemia and shock. Many Vibrio organisms are halophilic (salt requiring) and prefer marine and brackish environments. They are present in deep-sea salt water and coastal brackish water and can be cultured from raw or undercooked fish and shellfish (e.g. oysters, crabs , and shrimp). The mode of transmission of Vibrio infections is from ingestion of raw or undercooked seafood. Also , transm ission can occur from an exposed wound to contaminated seawater. The incubation period of the noncholera Vibrio infections are usually 12-24 hours.
Vibrio cholerae infections:
Cholera is an infection of the intestine caused by the bacterium Vibrio cholerae . Between 1817 and 1911 , six worldwide cholera outbreaks resulted in hundreds of thousands of deaths. The bacterium responsible for the seventh pandemic, now in progress, is known as V. cholerae 01 , biotype El Tor. Another serogroup associated with cholera outbreaks is 0139 . Other serogroups of V. cholerae have been reported in the United States and Georgia ; these are referred to "non01 , non-0139 V. cholerae" . These serotypes may also cause a cholera-like illness. Cholera is very rare in the United States and most of the cases are generally linked to eating seafood from the Louisiana and Texas Gulf Coast. Humans are the primary reservoir and environmental reservoirs are likely copepods and other zooplankton in brackish rivers and coastal estuaries. The mode of transmission of cholera is by ingestion of food or water contaminated with stool or vomitus of infected person . The incubation period is usually 2-3 days.

All Georgia physicians, laboratories and other health care providers are required by law to report both labconfirmed and clinical diagnoses of Vibrio infections to the Georgia Department of Public Health.
Public health staff interviews every Vibrio case with a standardized CDC form to facilitate centralized data collection in the event of an outbreak.
In 2011 , 12 cases (35% ) of Vibrio infections were due to the consumption of seafood (oysters, crab and fish).
There are several serotypes of Vibrio found in Georgia. Cultures should be sent to the Georgia Public Health Laboratory for species determination and may be forwarded to CDC for additional testing.
Table 1.

NONCHOLERA VIBRIO SPECIES IN GEORGIA, 2011

Serotype

#

1 Parahaemolyticus

10

2 Alginolyticus

8

3 Vulnificus

5

4 Mimicus

3

5 Fluvalis

2

6 Hollisae

1

Unknown

3

Active Surveillance for Vibrio infections are conducted through FoodNet, a component of the Emerging Infections Program (EIP). For more information , please visit: ll> http://dph .georgia.gov/EIP ll> http:1/www.cdc. gov/food neU
INCIDENCE
Noncholera Vibrio Infections:
In 2011 , there were 33 cases of noncholera Vibrio infections reported in Georgia for a rate of 0.34 cases per 100,000 populations (Figure 1).

Vibrio cholerae infections:
In 2011 , there were two cases of Vibrio cholerae reported in Georgia for a rate of 0.02 cases per 100,000 (Figure 2)

Georgia Department of Public Health- 2 Peachtree Street, NW- Atlanta, GA 30303- (404) 657-2588- http://dph.georgia.qov

Figure1.

Noncholera Vibrio Infections, 2001-2011

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Figure 4.

All Reported Cases of Noncholera Vibrio with Known Gender and Age
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Figure 2.

Vibrio Cholerae Infections, 2001 -2011
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IMPACT OF VIBRIO INFECTIONS
In 2011 , two deaths were reported from Vibrio infections in Georgia. Vibrio infections often occur during the summer months and near the coastal regions of Georgia due to the proximity to the salt water. It is important to obtain adequate travel history to and from endemic areas and food consumption data to identify outbreaks. Recent travel to and from cholera-endemic areas is the source for most cases of Vibrio cho/erae (serogroup 01 and 0139) . If severe disease is not treated , rapid dehydration , acidosis, circulatory collapse , hypoglycemia (in children) , renal failure, and death can occur.

DEMOGRAPHICS Noncholera Vibrio Infections:
In 2011 , 63% of cases were White , 19% of cases were Black, and 6% were Asian (Figure 3). Most infections occurred among males age 60 and older (Figure 4) .
Vibrio cholerae infections:
In 2011 , there was one case of Vibrio cholerae in a female .
Figure 3.
Noncholera Vibrio Infection s 2011
AMERICAN

PREVENTION AND SPECIAL PROJECTS
Prevention Tips
Avoid consuming raw or undercooked seafood , especially oysters, to prevent Vibrio infections.
Avoid cross-contamination of cooked seafood and other foods with raw seafood and juices from raw seafood .
Avoid exposing open wounds or broken skin to warm salt or brackish water or to raw shellfish harvested from such waters .
Special Projects
Monitoring trends in Vibrio epidemiology over time.

Date updated: October 201 3 Visit http:/ldph.georgia.gov/epidemiology for more information about Vibrio Infections in Georgia.
Georgia Department of Public Health- 2 Peachtree Street, NW- Atlanta, GA 30303- (404) 657-2588 - http://dph.georgia.gov