5 Things Pharmacists Should Know About Vibriosis Infections

Vibriosis infections most commonly occur through consumption of raw or undercooked seafood. There are approximately 80,000 illnesses, and 100 deaths caused by vibriosis in the United States each year.¹ Most infections occur May through October since water temperatures are warmer. However, illness can occur any time of the year.

Pharmacists can play an important role in counseling patients on food safety practices to prevent vibriosis infections. Here are 5 things pharmacists should know about vibriosis infections:

1. Vibriosis is associated with raw oyster consumption.

Individuals can develop vibriosis from consuming raw or undercooked oysters, and other shellfish. Raw oyster bars have become popular in restaurants across the country, which can increase the risk of developing vibriosis infections. Vibrio bacteria naturally inhabit coastal waters where oysters live and can concentrate in their tissues. These bacteria can cause illness after consumption. Unfortunately, individuals cannot identify whether oysters contain harmful bacteria from the taste or smell. Studies have shown that vibriosis infections can be prevented through regulations.² For example, California implemented a regulation restricting the sale of raw oysters harvested from the Gulf of Mexico during April-October, which resulted in a reduction in vibriosis illness and deaths.²

2. Exposing wounds to seawater can cause vibriosis.

Some Vibrio species can cause skin infections when an open would is exposed to a mixture of fresh and sea water (brackish water) or salt water. Individuals should avoid brackish or salt water if they have cuts or scrapes and wounds should be covered with waterproof bandages when in contact with the water.

3. Gastrointestinal symptoms are common with vibriosis infections.

Symptoms usually occur within 24 hours of ingestion, and include watery diarrhea, abdominal cramping, nausea, vomiting, fever, and chills.¹ Additionally, symptoms generally last for approximately 3 days.¹ Severe illness is rare, and it usually occurs in patients that are immunocompromised. Individuals with the following conditions are at an increased risk of infection or severe complications: liver disease, cancer, diabetes, and HIV.

4. Treatment usually consists of supportive care for mild cases.

Treatment is usually not necessary for mild vibriosis infections. Pharmacists should educate patients to drink plenty of fluids to replenish those lost through diarrhea and vomiting. Hospitalization and intravenous fluids may be necessary for patients with severe dehydration. Patients with severe illness may need antibiotic therapy with doxycycline or ciprofloxacin.

5. Prevention includes avoiding consumption of raw or undercooked shellfish.

Pharmacists can educate patients on the importance of food safety strategies when it comes to oysters, and other shellfish. These foods should be cooked before eating to avoid illness. Individuals should wash their hands with soap and water after handling raw shellfish. Also, educate patients to avoid contaminating cooked shellfish with raw shellfish and its juices. Individuals should wash wounds with soap and water after exposure to brackish or salt water.

References:

• Centers for Disease Control and Prevention. Vibrio species causing vibriosis. https://www.cdc.gov/vibrio/index.html. Accessed June 27, 2018.
• Vugia DJ, Tabnak F, Newton AE, et al. Impact of 2003 state regulation on raw oyster-associated Vibrio vulnificus illnesses and deaths, California, USA. Emerg Infect Dis. 2013;19(8):1276-80.