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Epidemiology, Disease Transmission, Prevention, and Control
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Waterborne microorganisms have been estimated to account for almost forty percent of the annual mortality due to infectious disease. They include Salmonella, Shigella, and V. cholerae. Vibrio cholerae, in addition to being acquired and spread through food, is also spread by bathing in or drinking contaminated water. It remains endemic in India, Bangladesh, and Africa. It has recently caused epidemics in the Americas. In the United States it exists in waters in the gulf coast of Texas, Louisiana, and Florida, Chesapeake Bay, the California coast, and coastal waters to the north. Vibrio cholerae occurs in riverine, brackish water, and estuarine ecosystems, being part of the natural flora of plankton and is found in the gut of, and attached to the surface of, both freshwater and marine copepods. Outbreaks in humans seem to be related to plankton blooms associated with warm sea-surface temperatures. The phytoplankton blooms are a food source for the copepods upon which the cholera bacterium thrives. Movement of tidal waters carries the algal blooms and copepods toward land and into rivers, bringing the bacterium into contact with humans who use this water for bathing or as a source of drinking water. Vibrio vulnificus is another Vibrio that could be found in estuarine waters and from shellfish and occasionally infects man in the U.S.
Diagnostic Approach to Rash and Fever in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Lee S. Engel, Charles V. Sanders, Fred A. Lopez
Vibrio vulnificus has been associated with two distinct syndromes: septicemia and wound infection [258,259]. A third syndrome of gastrointestinal illness has also been suggested [260]. Primary septicemia is a fulminant illness that occurs after the consumption of contaminated raw shellfish. Consumption of raw oysters within 14 days preceding the illness has been reported in 96% of the cases [261]. Wound infection occurs after a pre-existing or newly acquired wound is exposed to contaminated seawater.
Bacteria Causing Gastrointestinal Infections
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
B. Vinoth, M. Krishna Raja, B. Agieshkumar
Vibrio vulnificus is a gram-negative bacilli belonging to the family Vibrionaceae. It is highly lethal opportunistic organism affecting patients who are immunocompromised and those with chronic liver disease. In the United States, V. vulnificus is a leading cause of seafood-associated fatality. According to the CDC, there were about 96 cases of V. vulnificus infection with a 91% hospitalization rate and mortality rate of 34.8% (Scallan et al. 2011). They are acquired by ingestion of raw seafoods causing gastroenteritis and skin infections requiring amputations. Septicemia and necrotizing fasciitis are the common complications leading to high fatality. Special culture medium is needed for isolation of these organisms. According to the CDC, doxycycline and ceftazidime are the drugs of choice in adults, and septran and an aminoglycoside in children. However, the final decision on selection of the antibiotic should be based on the local susceptibility pattern.
Late-onset Vibrio vulnificus septicemia without cirrhosis
Published in Baylor University Medical Center Proceedings, 2019
Michelle T. Lee, An Q. Dinh, Stephanie Nguyen, Gus Krucke, Truc T. Tran
Initial management included intravenous fluids with broad-spectrum antibiotics (vancomycin, cefepime, clindamycin). On hospital day 4, cultures showed lactose-negative, oxidase-positive gram-negative bacilli; given potential infection with Aeromonas or Vibrio, doxycycline was added. Leukocytosis and fevers persisted despite resolving symptoms, and sudden clinical decompensation occurred on hospital day 5. The patient developed hypotension refractory to fluids and ecchymoses with enlarging bullae (Figure 1b). Prompt reevaluation was concerning for rapidly progressing necrotizing fasciitis. A below-knee amputation was performed and the patient gradually improved without postoperative complications. Vibrio vulnificus was identified from blood cultures, and antibiotics were changed to ceftriaxone and doxycycline.
Bacterial infection during wars, conflicts and post-natural disasters in Asia and the Middle East: a narrative review
Published in Expert Review of Anti-infective Therapy, 2020
Tania Nawfal Dagher, Charbel Al-Bayssari, Seydina M. Diene, Eid Azar, Jean-Marc Rolain
The exposure to environmental water increases the risk of skin infection; even in recreational marine or freshwater environments with no known source of infection because of residential sewage. During water-related disasters and due to contact with waste and sharp objects lying invisible in unclear waters, and by adhering to trees or climbing structures in attempts at self-rescue, wounds can occur and infections may consequently develop [4]. Moreover, even in the absence of wastewater contamination of water, infections can occur in saltwater due to the presence of Vibrio vulnificus and atypical mycobacteria or in fresh water due to the presence of Aeromonas hydrophila, Burkholderia pseudomallei (melioidosis) and Leptospira interrogans [4]. Furthermore, disasters that were related to water might also cause the interruption of the purification of water and the systems of sewage disposal, a burst of underground pipelines and storage tanks and flooding of poisonous waste. This can prompt expanded presentation to contaminated waste, food and more pathogens, which can lead to gastrointestinal disease [109]. On the other hand, numerous diseases can also occur in non-water related disasters, such as earthquakes and volcanoes. These diseases include cholera, TB and other respiratory diseases. A major leading cause for the outbreaks of such disease might be due to the movement of large numbers of people from their homes into overcrowded shelters where provisions may be restricted [5]. Moreover, the availability of medical services after such natural disasters may also pose a major problem [110]. The infectious diseases outbreaks that occur after a natural disaster are summarized in Table 1.