Pathogen Index - Foodborne Illnesses & Diseases

12 yıl 11 ay önce - 12 yıl 11 ay önce #1291 Yazan: pullsarr
Pathogen Index - Foodborne Illnesses & Diseases, pullsarr tarafından oluşturuldu
What is Campylobacter?
Campylobacter jejuni is a gram negative bacterium most commonly associated with the consumption of undercooked poultry meat and is a common bacterium found in the intestinal tracts of dogs, cats, poultry, swine, cattle, monkeys, wild birds and some humans.

What diseases are caused by Campylobacter?
Campylobacter jejuni causes an acute bacterial disease of varying severity that is characterized by diarrhea, abdominal pain, malaise, fever, nausea and vomiting. Studies indicate that consuming as little as 500 Campylobacter cells can cause disease. The disease if often associated with gross or occult blood and mucus in liquid stools.

Some of the complications following an acute campylobacter infection can include a typhoid-like syndrome or reactive arthritis and rarely Guillain-Barre syndrome or meningitis. Some cases of camplylobacteriosis may mimic acute appendicitis.

Incubation Period
The period of incubation relates directly to the infective dose ingested, but usually 2-5 days with a range of 1-10 days.

Epidemiology of Campylobacter
This organism is thought to be one of the most common causes of diarrheal illness worldwide. Campylobacter is often the cause of travelers diarrhea and there is a high incidence rate among children and young adults in developing countries. This foodborne illness is attributed to the consumption of uncooked chicken or pork, unpasteurized milk and nonchlorinated water and is often seasonal with most cases reported during warmer months.

Diagnosis of this organism is best completed by isolating the organism from a stool sample.

This disease is self limiting and there is no specific recommended treatment other than rehydration and electrolyte replacement. In some cases, physicians prescribe antibiotics such as erythromycin or ciprofloxacin when diarrhea is severe.

Clostridium botulinum
What is Clostridium botulinum?
Clostridium botulinum is a Gram-positive, spore-forming, obligate, motile, anaerobic rod shaped bacterium.

What is botulism?
Botulism is a serious, but rare intoxication caused by preformed neurotoxins produced by Clostridium botulinum. There are three different forms of botulism:

a) Foodborne botulism - Results from ingestion of preformed neurotoxins, commonly from foods that placed in anaerobic storage such as in cans or jars. Commonly implicated food products are inadequately processed, home canned foods. However, outbreaks in the US have also included various meat products, canned vegetables and salted or smoked seafood products.

b) Infant/Intestinal botulism - Usually affects infants and rarely, adults with altered gastrointestinal anatomy or microflora. It is caused by ingesting spores of the botulinum bacteria that multiply in the gut and produce the toxin.

c) Wound botulism - Occurs when an open wound is contaminated with botulinum spores.

What other diseases are caused by Clostridium species?
Members of the Clostridium genus are usually ubiquitous in nature. C. tetani releases an exotoxin causing tetanus and lock jaw. C. perfringes is usually acquired from dirt via open wounds. C. perfringes spores produce an exotoxin that causes gas necrosis of the infected area. C. difficile, is usually a part of the normal intestinal flora, and causes disease only when broad spectrum antibiotics such as Clindamycin deplete the other gut microflora. C. difficile then releases exotoxins that cause diarrhea.

Who is more susceptible to infection from Clostridium botulinum?
Susceptibility is general for both the foodborne and wound botulism. Most patients with infant/ intestinal variety are children between ages 2 weeks and 1 year. Rarely adults with altered gut flora either due to certain diseases, genetic susceptibility or improper antibiotic treatment are also affected.

Epidemiology of Clostridium botulinum
Botulinum spores are ubiquitous in the soil worldwide. Botulism toxin causes flaccid paralysis by blocking motor nerve terminals at the myoneural junction. The paralysis progresses in a downward fashion, affecting the eyes and face, throat, chest and extremities and eventually causing respiratory paralysis and death.

Incubation Period
Foodborne botulism usually produces neurologic symptoms within 12-36 hours of ingestion, but could also take up to several days. Generally, the shorter incubation periods are associated with severe diseases and higher case-fatality rates.

The history and physical examination is usually the first step in diagnosing botulism. However, nerve conduction studies (EMG), spinal fluid examinations and brain scans are helpful. Botulinum bacteria can be isolated from the stool of infected people in the foodborne and infant variety of the disease.

Treatment of botulism
Foodborne botulism - If diagnosed early, antitoxin should be administered to block the actions of the exotoxin. If respiratory failure has set in, mechanical ventilator and intensive care is required.

Infant botulism - Remove the contaminated food by inducing vomiting and enemas. Good supportive care is further required for recovery.

Wound botulism - Administration of antitoxins to neutralize the exotoxin, surgical debridement and excision of the effected area, followed by the required supportive treatment.

Cryptosporidium parvum
What is Cryptosporidium parvum?
Cryptosporidium parvum is a protozoan and an obligate intracellular parasite (a parasite that cannot survive without a host) that commonly causes an opportunistic infection in immunocompromised hosts.

What diseases are caused by Cryptosporidium parvum?
Cryptosporidiasis, a diarrheal disease is characterized by watery diarrhea, nausea and vomiting, dehydration, abdominal cramps and fever. Symptoms usually resolve in 2-4 weeks in immunocompetent hosts. Cryptosporidiosis can also manifest as pulmonary or tracheal disease, causing cough and fever. However, these patients also manifest with the intestinal component of the disease.

Who is more susceptible to infection from Cryptosporidium parvum?
Immunocompromised hosts, such as people infected with HIV/AIDS are unable to clear the parasite and could manifest with a serious illness. Young children and pregnant women are also at an increased susceptibility. Outbreaks are common in day care centers.

Epidemiology of Cryptosporidium parvum
Fecal-oral route is the most common mode of transmission of the disease. The parasite can survive in food, water, soil or in vertebrate hosts.

Incubation Period
Not precisely known; 1-12 days is the likely range with a mean of 7 days.

Identification of cysts in fecal smears or by intestinal biopsy.

Symptomatic treatment of the diarrhea by administering plenty of fluids to prevent dehydration is the primary management. A new drug, Nitazoxanide has been approved for the treatment of cryptosporidiosis.

Cyclospora cayetanensis
What is Cyclosporiasis?
Cyclosporiasis is a diarrheal disease that is caused by a protozoan that was discovered in the late 1990s as a result of several foodborne outbreaks attributed to the consumption of raw produce including raspberries, basil and lettuce.

What diseases are caused by Cyclospora?
The Cyclospora cayetanensis organism in responsible for watery diarrhea, nausea, abdominal cramping, anorexia and weight loss. It is interesting to note that since this disease is the result of a parasite, patients may not always exhibit signs of fever. In most people, the diarrhea is self limiting and can last for between 9-43 days. For those patients that are immunocompromised, diarrhea may last for months if not treated.

Who is more susceptible to infection from Cyclospora?
As with many parasitic diseases, all people are susceptible to the infection, but those that are immunocompromised stand the most risk.

Epidemiology of Cyclospora
The parasite responsible for Cyclospora is primarily waterborne and people are infected through drinking or swimming in contaminated water. Most notable are the international outbreaks that were attributed to the consumption of raspberries from Guatemala in the late 1990s. Outbreaks usually occur during the warmer months.

Incubation Period
The median incubation period is approximately 1 week.

The diagnosis of Cyclospora is made by the identification of oocysts in the stool. A stain is applied to the stool sample and the organisms fluoresce under ultraviolet light.

Cyclosporiasis can be treated with a week long course of oral trimethoprim (TMP)-sulfamethoxazole (SMX). Doses required will vary for children and adults. Unfortunately, for those patients that are sensitive to sulfa drugs, a treatment regiment has not yet been identified.

Escherichia coli O157:H7 - E. coli O157:H7
What is E. coli O157:H7?
Escherichia coli (E. coli) is a gram negative bacterium that is commonly present in the intestines of humans and animals.

What makes E. coli O157:H7 so dangerous?
Most strains of E. coli are harmless, but 0157:H7 is a key exception because this strain causes severe diarrhea leading to renal damage and other serious complications including death.

E. coli O157: H7 also has the ability to cause disease at a very low dose, survive at low temperatures and under acidic conditions.

Who is more susceptible to infection from E. coli O157:H7?
People of all age groups are susceptible to these bacteria; however immunocompromised, elderly and young children are at a higher risk.

What diseases are caused by E. coli O157:H7?
Infection with Escherichia coli O157:H7 can range from being asymptomatic to having mild to severe gastrointestinal symptoms. The most common symptoms are abdominal cramping and diarrhea, which or may not be bloody. In an uncomplicated case, the illness should recover in less than 5-10 days.

Complications: Hemolytic uremic syndrome (HUS) is one of the complications following E. coli O157:H7 infection especially in children below the age of 5. Hemolytic uremic syndrome is characterized by acute renal failure, microangiopathic hemolytic anemia, fever, and thrombocytopenia. Indeed, HUS is one of the most common causes of acute renal failure in children. One-third of children diagnosed with HUS do not recover completely, resulting in persistent renal failure and the need for long-term dialysis.

Epidemiology of E. coli O157:H7
The disease etiology is universal and can be foodborne or environmental amongst others. E. coli 0157:H7 can be transmitted by:

a) Eating uncooked/ undercooked ground beef
b) Consumption of contaminated sprouts, lettuce, salami, unpasteurized milk
c) Swimming in or drinking sewage contaminated water
d) Fecal-oral transmission through an infected person to a healthy individual due unhygienic practices.

Incubation Period
The incubation period is usually 3-4 days, although rarely the incubation can be as short as 12 hours or as long as 8 days.

An infection with E. coli O157: H7 can be diagnosed by isolating the bacteria from stool samples of infected patients.

Many of the patients recover without any antibiotic treatment within 5-10 days. However when the disease does progress to a life threatening complication such as hemolytic uremic syndrome, the patient must be hospitalized and treated supportively in an intensive care unit. Blood transfusions and renal dialysis is often required for such patients.

Giardia lamblia
What is Giardia lamblia?
Giardia lamblia is a protozoan (parasite) that is implicated to be the most common non-bacterial causative of diarrhea in North America. Giardia is implicated in 1/4th of all diarrheal diseases in adults in North America.

What diseases are caused by Giardia lamblia?
Infection with Giardia lamblia causes a chronic diarrheal disease called giardiasis that is characterized by steatorrhea (fatty stools), abdominal cramps, bloating, frequent loose stools, fatigue and weight loss. Reactive arthritis is a common complication after a severe and chronic episode of giardiasis.

Who is more susceptible to infection from Giardia lamblia?
All individuals are susceptible to infection with Giardia. However, the bug is more prevalent in children than in adults, possibly because many individuals seem to have a lasting immunity after infection. The bug is also commonly seen in homosexual and HIV infected men possibly secondary to sexual transmission.

Epidemiology of Giardia lamblia
Giardiasis is transmitted through the feco-oral route. It is more commonly associated with water consumption, though there have been a few episodes of food borne disease due to infected food handlers.

Incubation Period
Usually 3-25 days, sometimes longer, with a median of 7-10 days.

Identification of cysts or trophozoites in stool samples


Hepatitis A
What is Hepatitis A?
Hepatitis A is a Hepatovirus that is most commonly associated with foodborne illness.

What diseases are caused by Hepatitis A?
This virus causes fever, malaise, anorexia, nausea and abdominal discomfort followed the most prominently by jaundice or the yellowing of the skin and eyes. The infectious dose is unknown, but is thought to be as little as 10-100 virus particles.

Incubation Period
Fifteen to 50 days with an average of 28-30 days.

Epidemiology of Hepatitis A
Hepatitis A is considered to be a disease with a relatively low case-fatality rate. The virus is passed from person to person via the fecal-oral route. Numerous outbreaks within the United States have been attributed to the consumption of food or water that has been cross contaminated by infected food handlers.

There have also been cases attributed to drug use, sexual activity between acute cases and instances of transmission due to transfusion of blood. Studies indicate that the virus is most infective during the latter half of the incubation period. The virus may be shed for up to 6 months in infants and children.

Diagnosis of this disease is most commonly completed by demonstration of IgM antibodies against hepatitis A virus (IgM anti-HAV) in the serum of acutely ill or recently ill patients. The IgM anti-HAV becomes detectable 5-10 days after exposure.

Hepatitis A is a self limited disorder and unlike many bacterial diseases, this disease will not respond to antibiotic treatment.

Listeria monocytogenes
What is Listeria monocytogenes?
Listeria monocytogenes is a gram positive bacterium that causes listeriosis. It is one of the six species of the Listeria genus.

What diseases are caused by Listeria monocytogenes?
Listeriosis can manifest itself as sepsis, meningitis, encephalitis, intrauterine infections and spontaneous abortions in pregnant women. The onsets of these diseases are usually preceded by persistent fever or gastrointestinal symptoms such as nausea, vomiting and diarrhea.

Who is more susceptible to infection from Listeria monocytogenes?
Listeria monocytogenes is more prone to affect target populations such as pregnant women, newborn infants, immunocompromised individuals on corticosteroids, patients with cancer and other chronic diseases and the elderly. Normally, healthy people can also be infected by Listeria monocytogenes causing minimal gastrointestinal symptoms.

Epidemiology of Listeria monocytogenes
Reservoirs of Listeria monocytogenes are present in the environment, human and animal populations. Transmission of the disease causing bacteria can occur through:

a) Foodborne- Listeria monocytogenes has been associated with foods such as unpasteurized milk, cheeses, ice cream, raw vegetables, raw and smoked sausages, raw and cooked poultry, all types of raw meats, and raw and smoked fish. L. monocytogenes introduced as a foodborne disease initially manifests itself as a gastrointestinal illness before spreading through the blood stream to affect the brain and the nervous system.

b) Person to person spread- Listeria monocytogenes is spread from person to person in nosocomial and nursery settings.

c) Direct inoculation- Direct contact with infectious material. This is more common in people with lesions in their hands and arms and when they come in contact with the environment that is infected with Listeria monocytogenes.

d) In utero/ parental transmission- Listeria monocytogenes can be transmitted to the unborn fetus through an infected mother during her pregnancy term.

Incubation Period
The incubation period for listeriosis is variable and ranges from 3 to 70 days, with the median incubation period being three weeks.

The best method to diagnose a Listeria infection is to isolate the bacteria from body fluids such as Cerebrospinal fluid, blood, gastric secretions amongst others.

A full course of antibiotic treatment with either penicillin or ampicillin with aminogycosides is a good treatment plan. In penicillin resistant individuals, a third generation cephalosporins or Trimethoprin-Sulfamethoxazole combination is usually prescribed.

What is Norovirus?
Norovirus is the recently approved official genus name for the group of viruses provisionally described as Norwalk-like viruses (NLV). Norovirus is a group of positive DNA calcivirus.

What diseases are caused by Norovirus?
Infection with norovirus manifests as a mild diarrhea associated with nausea, vomiting,
abdominal cramps, malaise, headache and low-grade fever. The disease is usually self limited and lasts 1-3 days. Infection with norovirus is commonly known as stomach flu and viral gastroenteritis.

Who is more susceptible to infection from Norovirus?
All individuals are susceptible to Norovirus. However, Norovirus is more common in infants, and is the most common cause of diarrhea in children of the ages 1-5. It is also the primary cause of food borne outbreaks in day care centers.

Epidemiology of Norovirus
Norovirus induced diarrhea is transmitted by the fecal-oral route and is transmitted via contaminated food and water and also hand to mouth behavior in infants of contaminated objects. It is the most common cause of diarrhea in all ages under 18, and constitutes 2/3 of all diarrhea cases in children between 6-24 months. Shellfish, salads, raw clams and oysters are the foods most commonly implicated in the spread of Norovirus during outbreaks. Recently, highly publicized outbreaks on cruise ships have been identified. However, this is due in part to surveillance. Outbreaks at schools, prisons and health care facilities also occur and when investigated, Norovirus has been identified as the causative organism.

Incubation Period
The incubation period usually is between 24-48 hours after consumption of affected food or water; and the disease lasts anywhere between 24-60 hours.

The virus is commonly identified from stool specimens of infected individuals. The organism can then be identified by direct visualization, immunoassay or PCR identification of the stool sample.

The disease is usually self limited and treatment is supportive with plenty of fluids to prevent dehydration.

What is Salmonella?
Salmonella is a genus consisting of many species of gram negative bacteria, most of which are motile, and are present in animal reservoirs and in the environment.

What diseases are caused by Salmonella?
Members of the Salmonella genus cause a variety of diseases such as enteric fever, gastroenteritis, and septicemia. Reactive arthritis involving swelling, pain and inflammation of the joints, is a complication following salmonella enteritidis. Salmonella has also been implicated in cases of osteomyelitis in children with co-existant sickle cell anemia.

What species of Salmonella are known to cause gastrointestinal illness?
The top 4 Salmonella isolates that cause gastrointestinal illness are Salmonella typhimurium, Salmonella enteritidis, Salmonella Heidelberg and Salmonella newport. Other prominent members of the salmonella species that are implicated in gastrointestinal illness are Salmonella javiana, Salmonella poona and Salmonella montevedio.

What food products are commonly associated with Salmonella food poisoning?
Raw meats, poultry, eggs, milk and dairy products, fish, shrimp, frog legs, yeast, coconut, sauces and salad dressing, cake mixes, cream-filled desserts and toppings, dried gelatin, peanut butter, cocoa, and chocolate (from the bad bug book).

Who is more susceptible to infection from Salmonella?
People of all age groups are susceptible to these bacteria; however immunocompromised, elderly and young children are at a higher risk. Patients who are HIV positive and who have fully developed AIDS suffer from Salmonella infections more frequently.
Incubation period The Incubation period for food borne salmonellosis is 12-72 hours.

Epidemiology of salmonella
Salmonella is transmitted to humans via the feco-oral route. An infected individual sheds the bacteria in his feces, and the bacterium is viable for months in the environment in water, soil, and manure.

Salmonellosis can be diagnosed by isolating and culturing the bacteria from the stool or blood of the infected person.

Most people often recover from a bout of salmonellosis without a course of antibiotic treatment. Treatment for such individuals is only supportive, with intravenous or oral fluids, adequate nutrition and rest. Often times when the illness does get complicated a course of broad spectrum antibiotics might be necessary.

Shigella, Shigellosis
What is Shigella?
Shigella is a genus of Gram-negative, non motile, rod shaped bacterium that are commonly implicated in food borne illness and diarrheal diseases. The Shigella genus consists of 4 species or serogroups: S. sonnei, S. boydii, S. flexneri and S. dysenteriae

What is Shigellosis?
Shigellosis is an infectious disease caused by Shigella species of bacteria. The disease is characterized by diarrhea, fever and abdominal cramps. Typically the stools may contain blood and mucus, and is called Shigella induced dysentery.

Who is more susceptible to infection from Shigella species?
Susceptibility is general, but in endemic areas, infants, young children and the elderly, are more susceptible. Debilitated, immunocompromised and malnourished adults are also at a higher risk.

Epidemiology of Shigella species
The only significant reservoir of these bacteria is humans. Fecal-oral route is the most common mode of transmission of the disease. Infection may also occur after ingestion of contaminated food and water. Food handlers who demonstrate poor personal hygiene are often responsible for outbreaks. Outbreaks are also common in conditions of over crowding and poor sanitation such as prisons, refugee camps, as well as, third world nations with poor sewage disposal.

Incubation Period
Usually 1-3 days, but can range from 12 to 96 hours. Incubation period for S. dysenteriae could be up to 1 week.

Shigella can be identified in the stool of the infected person. A culture and sensitivity pattern is important to establish the species of Shigella and the right antibiotic treatment.

Treatment of Shigella
Shigellosis is treated with antibiotics and supportive care. Patients with mild infections can recover with only supportive care. Ampicillin, trimethoprim/ sulfamethoxazole or ciprofloxacin are usually the antibiotics of choice. If the patient is severely dehydrated, he needs to be rehydrated by intravenous fluids.

Staphylococcus aureus
What is Staphylococcus aureus?
Staphylococcus aureus is a gram positive bacterium that usually appears under the microscope as spherical (coccus) organisms appearing in pairs, short chains, or bunched, grape-like clusters.

What diseases are caused by Staphylococcus aureus?
Staphylococcus aureus has been implicated as a causative agent in acute food poisoning episodes, toxic shock syndrome, impetigo, scalded skin syndrome, cellulitis, folliculitis and furuncles.

It is also a common cause of systemic infections such as infective endocarditis, osteomyelitis, epiglottitis, and sinus infections amongst others. S. aureus is also responsible for many infective and systemic infections in the health care setting.

Who is more susceptible to infections with Staphylococcus aureus?
All people are susceptible to infections with Staphylococcus aureus, the disease however, may manifest with varying intensities.

Epidemiology of Staphylococcus aureus
Staphylococcus aureus can cause illness by preformed toxin production as well as by infecting both local tissues and the systemic circulation. Disease transmission can occur in the following settings:

a) Gastrointestinal: Staphylococcus aureus causes acute episodes of food poisoning via preformed enterotoxins. Food items likely to be infected by staphylococcal food poisoning include meat and meat products; poultry and egg products; salads such as egg, tuna, chicken, potato, and macaroni; bakery products such as cream-filled pastries, cream pies, and chocolate Ã?Æ?Ã?Æ?Ã?â? Ã?â??Ã?Æ?Ã?â??Ã?â??Ã?©clairs; sandwich fillings; and milk and dairy products.

b) Skin and hair infections: Staphylococcus aureus commonly colonizes many skin surfaces on the nasopharynx, and perineum; but can cause infection of these surfaces particularly if the cutaneous barrier has been disrupted or damaged.

c) Systemic infections: Staphylococcus aureus commonly causes infective endocarditis in IV drug abusers; osteomyelitis, sinus infections in the general population; and epiglottitis in young children.

d) Nosocomial infections: Methicillin resistant Staphylococcal aureus (MRSA) is a strain of the bacteria that is commonly implicated in nosocomial infections. Risk factors for MRSA colonization or infection in the hospital settings include prior antibiotic exposure, admission to an intensive care unit, surgical incisions, and exposure to infected patients.

Incubation Period
Incubation Period for foodborne Staphylococcal aureus disease is 1-6 hours.
Diagnosis Staphylococcal aureus gastrointestinal illness can be diagnosed by isolating the preformed toxins from the contaminated food item. Systemic infections are best diagnosed by blood cultures.

Staphylococcal aureus are susceptible to beta-lactamase resistant penicillins such as ticarcillin and pipercillin. Vancomycin is the drug of choice for MRSA infections.

Vibrio parahaemolyticus
What is Vibrio parahaemolyticus?
Vibrio parahemolyticus is a gram negative enteric bacterium, from the same family that causes cholera found abundantly along the coastal waters all over the world.

What diseases are caused by Vibrio parahaemolyticus?
Vibrio parahaemolyticus is an intestinal infection that is characterized by lower gastrointestinal distress such as diarrhea and cramps. In some cases, nausea, vomiting, fever and headache may also be present.

Occasionally, this disease may manifest itself as a dysentery-like illness with bloody or mucoid stools, high fever and a high white blood cell count, but normally the disease has a duration of only two to three days. Illness with Vibrio parahaemolyticus is most common during the summer months.

What food products are commonly associated with Vibrio parahaemolyticus food poisoning?
This disease is most often associated with eating raw or inadequately cooked seafood or any food contaminated by handling raw seafood or contaminated water. This disease is primarily associated with the consumption of raw oysters.

What other vibrios can cause disease?
There are several other bacterium from the vibrio family that may cause diarrheal disease including: V. chloerae (of serogroups other than 01), V. fluvialis, V. furnissii and V. hollisae. Sepiticemic disease associated with wound type infections have been associated with V. hollisae. V. alginolyticus and V. damsela.

Incubation Period
The incubation period for Vibrio parahaemolyticus is usually between 12 -24hours, but can range from 4-96 hours with a mean of 15 hours.

Epidemiology of Vibrio Parahaemolyticus
This organism is not communicable from person to person. Cases of Vibrio parahaemolyticus usually occur during the summer months, due to the fact that the organism can be found floating free in coastal waters and in fish and shellfish. During cooler months, the organism is commonly found in silt or mud on the bottom of marine environments.

Vibrio parahaemolyticus is diagnosed by isolating the Kanagawa Vibrio, which is halophilic and is one of the characteristics that produce the hemolytic reaction known as the Kanagawa phenomenon. There are twelve separate O antigen groups and approximately sixty different K antigen types that have been identified with this organism. Diagnosis can be determined by the presence of the Kanagawa vibrios in the patients stool culture or in implicated food.

This disease is self limiting and best treated with plenty of water replenishment. Antibiotics are usually not necessary but in very sever cases tetracycline, ampicillin or ciprofloxacin could be used.

Vibrio vulnificus
What is Vibrio vulnificus?
Vibrio vulnificus is a gram negative bacterium, that is biochemically similar to Vibrio parahaemolyticus and is most often associated with food borne illness after eating raw or inadequately cooked seafood, especially raw oysters.

What diseases are caused by Vibrio vulnificus?
Vibrio vulnificus is mainly implicated in gastrointestinal illness characterized by vomiting, diarrhea and abdominal pain. Vibrio vulnificus can also cause an infection or ulceration of the skin when open wounds are exposed to seawater.

Who is at a higher risk of infection with Vibrio vulnificus?
Infection with Vibrio vulnificus may cause complications such as septicemia in people with chronic liver disease, chronic alcoholism or hemochromatosis and those that are immunocompromised. This disease is of special concern to those with chronic diseases of the liver.

Incubation Period
The incubation period for Vibrio vulnificus is usually between 12 -72 hours after consuming raw or undercooked seafood.

Epidemiology of Vibrio vulnificus
This disease is not transmitted person to person. Sporadic cases are reported each year. Vibrio vulnificus is a free living organism found in marine waters. This organism is of special concern to the oyster industry and is found routinely in cultured oysters.

This is a very serious disease in that approximately one third of the patients seen for care associated with wound infections are either in shock or develop hypotension within 12 hours of hospitalization. Three quarters of the patients develop bullous skin lesions, thrombocytopenia and often disseminated intravascular coagulation.

Over 50% of the patients with primary septicemia die and the mortality rate exceeds 90% among those who become hypotensive. Vibrio vulnificus can also infect wounds sustained while in contact with coastal or estuarine waters (boating accidents, fisherman oyster shuckers) and can range from mild, self limited lesions to rapidly progressive cellulites and myositis.

This disease is diagnosed by culturing the organism from wounds, stool, or blood. Confirmation of the organism sometimes requires the use of DNA probes or numerical taxonomy in a reference laboratory.

V. vulnificus infection is treated with antibiotics. Doxycycline or a third-generation cephalosporin (e.g., ceftazidime) is appropriate. Tetracycline, chloramphenicol or penicillin could be used as a second line of therapy.

Yersinia enterocolitica
What is Yersinia enterocolitica?
Yersinia is a gram negative bacterium that causes an acute bacterial enteric disease characterized by a febrile diarrhea, enterocolitis and acute mesenteric lymphadenitis that mimics appendicitis.

What diseases are caused by the Yersinia species?
Yersinia pseudotuberculosis causes a zoonotic disease of wild and domesticated birds and mammals. Human beings are considered to be incidental hosts and may transmit the disease. Human cases of the disease have been due to contact with household pets, particularly sick puppies and kittens. This bacterium is of concern since it does have the ability to multiply rapidly under refrigeration and low oxygen conditions. Yersinia pestis has been implicated as the causative agent in plague.

How does the enteritis caused by Yersinia enterocolitica manifest?
Yersinia causes an acute bacterial disease that causes diarrhea and/ or vomiting. Fever and abdominal pain are also classic symptoms and the disease may mimic appendicitis. In up to Ã?Æ?Ã?Æ?Ã?¢Ã?â?¬Ã?Å¡Ã?Æ?Ã?â??Ã?â??Ã?¼ of the cases, bloody diarrhea is reported. The bacteria may also cause infections of other sites such as wounds, joints and the urinary tract.

Incubation Period
The most common incubation period is between 3 to 7 days and generally under 10 days.

Epidemiology of Yersinia
Yersinia enterocolitica is transmitted via the fecal-oral route and is most often transmitted by eating or drinking food or water that has been contaminated by contact with infected animals or people. This organism is most commonly found in raw pork or pork products such as chitterlings (pig intestines), but there have also been outbreaks associated with tofu and pasteurized milk that was cross contaminated. Nosocomial transmission has been reported and there have also been reports of transmission by transfusion of stored blood from asymptomatic donors.

Yersiniosis is usually diagnosed by a stool culture; however, yersinia can also be cultured in vomitus or in standard blood media.

This organism is resistant to penicillin and its derivatives. The best course of treatment seem to be from the tetracyclines, however, the newer quinolones such as ciprofloxacin may also be effective.

There must be some kind of way out of here,
said the joker to the thief
there's too much confusion,
I can't get no relief.
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