Shapiro R L, Altekruse S, Hutwagner L, Bishop R, Hammond R, Wilson S, Ray B, Thompson S, Tauxe R V, Griffin P M
Foodborne and Diarrheal Diseases Branch, Epidemic Intelligence Service, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Infect Dis. 1998 Sep;178(3):752-9. doi: 10.1086/515367.
Vibrio vulnificus infections are highly lethal and associated with consumption of raw shellfish and exposure of wounds to seawater. V. vulnificus infections were reported to the Centers for Disease Control and Prevention from 23 states. For primary septicemia infections, oyster trace-backs were performed and water temperature data obtained at harvesting sites. Between 1988 and 1996, 422 infections were reported; 45% were wound infections, 43% primary septicemia, 5% gastroenteritis, and 7% from undetermined exposure. Eighty-six percent of patients were male, and 96% with primary septicemia consumed raw oysters. Sixty-one percent with primary septicemia died; underlying liver disease was associated with fatal outcome. All trace-backs with complete information implicated oysters harvested in the Gulf of Mexico; 89% were harvested in water >22 degrees C, the mean annual temperature at the harvesting sites (P < .0001). Control measures should focus on the increased risk from oysters harvested from the Gulf of Mexico during warm months as well as education about host susceptibility factors.
创伤弧菌感染具有高度致死性，与食用生贝类以及伤口接触海水有关。美国23个州向疾病控制与预防中心报告了创伤弧菌感染病例。对于原发性败血症感染，开展了牡蛎溯源调查，并获取了收获地点的水温数据。1988年至1996年期间，共报告了422例感染病例；其中45%为伤口感染，43%为原发性败血症，5%为肠胃炎，7%感染源不明。86%的患者为男性，96%的原发性败血症患者食用过生牡蛎。原发性败血症患者的死亡率为61%；潜在的肝脏疾病与致命结局相关。所有信息完整的溯源调查均表明感染源为墨西哥湾收获的牡蛎；89%的牡蛎收获于水温>22摄氏度的海域，这是收获地点的年平均温度（P < .0001）。控制措施应聚焦于温暖月份从墨西哥湾收获的牡蛎带来的风险增加，以及关于宿主易感性因素的教育。
