Monday, July 23, 2018

CDC Issues Warning About Vibrio in Crab Meat From Venezuela

CDC issued a news release about an outbreak of Vibrio parahaemolyticus linked to fresh Crab Meat imported from Venezuela. CDC warns consumers to avoid crab meat from Venezuela, including confirming that crab meat is not from there before consuming.   Twelve people infected with Vibrio parahaemolyticus who ate fresh crab meat have been reported from Maryland, Louisiana, Pennsylvania, and the District of Columbia.

Cooking food will destroy the organism, so illness occurs when seafood is eaten raw/undercooked or the product is recontaminated after cooking.

Vibrio parahaemolyticus is a Gram-negative, curve-shaped rod frequently isolated from the estuarine and marine environments of the United States and other tropical-to-temperate coastal areas, worldwide.  Cases are more often seen in the warmer months when the water temperature is greater than 15C (59F).  One study showed that Vibrio infections maybe increasing with global warming and rising water temperatures.

The symptoms of a Vibrio infection from contaminated food include watery diarrhea and the following signs and symptoms within 24 hours (4 to 90 hours) including stomach cramping, nausea, vomiting, fever.  Symptoms usually lasts about 3 days (2 to 6), and most people recover without treatment.  However the illness can lead to septicemia in susceptible people (diabetes, liver disease, kidney disease, cancer, AIDS, or other illnesses that result in an immunocompromised state, and those on immunosuppressive medications).

CDC News Release
https://www.cdc.gov/vibrio/investigations/vibriop-07-18/index.html
Multistate Outbreak of Vibrio parahaemolyticus Infections Linked to Fresh Crab Meat Imported from Venezuela
At A Glance
Case Count: 12
Jurisdictions: 4
Deaths: 0
Hospitalizations: 4
Recall: No
Highlights



CDC, state and local health officials, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Vibrio parahaemolyticus infections linked to eating fresh crab meat imported from Venezuela.

Important advice to consumers, restaurants, and retailers:(https://www.cdc.gov/vibrio/investigations/vibriop-07-18/advice.html)
CDC recommends that consumers not eat, restaurants not serve, and retailers not sell fresh crab meat imported from Venezuela at this time.
This type of product may be labeled as fresh or precooked. It’s commonly found in plastic containers.
Food contaminated with Vibrio parahaemolyticus usually looks, smells, and tastes normal.
If you buy crab meat and do not know whether it is from Venezuela, do not eat, serve, or sell it. Throw it away.

Investigation details:
CDC, state and local health officials, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Vibrio parahaemolyticus infections linked to eating fresh crab meat imported from Venezuela.
Epidemiologic evidence(https://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/index.html) indicates that precooked fresh crab meat imported from Venezuela is the likely source of this outbreak.
Twelve people infected with Vibrio parahaemolyticus who ate fresh crab meat have been reported from Maryland, Louisiana, Pennsylvania, and the District of Columbia.
Four people (33%) have been hospitalized. No deaths have been reported.
Illnesses started on dates ranging from April 1, 2018 to July 3, 2018.
This investigation is ongoing and CDC will provide updates when more information is available.

Introduction

CDC, state and local health officials, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Vibrio parahaemolyticus infections linked to eating fresh crab meat imported from Venezuela.

Public health investigators are using the PulseNet(https://www.cdc.gov/pulsenet/index.html) system to help identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on Vibrio bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis(https://www.cdc.gov/pulsenet/pathogens/pfge.html) (PFGE) and whole genome sequencing(https://www.cdc.gov/amd/) (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE.

As of July 12, 2018, 12 people infected with Vibrio parahaemolyticus who ate fresh crab meat have been reported from 3 states and the District of Columbia. A list of the states and the number of cases in each can be found on the Case Count Map page(https://www.cdc.gov/vibrio/investigations/vibriop-07-18/map.html). WGS showed that available isolates from people in this outbreak are closely related genetically. This close genetic relationship means that people in this outbreak are likely to share a common source of infection.

Additional ill people associated with this outbreak include people who reported eating crab meat and who had a diagnostic test showing they were infected with Vibrio, which may or may not be the species Vibrio parahaemolyticus.

Illnesses started on dates ranging from April 1, 2018 to July 3, 2018. Ill people range from 26 to 69 years, with a median age of 54. Among ill people, 67% are female. Four people (33%) have been hospitalized. No deaths have been reported.

This outbreak can be illustrated with a chart showing the number of people who became ill each day. This chart is called an epidemic curve or epi curve. Some illnesses might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. For a more detailed explanation, see the Timeline for Reporting Cases of Salmonella Infection, which is similar for reporting of Vibrio cases.(https://www.cdc.gov/salmonella/reporting-timeline.html)
Investigation of the Outbreak

Epidemiologic evidence(https://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/index.html) indicates that crab meat labeled as fresh or precooked imported from Venezuela is a likely source of this outbreak. Investigation into the source is ongoing.

Public health officials in Maryland first detected this outbreak when they identified Vibrio infections among people who ate crab meat.

FDA and regulatory officials in Maryland traced back the source of the crab meat from the restaurants and grocery stores where ill people bought crab meat. Preliminary evidence gathered in this investigation showed that the crab meat was imported from Venezuela.

Based on the information available at this time, CDC recommends that consumers not eat, restaurants not serve, and retailers not sell precooked fresh crab meat imported from Venezuela until further notice. This type of product may be labeled as fresh or precooked. It is commonly found in plastic containers. Food contaminated with Vibrio usually looks, smells, and tastes normal.

This investigation is ongoing. FDA and state regulatory officials are working to determine the distribution of imported crab meat and if it was sold in other states. CDC will provide updates when more information is available.

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