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Published Date: 2018-07-10 09:33:58
Subject: PRO/EDR> Vibrio parahaemolyticus - USA (02): (MD) imported Venezuelan crab meat
Archive Number: 20180710.5895254
VIBRIO PARAHAEMOLYTICUS - USA (02): (MARYLAND) IMPORTED VENEZUELAN CRAB MEAT
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Date: Fri 6 Jul 2018
Source: Anne Arundel County Department of Health [edited]
https://www.aahealth.org/crab-meat-imported-from-venezuela-warning/


The Maryland Department of Health is warning consumers to avoid eating fresh crab meat imported from Venezuela because of potential risk of infection.

The Department is investigating a cluster of _Vibrio_ infections in individuals who reported eating "fresh" (non-pasteurized) crab meat from a plastic tub with a label indicating that it is imported from Venezuela. The imported crab meat is sold under different brand names. Maryland crab products have not been associated with this cluster. The implicated foods have been prepared in both household and restaurant settings, and include a variety of dishes, such as crab cakes, seafood salad containing crab, and crab benedict.

Symptoms of _Vibrio parahaemolyticus_ infection include watery diarrhea, abdominal cramping, nausea, vomiting, fever and chills. At least 9 cases who consumed imported crab meat have been confirmed in Maryland. Two of the individuals were hospitalized, and there have been no deaths.

_Vibrio_ infections can be caused by ingestion of _Vibrio_-containing water or shellfish and by direct skin exposure to _Vibrio_-containing salt or brackish water, including waters of the Chesapeake Bay and its tributaries. However, none of the individuals have reported contact with water as a likely cause of illness.

Individuals who have recently consumed imported crab meat from Venezuela and are experiencing any of the symptoms listed above should consult their primary care provider. The Maryland Department of Health continues to investigate this cluster. Consumers should refrain from eating these non-pasteurized imported products until further notice.

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[It is not stated whether the product was distributed in other parts of the USA. Unless the contaminated crab meat was eaten raw, the illnesses were acquired from either undercooking or poor kitchen hygiene with cross-contamination.

The following is from the CDC regarding _Vibrio parahaemolyticus_:

_V. parahaemolyticus_ is a bacterium in the same family as those that cause cholera. It lives in brackish saltwater and causes gastrointestinal illness in humans. _V. parahaemolyticus_ naturally inhabits coastal waters and is present in higher concentrations during summer; it is a halophilic, or salt-requiring organism.

When ingested, _V. parahaemolyticus_ causes watery diarrhea often with abdominal cramping, nausea, vomiting, fever, and chills. Usually these symptoms occur within 24 hours of ingestion. Illness is usually self-limited and lasts 3 days. Severe disease is rare and occurs more commonly in persons with weakened immune systems. _V. parahaemolyticus_ can also cause an infection of the skin when an open wound is exposed to warm seawater.

Most people become infected by eating raw or undercooked shellfish, particularly oysters. Less commonly, this organism can cause an infection in the skin when an open wound is exposed to warm seawater.

An estimated 4500 cases of _V. parahaemolyticus_ infection occur each year in the USA. However, the number of cases reported to CDC is much lower because surveillance is complicated by underreporting. Laboratories rarely use the selective medium that is necessary to identify this organism, and it is likely that many cases are undetected. To improve our ability to monitor trends, infections caused by _V. parahaemolyticus_ and other _Vibrio_ species became nationally notifiable in 2007. State health departments report cases to CDC, and these reports are summarized annually.

_Vibrio_ organisms can be isolated from cultures of stool, wound, or blood. For isolation from stool, use of a selective medium that has thiosulfate, citrate, bile salts, and sucrose (TCBS agar) is recommended. If there is clinical suspicion for infection with this organism, the microbiology laboratory should be notified so that they will perform cultures using this medium. A physician should suspect _V. parahaemolyticus_ infection if a patient has watery diarrhea and has eaten raw or undercooked seafood, especially oysters, or when a wound infection occurs after exposure to seawater.

Treatment is not necessary in most cases of _V. parahaemolyticus_ infection. There is no evidence that antibiotic treatment decreases the severity or the length of the illness. Patients should drink plenty of liquids to replace fluids lost through diarrhea. In severe or prolonged illnesses, antibiotics such as tetracycline or ciprofloxacin can be used. The choice of antibiotics should be based on antimicrobial susceptibilities of the organism.

Vibrio is a naturally occurring organism commonly found in waters where oysters are cultivated. When the appropriate conditions occur with regard to salt content and temperature, _V. parahaemolyticus_ thrives.

Most infections caused by _V. parahaemolyticus_ in the USA can be prevented by thoroughly cooking seafood, especially oysters. Wound infections can be prevented by avoiding exposure of open wounds to warm seawater. When an outbreak is traced to an oyster bed, health officials recommend closing the oyster bed until conditions are less favorable for _V. parahaemolyticus_. - Mod.LL

HealthMap/ProMED map available at:
Maryland, United States: http://healthmap.org/promed/p/223]

See Also

Ciguatera toxin - Bahamas (2): (NW) conch, correction, Vibrio sp. laboratory confirmation 20180707.5892262
Vibrio parahaemolyticus - USA: (AL) soft tissue infection 20180617.5859587
2017
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Vibrio parahaemolyticus - USA : (MA) raw oysters 20171003.5357399
Vibrio parahaemolyticus - USA: (WA) 20170720.5189640
2016
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Vibrio parahaemolyticus - Canada: (BC) shellfish 20160708.4333739
2015
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Vibrio parahaemolyticus - Canada (BC,AB): shellfish 20150815.3580619
Vibrio parahaemolyticus - Thailand: chicken blood 20150117.3097308
2014
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Vibrio parahaemolyticus - USA (02): (NY) shellfish harvesting ban 20140913.2768717
Vibrio parahaemolyticus - USA: eastern spread of western strains, 2013 20140418.2412007
2013
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Vibrio parahaemolyticus - USA (08) 20131206.2092369
Vibrio parahaemolyticus - USA (07): (MA) 20130917.1947675
Vibrio parahaemolyticus - USA (06): (MA) 20130911.1938075
Vibrio parahaemolyticus - USA (05): (CT) 20130817.1886013
Vibrio parahaemolyticus - USA (04): (WA) 20130815.1882918
Vibrio parahaemolyticus - USA (03): (CT) shellfish recall 20130805.1865072
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