Vibrio - Information for Clinicians
Type of infection
Vibrio are curved, motile gram-negative rods. There are a number of pathogenic species that are typical causes of gastroenteritis, including Vibrio cholerae O1 and O139 (which cause cholera), other Vibrio cholerae and Vibrio parahemolyticus. Other species, including Vibrio alginolyticus, Vibrio mimicus, and Vibrio vulnificus can be found in the stool of patients with diarrhea.
Sources of infection
- Vibrio live in the marine environment, predominantly in estuaries and salt water but can be found in fresh water.
- Most cases of Vibrio gastroenteritis come from eating raw or undercooked fish and shellfish (crab, shrimp, oysters, etc.).
- More infections occur during the warm summer months and are associated with warmer water temperatures. Many occur in the Gulf Coast or South Atlantic states.
- Other foods can become contaminated by contact with raw or undercooked fish or shellfish.
- Vibrio cholerae infections can result from fecal contamination of water or food.
Usual symptoms
- Incubation period is generally 12-72 hours.
- Diarrhea, vomiting, abdominal pain or cramps, occassionally fever. Diarrhea can be watery or may have mucous or blood.
Duration of illness
- Typically 2-5 days without treatment.
Treatment
- Prevent and treat dehydration and electrolyte abnormalities.
- For mild to moderate gastroenteritis, antibiotics are not necessary.
- For more severe illness, compromised hosts, or cases of suspected sepsis, antibiotic therapy is indicated. Doxycycline or a fluoroquinolone are the preferred oral therapies. For severe sepsis, ceftriaxone plus doxycycline is the preferred empiric therapy.
Complications
- Dehydration and electrolyte abnormalities. Dehydration can be severe or fatal, especially with Vibrio cholerae.
- Bacteremia can occur with a number of Vibrio species and can cause severe sepsis. Vibrio vulnificus causes severe sepsis in patients with liver disease, iron overload, and immune compromising conditions.
Comments
- To prevent Vibrio infections, avoid raw or undercooked fish and shellfish and be careful not to let other foods contact raw fish or shellfish.
- People with severe liver disease, immune compromising conditions, or iron overload should avoid raw shellfish.
- People with diarrhea should not prepare food.