Foodborne Gastroenteritis Caused by Vibrio, Yersinia, and Campylobacter Species 661
to 8 days, with a mean of about 4.6 days. Symptoms (along with percentage incidence of each) were
diarrhea (95), cramps (92), weakness (90), nausea (72), chills (55), headache (48), and vomiting (12).
Both sexes were equally affected, the age of victims ranging from 13 to 78 years. No illness occurred
among 14 volunteers who ingested more than 10
9 cells, but illness did occur in one person from the
accidental ingestion of approximately 10
7 K
+ cells.
110 In another study, 2 × 10
5 to 3 × 10
7 K
+ cells
produced symptoms in volunteers, whereas 10
10 cells of K
− strains did not.
111,131 Some K
− strains
have been associated with outbreaks.
6,110
Vehicle foods for outbreaks are seafoods such as oysters, shrimps, crabs, lobsters, clams, and related
shellfish. Cross-contamination may lead to other foods as vehicles. The leading cause of food poisoning
in Japan in 1996 and 1997 was salmonellosis with V. parahaemolyticus food poisoning being second.
However, the latter became the leading cause in 1998 followed by salmonellosis. An outbreak in Japan
in 1996 involved 691 cases traced to boiled crabs, and the serovar was 03:K6.This serovar has replaced
04:K8 since 1996. There were 209 and 23 cases in the United States in 1997 and 1998 respectively, all
traced to raw oysters; and the serovar was 03:K6 (WHO Surveillance Newsletter No. 62, December
1999).
OTHER VIBRIOS
Vibrio cholerae
V. cholerae is best known as the cause of human cholera contracted from polluted water, and
seven pandemics have been recorded. Prior to 1992, the strains that cause epidemic/pandemic cholera
belonged to serovar O group 1, differentiated biochemically into two biotypes: classic and E1 Tor,
and two serotypes, Inaba and Ogawa. Those strains of V. cholerae that do not agglutinate in O group
I antiserum are referred to as non-01 or nonagglutinating vibrios (NAGs). The non-01 strains are
considered to be autochthonous estuarine bacteria and they are widely distributed. Although generally
nonpathogenic, non-01 strains are known to cause gastroenteritis, soft-tissue infections, and septicemia
in humans.
The seven pandemics of cholera have been caused by V. cholerae 01. The seventh pandemic, caused
by a 01 strain biotype El Tor, started in 1961 and waned after 1975. In 1992, a cholera epidemic
occurred on the Indian subcontinent that was not caused by a 01 strain but by a new non-01 serotype,
0139. Because it was first isolated from the coastal areas of the Bay of Bengal, it was designated 0139
Bengal.
60 The 0139 serotype has been shown to be genetically similar to the seventh pandemic 01 El Tor
biotype, and evidence has been presented to indicate that it evolved from seventh pandemic isolates.
64
Because 0139 lacks the 01 antigen gene cluster, this has been postulated by some as its evolutionary
path from the El Tor biotype,
21 and by use of molecular fingerprinting methods, it appears that 0139
strains represent a clone that arose from an El Tor strain of the seventh pandemic.
104 Like 01, 0139
contains genes for the cholera toxin, but unlike 01, 0139 produces a capsule and its lipopolysaccharide
(LPS) is reported to contain the sugar colitose.
104
Among the earliest information linking non-01 V. cholerae to gastroenteritis in the United States
are findings from 26 of 28 patients with acute diarrheal illness between 1972 and 1975. Although
some had systemic infections, 50% of the 28 yielded noncholera vibrios from stools and no other
pathogens.
58 In another retrospective study of non-01 V. cholerae cultures submitted to the Centers
for Disease Control (CDC) in 1979, nine were from domestically acquired cases of gastroenteritis and
each patient had eaten raw oysters within 72 hours of symptoms.
87 One of these isolates produced a
heat-labile toxin, whereas none produced heat-stable toxins.
to 8 days, with a mean of about 4.6 days. Symptoms (along with percentage incidence of each) were
diarrhea (95), cramps (92), weakness (90), nausea (72), chills (55), headache (48), and vomiting (12).
Both sexes were equally affected, the age of victims ranging from 13 to 78 years. No illness occurred
among 14 volunteers who ingested more than 10
9 cells, but illness did occur in one person from the
accidental ingestion of approximately 10
7 K
+ cells.
110 In another study, 2 × 10
5 to 3 × 10
7 K
+ cells
produced symptoms in volunteers, whereas 10
10 cells of K
− strains did not.
111,131 Some K
− strains
have been associated with outbreaks.
6,110
Vehicle foods for outbreaks are seafoods such as oysters, shrimps, crabs, lobsters, clams, and related
shellfish. Cross-contamination may lead to other foods as vehicles. The leading cause of food poisoning
in Japan in 1996 and 1997 was salmonellosis with V. parahaemolyticus food poisoning being second.
However, the latter became the leading cause in 1998 followed by salmonellosis. An outbreak in Japan
in 1996 involved 691 cases traced to boiled crabs, and the serovar was 03:K6.This serovar has replaced
04:K8 since 1996. There were 209 and 23 cases in the United States in 1997 and 1998 respectively, all
traced to raw oysters; and the serovar was 03:K6 (WHO Surveillance Newsletter No. 62, December
1999).
OTHER VIBRIOS
Vibrio cholerae
V. cholerae is best known as the cause of human cholera contracted from polluted water, and
seven pandemics have been recorded. Prior to 1992, the strains that cause epidemic/pandemic cholera
belonged to serovar O group 1, differentiated biochemically into two biotypes: classic and E1 Tor,
and two serotypes, Inaba and Ogawa. Those strains of V. cholerae that do not agglutinate in O group
I antiserum are referred to as non-01 or nonagglutinating vibrios (NAGs). The non-01 strains are
considered to be autochthonous estuarine bacteria and they are widely distributed. Although generally
nonpathogenic, non-01 strains are known to cause gastroenteritis, soft-tissue infections, and septicemia
in humans.
The seven pandemics of cholera have been caused by V. cholerae 01. The seventh pandemic, caused
by a 01 strain biotype El Tor, started in 1961 and waned after 1975. In 1992, a cholera epidemic
occurred on the Indian subcontinent that was not caused by a 01 strain but by a new non-01 serotype,
0139. Because it was first isolated from the coastal areas of the Bay of Bengal, it was designated 0139
Bengal.
60 The 0139 serotype has been shown to be genetically similar to the seventh pandemic 01 El Tor
biotype, and evidence has been presented to indicate that it evolved from seventh pandemic isolates.
64
Because 0139 lacks the 01 antigen gene cluster, this has been postulated by some as its evolutionary
path from the El Tor biotype,
21 and by use of molecular fingerprinting methods, it appears that 0139
strains represent a clone that arose from an El Tor strain of the seventh pandemic.
104 Like 01, 0139
contains genes for the cholera toxin, but unlike 01, 0139 produces a capsule and its lipopolysaccharide
(LPS) is reported to contain the sugar colitose.
104
Among the earliest information linking non-01 V. cholerae to gastroenteritis in the United States
are findings from 26 of 28 patients with acute diarrheal illness between 1972 and 1975. Although
some had systemic infections, 50% of the 28 yielded noncholera vibrios from stools and no other
pathogens.
58 In another retrospective study of non-01 V. cholerae cultures submitted to the Centers
for Disease Control (CDC) in 1979, nine were from domestically acquired cases of gastroenteritis and
each patient had eaten raw oysters within 72 hours of symptoms.
87 One of these isolates produced a
heat-labile toxin, whereas none produced heat-stable toxins.