{"id":4517,"date":"2023-09-05T12:15:06","date_gmt":"2023-09-05T17:15:06","guid":{"rendered":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/?p=4517"},"modified":"2023-09-05T12:59:19","modified_gmt":"2023-09-05T17:59:19","slug":"severe-vibrio-vulnificus-infections-in-the-united-states-associated-with-warming-coastal-waters","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/2023\/09\/05\/severe-vibrio-vulnificus-infections-in-the-united-states-associated-with-warming-coastal-waters\/","title":{"rendered":"Severe\u00a0Vibrio vulnificus\u00a0Infections in the United States Associated with Warming Coastal Waters"},"content":{"rendered":"<div class=\"panel body-content\"><div class=\"panel__container\">\n<p><a href=\"https:\/\/emergency.cdc.gov\/han\/2023\/han00497.asp\">CDC<\/a> <\/p>\n\n\n\n<p><strong>Summary<\/strong><br>The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Notify healthcare providers, laboratories, and public health departments about recent reports of fatal&nbsp;<em>Vibrio vulnificus&nbsp;<\/em>(<em>V. vulnificus<\/em>&nbsp;) infections, including wound and foodborne infections.<\/li>\n\n\n\n<li>Urge healthcare professionals to consider&nbsp;<em>V. vulnificus&nbsp;<\/em>as a possible cause of infected wounds that were exposed to coastal waters, particularly near the Gulf of Mexico or East Coast, and during periods with&nbsp;<a href=\"https:\/\/www.ncei.noaa.gov\/products\/coastal-water-temperature-guide\">warmer coastal sea surface temperatures<\/a>.<\/li>\n\n\n\n<li>Share important guidance for managing&nbsp;<em>V. vulnificus&nbsp;<\/em>wound infections.<\/li>\n<\/ul>\n\n\n\n<p><strong>Background<\/strong><br><em>Vibrio&nbsp;<\/em>are bacteria that cause an estimated 80,000 illnesses each year in the United States. About a dozen species of&nbsp;<em>Vibrio<\/em>&nbsp;are pathogenic to humans.&nbsp;<em>V. parahaemolyticus<\/em>&nbsp;causes the most infections in the United States, accounting for about 40% of reported cases of vibriosis, followed by&nbsp;<em>V. alginolyticus<\/em>, which accounts for about 20%. Most people with&nbsp;<em>Vibrio<\/em>&nbsp;infection have diarrhea. Some people might also have stomach cramping, nausea, vomiting, fever, and chills. One species,<em>&nbsp;V. vulnificus<\/em>, is known to cause life-threatening infections. About 150\u2013200&nbsp;<em>V. vulnificus<\/em>&nbsp;infections are reported to CDC each year and about one in five people with this infection die\u2014sometimes within 1\u20132 days of becoming ill.<\/p>\n\n\n\n<p><em>Vibrio&nbsp;<\/em>naturally live in coastal waters, including salt water and brackish water, which is a mixture of salt water and fresh water. Most people get infected with&nbsp;<em>Vibrio<\/em>&nbsp;by eating raw or undercooked shellfish, particularly oysters. Some people get infected when an open wound is exposed to salt water or brackish water containing&nbsp;<em>Vibrio&nbsp;<\/em>[1]. People can also get infected if an open wound comes in contact with raw or undercooked seafood. Open wounds include those from a recent surgery, piercing, tattoo, and other cuts or scrapes\u2014including those acquired during aquatic activity. Extreme weather events, such as coastal floods, hurricanes, and storm surges, can force coastal waters into inland areas, putting people that are exposed to these waters\u2014especially evacuees who are older or have underlying health conditions\u2014at increased risk for&nbsp;<em>Vibrio&nbsp;<\/em>wound infections. This effect was observed in Florida after Hurricane Ian in 2022 [2].<\/p>\n\n\n\n<p>Unlike other&nbsp;<em>Vibrio<\/em>&nbsp;species,&nbsp;<em>V. vulnificus<\/em>&nbsp;is primarily transmitted through open-wound contact with salt water or brackish water, but occasionally (in approximately 10% of cases) the bacteria also can infect people if they eat raw or undercooked shellfish. Person-to-person transmission has not been reported. People at higher risk for wound infection include those with underlying health conditions such as liver disease, diabetes, and immunocompromising conditions [3].&nbsp;<strong><em>V. vulnificus<\/em><\/strong>&nbsp;<strong>wound infections have a short incubation period and are characterized by necrotizing skin and soft tissue infection<\/strong>, with or without hemorrhagic bullae. Many people with&nbsp;<em>V. vulnificus<\/em>&nbsp;wound infection require intensive care or surgical tissue removal.<\/p>\n\n\n\n<p><strong><em>V. vulnificus&nbsp;<\/em><\/strong><strong>bacteria thrive in warmer waters\u2014especially during the summer months (May to October) and in low-salt marine environments like estuaries<\/strong>. In the United States,&nbsp;<em>V. vulnificus&nbsp;&nbsp;<\/em>infections have been most commonly reported by Gulf Coast states. However,&nbsp;<em>V. vulnificus<\/em>&nbsp;infections in the Eastern United States increased eightfold from 1988\u20132018, and the northern geographic range of infections has increased 48 km per year [4]. During July\u2013August 2023, the United States has experienced above-average coastal sea surface temperatures and widespread heat waves [5]. During the same period, several East Coast states, including&nbsp;<a href=\"https:\/\/portal.ct.gov\/DPH\/Press-Room\/Press-Releases---2023\/Vibrio\">Connecticut<\/a>,&nbsp;<a href=\"https:\/\/www.governor.ny.gov\/news\/following-death-suffolk-county-tied-rare-vibrio-vulnificus-bacteria-governor-hochul-updates\">New York<\/a>, and&nbsp;<a href=\"https:\/\/www.ncdhhs.gov\/news\/press-releases\/2023\/07\/28\/ncdhhs-urges-caution-after-three-deaths-due-vibrio-summer\">North Carolina<\/a>, have reported severe and fatal&nbsp;<em>V. vulnificus<\/em>&nbsp;infections. Many of these infections were acquired after an open wound was exposed to coastal waters in those states. Some of these infections were associated with consumption of raw or undercooked seafood or had unclear etiology.<\/p>\n\n\n\n<p>Amid increasing water temperatures and extreme weather events (e.g., heat waves, flooding, and severe storms) associated with climate change [6],&nbsp;<strong>people who are at increased risk for&nbsp;<em>V. vulnificus<\/em>&nbsp;infection should exercise caution when engaging in coastal water activities<\/strong>.&nbsp;<strong>Prompt treatment is crucial to reduce mortality from severe&nbsp;<em>V. vulnificus<\/em>&nbsp;infection<\/strong>.&nbsp;CDC continues to monitor reports of&nbsp;<em>V. vulnificus<\/em>&nbsp;infections.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>CDC SummaryThe Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to: BackgroundVibrio&nbsp;are bacteria that cause an estimated 80,000 illnesses each year in the United States. About a dozen species of&nbsp;Vibrio&nbsp;are pathogenic to humans.&nbsp;V. parahaemolyticus&nbsp;causes the most infections in the United States, accounting for about 40% of reported [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[21],"tags":[],"class_list":["post-4517","post","type-post","status-publish","format-standard","hentry","category-featured"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/4517","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/comments?post=4517"}],"version-history":[{"count":2,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/4517\/revisions"}],"predecessor-version":[{"id":4519,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/4517\/revisions\/4519"}],"wp:attachment":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/media?parent=4517"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/categories?post=4517"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/tags?post=4517"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}