Vibrio parahaemolyticus

Like V. cho/erae (and several other aquatic organisms described later), V. parahaemo/yticus is an aquatic organism that thrives in shallow coastal waters. Deep-sea fish do not tend to harbor the organism and usually become contaminated in fish markets. Precooked frozen shrimp may be contaminated and cause FP if served without further cooking, as in a seafood cocktail. Vibrio parahaemo/yticus FP is associated with raw, undercooked, or contaminated seafood and is especially common in Japan and probably other countries in which seafood is a staple of the diet. Contamination from raw to cooked seafood is a common cause. The incidence of V. parahaemo/yticus FP has increased in many Asian countries and the United States since 1996, and this is thought to be caused by a pandemic clone. Diarrhea, abdominal pain, and nausea are the predominant symptoms. The diarrhea can be severe, with blood or mucus in the stool. Vomiting is a less common feature, but fever can occur. The incubation period ranges from 4 h to 4 days, but most cases occur between 12 and 24 h. Death is uncommon.

The diagnosis is made by culture of the organism from feces or food. Vibrio parahaemo/yticus can be easily isolated from most aquatic environments, but such strains are predominantly Kanagawa negative. Only the Kanagawa-positive strains (i.e., those producing a thermostable hemolysin that can be confirmed in a laboratory) cause GE, and it is thought that they multiply selectively in the human intestine. The infectious dose can be fairly small, 2 x 105 to 3 x 107.

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