Pathogen Safety Data Sheets: Infectious Substances – Vibrio parahaemolyticus
PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES
SECTION I - INFECTIOUS AGENT
NAME: Vibrio parahaemolyticus
SYNONYM OR CROSS REFERENCE: VP, gastroenteritis.
CHARACTERISTICS: Vibrio parahaemolyticus , of the Vibriomaceae family, is a gram- negative, halophilic, non-sporeforming, curved rod-shaped bacterium that is 0.5 - 0.8 μm in width and 1.4 - 2.4 μm in lengthFootnote 1Footnote 2Footnote 3. It is an oxidase-positive facultative anaerobe that can ferment glucose without gas productionFootnote 4. It has a polar flagellum which enables its high motility in liquid media, and its lateral flagella allow it to migrate across semi-solid surfaces by swarmingFootnote 2. Virulent strains isolated from patients have been shown to produce thermostable direct hemolysin (TDH), and/or TDH-related hemolysin, which is a characteristic that is not observed in other non-pathogenic/non-virulent strains found in the environment. TDH-producing isolates are known as Kanagawa positive and can be identified using β-hemolysis on a Wagatsuma blood agar.
SECTION II - HAZARD IDENTIFICATION
PATHOGENICITY/TOXICITY: Infections usually present in one of three major clinical syndromes: 60-80% of infections cause gastroenteritis, 34% wound infections, and 5% septicaemiaFootnote 4. The most common presentation is gastroenteritis, with symptoms including diarrhea (sometimes bloody and watery) with abdominal cramps, nausea, vomiting, headache, chills, and low-grade feverFootnote 1. Infection is usually self-limiting and of moderate severity, lasting approximately 3 days in immunocompetent patients, and can be treated with oral rehydration aloneFootnote 2. Wound infection and septicaemia can also results from exposure to the bacteria, and was the cause of 3 cases and 2 deaths in Louisiana and Mississippi after Hurricane Katrina in 2005Footnote 5. Fatal cases of septicaemia may occur in immunocompromised patients or those with a pre-existing medical condition (such as liver disease, cancer, heart disease, recent gastric surgery, antacid use, or diabetes).
EPIDEMIOLOGY: Worldwide - widely distributed in inshore marine waters, and has been found in seawater, sediments, and is a part of the natural flora of bivalve shellfishFootnote 2. The bacteria are most prevalent during warm summer seasons. Food-borne outbreaks have been caused by V. parahaemolyticus (serotype O3:K6 strain has increasing prominence) in Chile, France, Japan, Korea, Laos, Mozambique, Peru, Russia, Spain, Taiwan, United States, and especially in far east countries such as India, Bangladesh, and Thailand, where raw seafood consumption is highFootnote 1Footnote 2. The first recorded outbreak was in Japan in 1950, where there were 272 cases and 20 deaths after the consumption of semi-dried juvenile sardines. Outbreaks have also occurred in the United States, such as an outbreak in 1971 due to consumption of contaminated crab-meat, where the bacteria are estimated to be responsible for 5000 illnesses annually.
MODE OF TRANSMISSION: Primary mode of transmission is through the ingestion of raw, undercooked, or contaminated shellfish (such as oysters, clams, and mussels). Cooked crustaceans (such as crab, lobster, and shrimp) can still harbour the bacteria if it has not been properly cooked/heated, or if recontamination occurred by coming in contact with uncooked seafoodFootnote 2. Exposure of open wounds to contaminated seawater, shellfish, or finfish can cause infections and septicaemiaFootnote 4.
INCUBATION PERIOD: Usually at 15 hours after infection, with a range of 4 - 96 hoursFootnote 1.
COMMUNICABILITY: Infection cannot be transmitted from person-to-person.
SECTION III - DISSEMINATION
RESERVOIR: V. parahaemolyticus can survive in shellfish during warm seasons, and are naturally part of the flora of bivalve shellfishFootnote 2.
SECTION IV - STABILITY AND VIABILITY
DRUG SUSCEPTIBILITY: Susceptibility has been shown for a range of antibiotics such as doxycycline, or ciprofloxacin, tetracycline, ceftriaxone, chloramphenicol, imipenem, ofloxacin, nitrofurantoin, meropenem, oxytetracycline, fluoroquinolones, third generation cephalosporins, and aminoglycosidesFootnote 2Footnote 4Footnote 6. Erythromycin may be used by pregnant women and children.
DRUG RESISTANCE: Resistance has been confirmed for penicillin, ampicillin, apramycin, cephalothin, gentamycin, trimethoprim, and streptomycinFootnote 6.
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite, 70% ethanol, 2% glutaraldehyde, and formaldehydeFootnote 7.
PHYSICAL INACTIVATION: Extremely sensitive to heat as cells are no longer detectable at 48 - 50 C after 5 minutes; therefore proper cooking of shellfish products can effectively inactivate the bacteria(Footnote 2). Reduction of the bacteria in seafood can be achieved by cold storage at 3 °C for 7 days, freezing, and low temperature pasteurization; viable cells can be completely inactivated at -18 °C or -24 °C for 15-28 weeks(Footnote 5). High hydrostatic pressure can also destroy bacterial cells in food without affecting the nature of the food, and irradiation using Cobalt-60 gamma at 0.75 kGy has been shown to reduce bacteria to undetectable levels.
SURVIVAL OUTSIDE HOST: Salinity is crucial for its survival and growth, with multiplication observed at 0.5 - 10%, the optimal level being around 1 - 3%Footnote 2. The bacteria can survive through the winter season in marine sediments, and will resume multiplication when temperature rises to at least 15 °C(5), and the bacteria is also highly resistant to metal ions (up to 300 mM Mg Footnote 2 +). V. parahaemolyticus can enter a viable but non-culturable state in the presence of extreme conditions such as after 12 days of food-starvation or temperature stress around 4 °C.
SECTION V - FIRST AID / MEDICAL
SURVEILLANCE: Monitor for symptoms and confirm through culturing stool samples of patients suspected of infectionFootnote 8. Detection of V. parahaemolyticus in foods is commonly done using the most probable number (MPN) method; however, this method cannot differentiate between Vibrio parahaemolyticus, and strains such as Vibrio vulnificus, or Vibrio mimicus as growth of strains that do not ferment sucrose will all appear as similar round (2-3 mm), green or blue colonies on TCBS media (thiosulfate-citrate-bilesalts-sucrose agar). Polymerase chain reaction (PCR>), DNA hybridization, and chromogenic medium (plating technique that can detect and distinguished V. parahaemolyticus from other species by its unique purple colonies on the medium) can also be used for detection of contamination or infectionFootnote 5.
Note: All diagnostic methods are not necessarily available in all countries.
FIRST AID/TREATMENT: Administer appropriate antibiotic therapy. Oral rehydration in infected patients with mild gastroenteritis symptoms, and intravenous fluid and electrolyte replacement should be administered in severe casesFootnote 2. Antibiotics should be used for patients with wound infections or septicaemiaFootnote 4.
IMMUNIZATION: No vaccines are currently available.
PROPHYLAXIS: No drug prophylaxis is currently available. Avoid infection by keeping raw shellfish for consumption at cool temperatures as soon as possible after harvest, as V. paraheamolyticus have been shown to be able to multiply 50-fold in shellfish after 10 hours at 26 °C, and 760-fold after 24 hoursFootnote 2.
SECTION VI - LABORATORY HAZARDS
LABORATORY-ACQUIRED INFECTIONS: The first laboratory-acquired infection was recorded in 1972 when a worker was subculturing different strains of the bacteriaFootnote 8, and another infection was reported in 2002, and was caused through handling experimentally infected abalonesFootnote 9.
PRIMARY HAZARDS: Major hazards in the laboratory are ingestion and accidental parenteral inoculationFootnote 10.
SECTION VII - EXPOSURE CONTROLS / PERSONAL PROTECTION
RISK GROUP CLASSIFICATION: Risk Group 2.
CONTAINMENT REQUIREMENTS: Containment Level 2 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, or cultures.
PROTECTIVE CLOTHING: Lab coat. Gloves when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk to splashesFootnote 11.
OTHER PRECAUTIONS: All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC)Footnote 11. The use of needles, syringes and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activitiesFootnote 11.
SECTION VIII - HANDLING AND STORAGE
SPILLS: Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply appropriate disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up (30 min)Footnote 11.
DISPOSAL: Decontaminate all wastes that contain or have come in contact with the infectious organism before disposing by autoclave, chemical disinfection, gamma irradiation, or incinerationFootnote 11.
STORAGE: Properly labelled and sealed containersFootnote 11.
SECTION IX - REGULATORY AND OTHER INFORMATION
REGULATORY INFORMATION: The import, transport, and use of pathogens in Canada is regulated under many regulatory bodies, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment Canada, and Transport Canada. Users are responsible for ensuring they are compliant with all relevant acts, regulations, guidelines, and standards.
UPDATED: September 2010
PREPARED BY: Pathogen Regulation Directorate, Public Health Agency of Canada
Although the information, opinions and recommendations contained in this Pathogen Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Public Health Agency of Canada, 2010
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