Vibrio parahaemolyticus in the United States,

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1 Vibrio parahaemolyticus in the United States, Anna Newton, MPH Surveillance Epidemiologist ISSC webinar January 8, 2013 National Center for Emerging and Zoonotic Infectious Diseases Division of Foodborne, Waterborne, and Environmental Diseases

2 Cholera and Other Vibrio Illness Surveillance (COVIS) National database of reported Vibrio infections Cholera and vibriosis Started in 1988 by Gulf Coast states, CDC, and FDA Nearly all states reporting by early 2000s Nationally notifiable in 2007 Standard reporting form Demographics Clinical syndrome Exposure history Seafood traceback

3 Vibriosis transmission Transmission Category Clinical Presentation Exposure Foodborne Non-foodborne Unknown Gastroenteritis, septicemia Extra-intestinal infection, septicemia Seafood consumption Direct skin contact

4 Estimated annual number of infections in the United States Vibrio parahaemolyticus Domestically acquired foodborne Vibrio vulnificus Domestically acquired foodborne Illnesses 35, Hospitalizations Deaths 4 40 Scallan, E., et al., Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis, (1): p

5 Reported foodborne infections, Year Vibrio parahaemolyticus No. (% of foodborne) Vibrio vulnificus No. (% of foodborne) (61) 96 (11) (63) 83 (8) (65) 110 (7) (67) 133 (6) (59) 113 (7) (65) 119 (5)

6 Clam-associated infections Slayton et al. Clam-associated Vibriosis, USA, Epidemiol Infect. 2013

7 Clam-associated infections Slayton et al. Clam-associated Vibriosis, USA, Epidemiol Infect. 2013

8 Geographic distribution of foodborne infections, Region illness reported Vibrio vulnificus No. (%) Vibrio parahaemolyticus No. (%) Atlantic 40 (22) 521 (31) Gulf Coast 100 (56) 185 (11) Non-Coastal 34 (19) 280 (17) Pacific 6 (3) 669 (40) Total 180 (100) 1655 (100)

9 Vibrio vulnificus seasonality,

10 Vibrio parahaemolyticus seasonality,

11 Vibrio parahaemolyticus serotypes Classification scheme dependent upon O and K antigens >75 combinations have been described

12 Vibrio parahaemolyticus serotype distribution Pandemic Strain: serotype O3:K6 Most recent US outbreaks occurred in 1998 Oyster Bay Harbor, NY Galveston Bay, TX *Balakrish Nair, G et al. Global Dissemination of Vibrio parahaemolyticus Serotype O3:K6 and Its Serovariants. Clin Mirobiol Rev (1):39

13 Vibrio parahaemolyticus serotype distribution Pacific Northwest Strain: serotypes O4:K12 and O4:Kunknown Most recent US outbreak occurred in 2006 Washington and British Columbia, Canada *Balakrish Nair, G et al. Global Dissemination of Vibrio parahaemolyticus Serotype O3:K6 and Its Serovariants. Clin Mirobiol Rev (1):39

14 Increase in V. parahaemolyticus infections associated with Atlantic coast shellfish, Cases match by: Pulsed-field Gel Electrophoresis (PFGE) Serotype O4:K12 or O4:Kunknown

15 Increase in V. parahaemolyticus infections associated with Atlantic coast shellfish, Outbreak: 28 cases in 9 states Onset dates April-July 2012 Associated with consumption of raw shellfish Harvested from Oyster Bay Harbor, NY

16 2012 outbreak case definitions: confirmed and probable Confirmed Probable Outbreak PFGE Outbreak Serotype Seafood Traceback + + OBH + Not tested OBH Any Seafood Multiple sources (including OBH) or Unknown Evidence of crosscontamination with OBH shellfish Not tested Not tested OBH Oyster Clam

17 Increase in V. parahaemolyticus infections associated with Atlantic coast shellfish, : 104 cases in 13 states Onset dates May-September 2013 Associated with raw shellfish consumption Shellfish harvest areas identified in Connecticut, Massachusetts, New York, and Virginia

18 Top 4 Vibrio parahaemolyticus serotypes, United States,

19 Vibrio parahaemolyticus PFGE patterns, PulseNet,

20 Thank you National Center for Emerging and Zoonotic Infectious Diseases Division of Foodborne, Waterborne, and Emerging Diseases