Disease Caused by a Marine Vibrio: Clinical Characteristics and Epidemiology

We studied the clinical characteristics and epidemiology of disease associated with a rare, unnamed halophilic lactose-fermenting Vibrio species in 39 persons from whom the organism had been isolated. Two distinct clinical presentations were seen. In the first, the illness began with septicemia, often within 24 hours after raw oysters had been eaten; 18 of 24 such patients had pre-existing hepatic disease, and 11 of the 24 died. In the second, there was a wound infection after exposure to seawater or an injury incurred during the handling of crabs; none of these persons had pre-existing hepatic disease, and one of 15 died. Most cases (85 per cent) occurred during relatively warm months (May to October) in men (90 per cent) 40 or more years of age (95 per cent). This Vibrio species is a pathogen and should be considered in the differential diagnosis of septicemia with secondary skin lesions and of wound infections after exposure to seawater. (N Engl J Med 300:1–5, 1979) RECENTLY, Hollis et al. described the laboratory characteristics of an as yet unnamed halophilic Vibrio species.¹ This Vibrio has been shown by deoxyribonucleic acid reassociation experiments to be a single species distinct from two other halophilic species, Vibrio parahaemolyticus and V. alginolyticus²; it can be distinguished from them biochemically by several reactions, including the fermentation of lactose (Table 1). This lactose-positive (L+) Vibrio is remarkable in that isolates from human beings have been from blood and infected tissue rather than from stool. In this report, we describe the clinical and epidemiologic characteristics of 39 illnesses associated with isolation of.