title: Emergence of a new Vibrio parahaemolyticus serotype in raw oysters: A prevention quandary.
abstract: BACKGROUND
  In May and June 1998, reported Vibrio parahaemolyticus infections increased sharply in Texas.
  
  
  OBJECTIVE
  To determine factors that contributed to the increase in V parahaemolyticus infections.
  
  
  METHODS
  Cross-sectional survey of persons reporting gastroenteritis after eating seafood in Texas; survey of environmental conditions in Galveston Bay.
  
  
  METHODS
  Traceback of oysters, water quality measures in harvest areas, presence of V parahaemolyticus in stool cultures; comparison of median values for environmental conditions before and during the outbreak compared with during the previous 5 years.
  
  
  RESULTS
  Between May 31 and July 10, 1998, 416 persons in 13 states reported having gastroenteritis after eating oysters harvested from Galveston Bay. All 28 available stool specimens from affected persons yielded V parahaemolyticus serotype O3:K6 isolates. Oyster beds met current bacteriologic standards during harvest and fecal coliform counts in water samples were within acceptable limits. Median water temperature and salinity during May and June 1998 were 30.0 degrees C and 29.6 parts per thousand (ppt) compared with 28.9 degrees C and 15.6 ppt for the previous 5 years (P<.001).
  
  
  CONCLUSIONS
  This is the first reported outbreak of V parahaemolyticus serotype O3:K6 infection in the United States. The emergence of a virulent serotype and elevated seawater temperatures and salinity levels may have contributed to this large multistate outbreak of V parahaemolyticus. Bacteriologic monitoring at harvest sites did not prevent this outbreak, suggesting that current policy and regulations regarding the safety of raw oysters require reevaluation. Consumers and physicians should understand that raw or undercooked oysters can cause illness even if harvested from monitored beds. In patients who develop acute gastroenteritis within 4 days of consuming raw or undercooked oysters, a stool specimen should be tested for Vibrio species using specific media. JAMA. 2000;284:1541-1545.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, 1701 Divisadero, Suite 500, San Francisco, CA 94115, USA. ndaniels@medicine.ucsf.edu
authors.forename: N A
authors.initials: NA
authors.lastname: Daniels
authors.forename: B
authors.initials: B
authors.lastname: Ray
authors.forename: A
authors.initials: A
authors.lastname: Easton
authors.forename: N
authors.initials: N
authors.lastname: Marano
authors.forename: E
authors.initials: E
authors.lastname: Kahn
authors.forename: A L
authors.initials: AL
authors.lastname: McShan
authors.forename: L
authors.initials: L
authors.lastname: Del Rosario
authors.forename: T
authors.initials: T
authors.lastname: Baldwin
authors.forename: M A
authors.initials: MA
authors.lastname: Kingsley
authors.forename: N D
authors.initials: ND
authors.lastname: Puhr
authors.forename: J G
authors.initials: JG
authors.lastname: Wells
authors.forename: F J
authors.initials: FJ
authors.lastname: Angulo
mesh_terms: D000818:Animals; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D004777:Environment; D005759:Gastroenteritis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D006801:Humans; D010125:Ostreidae / Q000382:microbiology*; D017747:Seafood / Q000506:poisoning*; D012703:Serotyping; D013781:Texas / Q000453:epidemiology; D014733:Vibrio / Q000145:classification / Q000302:isolation & purification*; D014735:Vibrio Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology