Cholera-related bacteria kills 5
http://www.cnn.com/2005/US/09/06/news.update/9/7/05 ATLANTA (CNN) -- The Centers for Disease Control and Prevention said Tuesday that five people have died in the area hit by Hurricane Katrina after becoming infected with Vibrio vulnificus, typically a more benign relative of the bacteria that cause cholera.
One of the fatalities occurred in Texas; the other four were in Mississippi, said CDC spokesman Tom Skinner
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CDC Dispatch
September 14, 2005 / 54(Dispatch);1-4
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm54d914a1.htm Vibrio Illnesses After Hurricane Katrina --- Multiple States, August--September 2005
Hurricane Katrina made landfall on August 29, 2005, with major impact on the U.S. Gulf Coast. During August 29–September 11, surveillance identified 22 new cases of Vibrio illness with five deaths in persons who had resided in two states (Figure 1). These illnesses were caused by V. vulnificus, V. parahaemolyticus, and nontoxigenic V. cholerae. These organisms are acquired from the environment and are unlikely to cause outbreaks from person-to-person transmission. No cases of toxigenic V. cholerae serogroups O1 or O139, the causative agents of cholera, were identified. This report summarizes the investigation by state and local health departments and CDC, describes three illustrative cases, and provides background information on Vibrio illnesses. Results of the investigation underscore the need for heightened clinical awareness, appropriate culturing of specimens from patients, and empiric treatment of illnesses (particularly those associated with wound infections) caused by Vibrio species. No confirmed cases of illness have been identified with onset after September 5; additional Vibrio cases are under investigation.
A case of post-hurricane Vibrio infection was defined as clinical illness in a person who had resided in a state struck by Hurricane Katrina (i.e., Alabama, Louisiana, or Mississippi) with illness onset and reporting during August 29–September 11, where Vibrio species was isolated from a wound, blood, or stool culture. Among cases, a wound-associated Vibrio case was defined as an illness that likely resulted from infection of a wound or abrasion acquired before or during immersion in floodwaters.
Wound-Associated Illnesses
Eighteen wound-associated Vibrio cases were reported, in residents of Mississippi (seven) and Louisiana (five); in persons displaced from Louisiana to Texas (two), Arkansas (two), and Arizona (one); and in a person displaced from Mississippi to Florida (one). Speciation was performed in clinical laboratories for 17 of the wound-associated cases; 14 (82%) were V. vulnificus, and three (18%) were V. parahaemolyticus. Five (28%) patients with wound-associated Vibrio infections died; three deaths were associated with V. vulnificus infection, and two were associated with V. parahaemolyticus infection.
Age of patients with wound-associated illnesses ranged from 31 to 89 years (median: 73 years). Fifteen (83%) were male. The majority of patients were hospitalized; admission dates ranged from August 29 to September 5. Not all patients were initially hospitalized because of their wounds. An underlying condition that might have increased risk for severe Vibrio illness was reported in 13 (72%) of the patients with wounds; these conditions included heart disease (seven patients), diabetes mellitus (four), renal disease (three), alcoholism (three), liver disease (two), peptic ulcer disease (one), immunodeficiency (one), and malignancy (one).
Non-Wound–Associated Illnesses
Four persons were reported with non-wound–associated Vibrio infections (two in Mississippi, one in Louisiana, and one displaced from Louisiana to Arizona). Information on the Vibrio species and clinical illness was available for two of these patients; the species were nontoxigenic V. cholerae isolated from patients with gastroenteritis. One of the infections occurred in a boy aged 2 months with diarrhea whose stool culture yielded both Salmonella group C2 and V. cholerae non- O1, non-O139. He was hospitalized for 2 days in Mississippi. The other V. cholerae non-O1, non-O139 isolate was from a stool specimen from an adult who was not hospitalized. No deaths were associated with the non-wound cases.
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