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Toxigenic Vibrio cholerae infections are highly unusual in Florida. Due to the recent outbreak of cholera in Haiti, increased awareness and testing were occurring to detect imported cholera cases. Eight suspected cases on V. Cholerae non-O1/O139 were detected between March 23 and April 13, 2011. The first reported incident in Florida of a case of a toxigenic V. Cholerae O75 occurred in November 2010. Previously this serogroup had been associated with sporadic cases of gastrointestinal disease in other southeastern US states.
METHODS:
Specimens collected from the cases were forwarded to the Centers for Disease Control and Prevention (CDC) Laboratory for analysis. Cases were interviewed for location and dates of possible exposures. Required tags on oyster bags were collected to obtain information identifying the dates and locations of harvest areas.
RESULTS:
Ten cases of toxigenic V. cholerae O75 were associated with this outbreak. Eight were confirmed by laboratory analysis at CDC as being V. cholerae O75. Sixty percent of the cases were males, age ranged from 22 – 74 years of age with a median of 45 years. The most commonly reported symptoms were: diarrhea (90%), cramps (80%), and nausea (70%). Incubation period ranged from 1 - 6 days with a median of two days. No cases required hospitalization and no deaths were reported. Exposure information yielded oysters as a common food consumed by all cases and collection of the oyster tag information revealed that the oysters had been harvested in Apalachicola Bay in Florida and was the most likely source of the oysters causing illness.
CONCLUSIONS:
This is the first recorded outbreak related to V. cholerae O75 and oyster consumption. The identification of the outbreak could be the result of an increase in testing for V. cholerae in human stool isolates, allowing unprecedented detection of human disease that may have gone undiagnosed in the past.