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Vibriosis (infection with Vibrio): For health professionals

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What health professionals need to know about vibriosis

Vibrio exist worldwide in marine and coastal waters. They are part of the natural flora of bivalve shellfish, particularly during seasons where water temperatures are warmer.

Infection with Vibrio species (other than those that cause cholera) have been associated with sporadic illness and outbreaks in Canada. Outbreaks in Canada have been associated with eating raw or undercooked shellfish, particularly oysters.

Species of Vibrio known to cause illness in humans include:

  • V. parahaemolyticus
  • V. vulnificus
  • V. alginolyticus
  • other Vibrio species, including:
    • V. cholera other than O1 and O139
    • V. mimicus
    • non-toxigenic V. cholera O1

Clinical symptoms

Vibrio parahaemolyticus

  • Incubation period: Usually 24 hours but can range from 4 to 96 hours.
  • The most common clinical presentation is gastroenteritis characterized by watery diarrhea and abdominal cramps, often with nausea, vomiting and headache. Some patients may have dysentery like illness with bloody or mucoid stools.
  • Wound infections may occur from exposure to the bacteria.
  • The disease is moderate in severity, lasting for 1 to 7 days. Systemic infection and death rarely occur.

Vibrio vulnificus

  • Incubation period: Usually 12 to 72 hours after eating raw or undercooked seafood.
  • Intestinal manifestations are rare. This Vibrio presents with fever, chills, hypotension and bullous skin lesions that progress to necrotic ulcers.
  • Wound infections may occur from exposure to the bacteria.
  • There is an increased risk of septicemia and death for patients with immunocompromising medical conditions, cirrhosis, hemochromatosis or other chronic liver diseases.

Vibrio alginolyticus

  • Incubation period: 12 to 24 hours.
  • Causes otitis externa, otitis media and cellulitis.

Other Vibrio

This category includes other Vibrio that cause vibriosis, such as V. cholera other than O1 and O139, V. mimicus and non-toxigenic V. cholera O1.

  • Incubation period: 12 to 24 hours.
  • Causes gastroenteritis ranging from mild to severe, but has not resulted in large epidemics.

Transmission

Vibrio infection is transmitted via:

  • ingestion of raw or undercooked contaminated shellfish (for example, oysters, clams and mussels)
  • environmental exposure of wounds to estuarine or marine waters or to sea life
  • occupational wounds (for example, fishery workers and oyster shuckers)
  • ingestion of surface waters in tropical endemic areas

Vibrio infection is not transmitted person-to-person.

Diagnosis

Patients may present with any of the symptoms outlined above. When trying to establish a diagnosis, consider sources of exposure as well as individual risk factors.

Laboratory diagnosis is achieved by isolating the pathogen from clinical specimens of:

  • stool
  • blood, or
  • wound

There are no serodiagnostic or rapid tests for vibriosis.

Treatment

Rehydration is the primary treatment for gastrointestinal infections with Vibrio.

Antibiotic treatment is recommended for:

  • cellulitis
  • septicemia
  • otitis media
  • otitis externa

Debridement or amputation may be necessary for severely infected wounds.

Surveillance

Infections with Vibrio species (other than those that cause cholera) are not nationally notifiable diseases.

Canada uses the National Enteric Surveillance Program (NESP) to monitor the national incidence of infections caused by Vibrio species.

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2022-11-30

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