Review
Infections related to the ingestion of seafood Part I: viral and bacterial infections

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Summary

Foodborne diseases cause an estimated 76 million illnesses in the USA each year. Seafood is implicated in 10–19% of these illnesses. A causative agent can be traced in about 44% of seafood-related outbreaks, viruses accounting for around half of these illnesses. Although viruses are the most common cause of seafood-related infections, most hospitalisations and deaths are due to bacterial agents. A wide variety of viruses, bacteria, and parasites have been implicated in seafood-related outbreaks, which are reported worldwide. The factor most commonly associated with infection is consumption of raw or undercooked seafood. People with underlying disorders, particularly liver disease, are more susceptible to infection. The first part of this two-part review summarises the general incidence of seafood-related infections and discusses the common viral and bacterial causes of these infections. For each agent, the microbiology, epidemiology, mode of transmission, and treatment are discussed. In the May issue of the journal we will discuss parasites associated with seafood consumption, the safety of seafood, and the measures put in place in the USA to increase its safety.

Section snippets

Microbiology

The family Calicividae is comprised of four antigenically and genetically diverse groups of viruses that also differ in their animal host preference. The viruses contain single-strand RNA with a positive polarity. The exterior surface of the virions is composed of a single major protein that forms the capsid and appears as 32 cup-shaped depressions on the surface showing an icosahedral symmetry on microscopy. Human caliciviruses have been grouped into two genera: norovirus and sapovirus.

Microbiology

Vibrionaceae are Gram-negative, comma shaped or straight rods that are motile in liquid media (figure 3A and 3B).51 They are oxidase-positive facultative anaerobes that ferment glucose without gas production.52 Several Vibrio species have been implicated in foodborne illnesses worldwide although the aetiological evidence is not firm for some species. Vibrio parahaemolyticus is the most common species associated with human disease in the USA, followed by V vulnificus, and non-epidemic V cholerae

Microbiology

Clostridium botulinum is a Gram-positive, anaerobic bacillus that forms subterminal spores (figure 5). There are four groups based on proteolytic activity and type of toxin produced. C botulinum spores are often seen in the soil and marine sediment and can tolerate extr eme temperatures for many hours. The toxin is heat labile and can be destroyed if the food is sufficiently cooked. Based on antigenic properties botulism toxins are divided into six types; type E predominates in foodborne

Other bacteria

Campylobacter spp are Gram-negative, comma-shaped bacteria that are recognised worldwide as zoonotic pathogens in both wild and domesticated animals. In human beings Campylobacter spp cause both enteric and extraintestinal infections. The most common cause of human enteritis is Campylobacter jejuni (to a lesser degree C coli but they are indistinguishable clinically) and the US Centers for Disease Control and Prevention (CDC) estimates an incident rate of 2·4 million cases annually.146 The

Search strategy and selection criteria

We searched Medline for English language articles using the search terms “seafood”, “infection”, “bacteria”, and “virus”, and the specific organisms covered in this review between 1980 and 2003. Articles reporting infections or outbreaks related to seafood consumption were selected. Cited references in the selected articles were also screened and pertinent articles retrieved.

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