Albany, November 2 --- A recent report of a death associated with a bacterial organism found in raw shellfish from Florida waters has prompted the State Health Department to advise certain high-risk or immune-compromised individuals not to eat raw or lightly cooked clams or oysters from those waters, State Health Commissioner, Barbara DeBuono, M.D., said today.
"It is important for certain high-risk individuals, such as those with underlying liver disease, to realize that eating raw or lightly cooked clams or oysters contaminated with Vibrio vulnificus bacteria can be fatal," Dr. DeBuono said. "Some of the clams and oysters currently sold in New York State on a seasonal basis are harvested in waters of Gulf Coast states where contamination with this organism is common." Thorough cooking of shellfish will kill this organism.
The Commissioner said the health advisory was being issued based on reports of illness nationwide, including the death in late September of a western New York woman, who had an existing liver disease and became ill with a blood stream infection after consuming raw shellfish at a clam bake in Steuben County. The clams were reported to have been harvested from the Indian River area in Florida. The infecting agent was found to be Vibrio vulnificus, a bacterial organism which can cause gastroenteritis among healthy individuals, or blood poisoning among certain high-risk groups, such as those with liver disease or diabetes. Two other Vibrio vulinificus deaths in other states have been associated with the consumption of raw clams from the Indian River this year.
According to United States Food and Drug Administration (FDA), Vibrio vulnificus is found in 5 to 10 percent of all shellfish harvested in warm, coastal waters such as those bordering Florida and Louisiana. The shellfish harvested during the months of May through October are considered to be the greatest risk. The bacteria are not the result of pollution. They are naturally occurring bacteria in warm saltwater and shellfish harvested from those waters. Cooking shellfish thoroughly to 165 degrees Fahrenheit or greater will destroy the Vibrio vulnificus bacteria.
While the recent death is the only case reported in New York State this year, two cases of Vibrio vulnificus illness, which resulted in the death of one person, were reported last year in New York State. During the period 1988-1995, more than 100 cases of raw shellfish associated with Vibrio vulnificus infections were reported nationwide with a mortality rate of approximately 40 percent.
Dr. DeBuono said the following groups are considered high-risk and should stringently adhere to the advisory: people with liver disease or liver involvement, such as diabetes mellitus, alcoholism, hemochromatosis (an iron metabolism disorder), or Thalassemia (a hereditary anemic condition); people with therapeutically-induced or naturally low gastric acid, such as those who have had gastric surgery or those using antacids on a routine basis; and persons with compromised immune systems, such as those individuals with AIDS or undergoing cancer treatment. The risk of death is almost 200 times greater in those with liver disease than those without liver disease, according to the FDA.
The Interstate Shellfish Sanitation Conference and the FDA have been working with the shellfish industry to promote an education campaign to create an awareness among high-risk individuals. Individuals who are concerned about potential danger from Florida clams can ask their shellfish dealers for the source of their clams and oysters, Dr. DeBuono said. The FDA issued a nationwide notice to physicians in August 1995 regarding vulnificus in oysters. Also the FDA issued a brochure regarding raw oysters and proper cooking procedures to kill Vibrio vulnificus bacteria which can be obtained by calling the FDA at 1-800 FDA-4010. The NYSDOH will also be providing information to all county health departments on shellfish safety for distribution to physicians responsible for treatment of high-risk individuals in the next few weeks.
11/2/95-122 OPAContact: Claudia Hutton, Director, Public Affairs (518) 474-7354
New York State Department of Health, Posted: November 14, 1995