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Shellfishborne disease control in the United States: a commentary.

Shellfishborne disease control in the United States began in the 1920's. The water quality standard promulgated at that time to reduce the incidence of shellfishborne disease has never been adequately evaluated. Evidence suggesting such an evaluation is needed comes from 1) the frequency of shellfishborne disease outbreaks, 2) the changing nature of disease agents, 3) reports of shellfishborne disease in non-outbreak settings, and 4) microbiological studies indicating a lack of correlation between the standard and potential pathogenic organisms. A proper evaluation will define the standard's ability to protect human health and allow for the harvesting of an important food resource.

Animals↗

Vibrio parahaemolyticus gastroenteritis. An outbreak associated with raw oysters in the Pacific northwest.

During a 3-month period in the late summer and fall of 1981, six cases of gastroenteritis and one wound infection due to Vibrio parahaemolyticus were reported to public health agencies in Washington and Oregon. An investigation revealed that all of the gastroenteric illnesses were associated with eating raw oysters; that oysters eaten by five of the six patients were harvested at four divergent sites at Willapa Bay, Washington, a large commercial growing area; and that the V. parahaemolyticus isolates from those five patients were all Kanagawa positive, belonged to serotype 04:K12, and exhibited an atypical biochemical reaction, urea hydrolysis. No further cases linked to Willapa Bay oysters have been reported, and the infecting strain could not be found in sediment samples from the bay in February 1982. Thus, even though the origin of this self-limiting outbreak is obscure, the investigation demonstrated that the geographic distribution of V. parahaemolyticus infection in the United States includes the Pacific seacoast . Furthermore, oysters must be considered, along with crabs, shrimp, and lobster, as a vehicle of transmission of this infection in the United States.

Adult↗

Occurrence of Vibrionaceae in natural and cultivated oyster populations in the Pacific Northwest.

Studies were done to assess the role of oysters from the Pacific Northwest as a potential source of Vibrionaceae. Oysters collected from natural and cultivated populations on the British Columbia Coast were opened using sterile instruments. The gills and oyster meat were each removed, and the meat was cut in half. The gills and the cut surface of the oyster meat were each cultured by inoculating them directly to the surface of agar plating media for the isolation of Vibrionaceae. Overall, 120 oysters were cultured, and 60 yielded Vibrionaceae. Vibrio parahaemolyticus, Vibrio fluvialis, and Vibrio vulnificus were the most commonly isolated organisms. Vibrionaceae were most often recovered from oysters collected under warm-water conditions from natural stocks (83% positive), followed by oysters from the same sites collected under cold-water conditions (35% positive). Only 29% of oysters collected from cultivated commercial stocks under warm water conditions yielded Vibrionaceae, and no Vibrionaceae were isolated from oysters collected from these sites during periods when water temperatures were low. The results suggest that oysters are a significant source of potentially pathogenic Vibrionaceae in the Pacific Northwest. However, the risk of exposure to these bacteria can be reduced by consumption of cultivated oysters harvested under cold-water conditions.

Animals↗

Okadaic acid: a new probe for the study of cellular regulation.

The tumour promoter okadaic acid is a potent and specific inhibitor of protein phosphatases 1 and 2A. Here we review recent studies which demonstrate that this toxin is extremely useful for identifying biological processes that are controlled through the reversible phosphorylation of proteins.

Animals↗

Oyster-associated outbreaks of Norovirus gastroenteritis in Singapore.

Outbreaks of gastroenteritis associated with the consumption of raw imported half-shelled frozen oysters occurred in Singapore between 16 Dec 2003 and 04 Jan 2004. A total of 305 cases were reported with clinical symptoms of diarrhoea (94%), abdominal cramps (72%), vomiting (69%) and fever (54%). The median incubation period was 30.8h and the duration of illness was 2-3 days. The overall relative risk of oyster consumption was 14.1 (95% CI: 8.3-24.0, P<0.001). Stool and oyster samples tested negative for common bacterial pathogens, including Vibrio parahaemolyticus. However, stool samples were positive for the presence of Norovirus group II RNA via RT PCR while oyster samples indicated the presence of Norovirus particles by electron microscopy. The clinical and epidemiological features were suggestive of Norovirus gastroenteritis and were subsequently confirmed by laboratory tests of stools and implicated oysters. Steps have been taken to ensure that food outlets do not thaw frozen oysters and serve them raw.

Adolescent↗

Functional assays in marine biotoxin detection.

The contamination of seafood by algal toxins regularly affects animals living in several areas of the world, and the number of toxic phycotoxins which are being characterized is steadily increasing. The extreme dynamics characterizing the field of algal toxins has stimulated the development of tools to be implemented in the monitoring of contamination of seafood by individual toxin classes. Under these circumstances, functional assays which can encompass the analytical potential of chemical methods and the predictive features of biological tests are sought. A variety of functional assays for the detection of phycotoxins has been developed in the last 20 years, and the analysis of their features reveals that their specificity is related to the hierarchical level of the biological response to the toxin that has been exploited for its detection. Ideally, analytical methods which could allow accurate estimates of the overall toxicity of multiple classes of toxins in a single procedure would provide the best means for the highest standards in consumer protection and the most rational and economical tools in the management of risks posed by phycotoxins in a wider scale. The achievement of a "systemic functional assay for marine biotoxins" does not appear to be at hand, but its inclusion among the foreseeable events is fully justified by the new research tools and approaches which have become available for the high throughput analysis of entire molecular domains at the cellular level.

Animals↗

Pectenotoxin-2 seco acid: a toxin converted from pectenotoxin-2 by the New Zealand Greenshell mussel, Perna canaliculus.

Comparison of pectenotoxin (PTX) profiles of toxic dinoflagellate Dinophysis acuta, Greenshell mussels (Perna canaliculus) and Blue mussels (Mytilus galloprovincialis) collected from Wedge Point, Queen Charlotte Sound, New Zealand was carried out by liquid chromatography-mass spectrometry with turbo-ionspray ionization. Although the major PTX homologue in D. acuta was pectenotoxin-2 (PTX2), both Greenshell and Blue mussels contained pectenotoxin-2 seco acid (PTX2SA) as the predominant toxin. More than 90% of PTX2 isolated from D. acuta was rapidly converted to PTX2SA and its epimer 7-epi-pectenotoxin-2 seco acid (7-epi-PTX2SA) in the Greenshell mussel extracts. The conversion from PTX2 to PTX2SA and 7-epi-PTX2SA was not observed in phosphate buffers at various pH ranging from 4.1 to 9.1. These findings indicate that PTX2SA and 7-epi-PTX2SA are not artifact toxins resulting from hydrolysis of PTX2, but arise from the conversion of PTX2 by mussel tissues.

Animals↗

The repeatability of two HPLC methods and the PP2A assay in the quantification of diarrhetic toxins in blue mussels (Mytilus edulis).

Repeatability in the quantification of diarrhetic shellfish toxins was investigated for two fluorometric HPLC methods and a colorimetric PP2A assay, using agreement analysis. Blue mussels (Mytilus edulis) from the Sognefjord on the southwest coast of Norway were sampled during the periods of July to October, 1996, March to November, 1997, and October to December, 1998. The results from the first and the duplicate measurement were found to be very similar for both HPLC methods using two fluorogenic reagents, 4-bromomethyl,7-methoxycoumarin and 9-anthryl diazomethane, and the colorimetric PP2A inhibition assay in detection of diarrhetic shellfish toxins. The levels of agreement between the measurements were satisfactory for all three methods. Significant correlations were found between the level of observation and the absolute difference between the two measurements and were mainly due to concentrations of OA/DTX-1 higher than 100 microg/100 g mussel meat. However, the precision of quantifying DSP toxins in the upper level was not found to be less than in the lower level. Both the HPLC methods and the PP2A assay were found to give repeatable results and thereby found to be reliable.

Animals↗

Particle size fractionation of paralytic shellfish toxins (PSTs): seasonal distribution and bacterial production in the St Lawrence estuary, Canada.

We determined the seasonal distribution of paralytic shellfish toxins (PSTs) and PST producing bacteria in > 15, 5-15, and 0.22-5 microm size fractions in the St Lawrence. We also measured PSTs in a local population of Mytilus edulis. PST concentrations were determined in each size fraction and in laboratory incubations of sub-samples by high performance liquid chromatography (HPLC), including the rigorous elimination of suspected toxin 'imposter' peaks. Mussel toxin levels were determined by mouse bioassay and HPLC. PSTs were detected in all size fractions during the summer sampling season, with 47% of the water column toxin levels associated with particles smaller than Alexandrium tamarense (< 15 microm). Even in the > 15 microm size fraction, we estimated that as much as 92% of PSTs could be associated with particles other than A. tamarense. Our results stress the importance of taking into account the potential presence of PSTs in size fractions other than that containing the known algal producer when attempting to model shellfish intoxication, especially during years of low cell abundance. Finally, our HPLC results confirmed the presence of bacteria capable of autonomous PST production in the St Lawrence as well as demonstrating their regular presence and apparent diversity in the plankton.

Animals↗

DSP toxin profile in the coastal waters of the central Adriatic Sea.

A monitoring program, carried out in 1996 and 1997, has confirmed that toxic compounds, other than the most frequently detected toxins okadaic acid (OA) and dinophysistoxin-1 (DTX-1), are involved in DSP phenomena in the Adriatic Sea. Toxicity was assessed by the mouse bioassay; the content and the nature of the toxic components were established through fluorometric HPLC analysis combined with mass spectrometry. A rare pectenotoxin-2 (PTX-2) derivative, 7-epi-pectenotoxin-2 seco acid (7-epi-PTX-2SA), was the exclusive contaminant of samples collected from the central Adriatic in 1996. Contrary to its marked oral toxicity, intraperitoneally 7-epi-PTX-2SA displayed no toxic effects, hampering its detection by the mouse bioassay. In 1997, its concentration and frequency of appearance were lower than in 1996, with concomitant occurrence of OA, DTX-2, and a new unidentified component related to the DSP toxic group of compounds. This is the first report on the occurrence of DTX-2 in Adriatic mussels. A survey of the phytoplankton community in the surrounding seawater has established the presence of Prorocentrum micans and several potentially toxic species from the Dinophysis genus. A case of unexplained toxicity, associated with the occurrence of Gonyaulax polyedra, suggested possible shellfish contamination with yessotoxin (YTX).

Animals↗

Recurrence of Pelecypod-associated cholera in Sardinia.

From Oct. 30 to Nov. 7, 1979, 10 people in the Sardinian province of Cagliari had onset of bacteriologically confirmed cholera. Two symptom-free excretors of Vibrio cholerae O:1 were detected in household contacts of the patients. There were no deaths. All but 1 of the 12 people with V. cholerae O:1 infection gave a history of recent consumption of marine bivalves known locally as arselle (pelecypods). Triplicate matched neighbourhood controls for each of the first 7 cases identified were also interviewed; none had recently eaten arselle. V. cholerae O:1 was also recovered from samples of water and bivalves obtained from a lagoon on the outskirts of the city of Cagliari. Arselle had also been implicated as the vehicle of transmission in 1973 in the last outbreak of cholera in Sardinia. It seems unlikely that cholera transmission had persisted locally in the interim.

Adolescent↗

Update on emerging infections from the Centers for Disease Control and Prevention. Outbreak of Vibrio parahaemolyticus infection associated with eating raw oysters and clams harvested from Long Island Sound--Connecticut, New Jersey, and New York, 1998.

This article is part of a regular series on emerging infections from the Centers for Disease Control and Prevention (CDC) and the EMERGEncy ID NET, an emergency department-based and CDC-collaborative surveillance network. Important infectious disease public health information with relevance to emergency physicians is reported. The goal of this series is to advance knowledge about communicable diseases in emergency medicine, and foster cooperation between the front line of clinical medicine and public health agencies.

Animals↗

Neurotoxin domoic acid produces cytotoxicity via kainate- and AMPA-sensitive receptors in cultured cortical neurones.

Domoic acid, a naturally occurring kainoid, has been responsible for several outbreaks of fatal poisoning after shellfish ingestion, and we examined its neurotoxic mechanism in cultured murine cortical neurones. Using observations of neuronal viability and morphology, exposure to domoic acid for 24 h was found to induce substantial concentration-dependent neuronal cell death. Domoic acid-mediated neuronal death was attenuated by the non-N-methyl-D-aspartate receptor antagonist 6-cyano-7-nitro-quinoxaline-2,3-dione and the alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) receptor-selective antagonist LY293558 ((3S,4aR,6R,8aR)-6-[2-(1H-tetrazol-5-yl)-ethyl]-1,2,3, 4,4a,5,6,7,8,8a-decahydroisoquinoline-3-carboxylic acid), but unaffected by NS-102 (5-nitro-6,7,8,9-tetrahydrobenzo[g]indole-2, 3-dione-3-oxime)--a low-affinity kainate receptor antagonist. Domoic acid was equipotent with (S)-AMPA (EC50 values 3.8 and 3.4 microM respectively); however, (S)-AMPA induced only 50% cell death compared to > 80% cell death induced by domoic acid. Kainate also killed > 80% of cortical neurones; however, domoic acid was about 19 times more potent than kainate (EC50 75 microM). We show the potent neurotoxicity of domoic acid for the first time in a pure neuronal model and indicate that domoic acid acts via high-affinity AMPA- and kainate-sensitive glutamate receptors to produce excitotoxic cell death.

Animals↗

[Acute myocardial infarction secondary to anaphylactic reaction following shellfish ingestion. The need for rescue coronary angioplasty].

During anaphylactic (or anaphylactoid) reactions severe cardiovascular events may occur, acute myocardial infarction among them. This etiology of myocardial infarction, is known, although it is infrequent and only sporadically reported in literature. A case of acute myocardial infarction secondary to anaphylactic reaction following shellfish ingestion, treated with subcutaneous epinephrine and in whom a rescue coronary angioplasty was necessary is reported. The mechanism of coronary occlusion in this kind of reaction and the possible influence on the efficacy of treatment is discussed.

Adult↗