Academic journal article Environmental Health Perspectives

Environmental Suitability of Vibrio Infections in a Warming Climate: An Early Warning System

Academic journal article Environmental Health Perspectives

Environmental Suitability of Vibrio Infections in a Warming Climate: An Early Warning System

Article excerpt


Vibrio spp. are aquatic bacteria that are ubiquitous in warm estuarine and coastal waters with low to moderate salinity (Vezzulli et al. 2013). Vibrio cholerae (serogroups O1 and O139) is the causative agent of cholera epidemics, including the outbreak in Haiti (CDC 2010; Chin et al. 2011). Other Vibrio species are also pathogenic to humans, including V. parahaemolyticus, V. vulnificus, and nontoxigenic V. cholerae (nonO1/nonO139), although they are not responsible for widespread epidemics (Chowdhury et al. 2016; Heng et al. 2017; Letchumanan et al. 2014). Rather, they are associated with sporadic cases of gastroenteritis, wound infections, ear infections, and septicemia. V. parahaemolyticus is one of the most common bacterial causes of gastroenteritis due to contaminated seafood (Odeyemi 2016) and also causes wound infections on occasions (Ellingsen et al. 2008; Tena et al. 2010). Whereas death from gastroenteritis due to V. parahaemolyticus is rare, the case-fatality rate from primary septicemia or wound infections due to V. vulnificus is over 50% (Heymann 2008; Oliver 2005; Torres et al. 2002). For example, following Hurricane Katrina in the United States in 2005, there were 22 new cases of Vibrio illness, with five deaths, due to V. vulnificus, V. parahaemolyticus, or nontoxigenic V. cholera (CDC 2005). These infections were predominantly present in men over 50 y of age with underlying liver and immune-competency issues.

In all European countries, cholera infection due to Vibrio cholerae is a reportable disease, but other Vibrio infections are not reportable in all countries. In some countries, screening of patients with diarrheal diseases is only done in travel-related cases. Consequently, accurate estimates of Vibrio spp. infections are not available in Europe, although outbreaks of Vibrio-associated illnesses have been reported from a number of European countries (LeRoux et al. 2015).

The sea surface temperature (SST) of enclosed bodies of water and estuaries has increased more rapidly as a result of climate change than that of oceans (European Environmental Agency 2012). Elevated SST in brackish water provides ideal environmental growth conditions for Vibrio species (Johnson et al. 2012; Julie et al. 2010; Kaspar and Tamplin 1993; Motes et al. 1998; Pfeffer et al. 2003; Vezzulli et al. 2013; Whitaker et al. 2010). These conditions can be found during the summer months in areas of water with moderate salinity such as the Baltic Sea, Chesapeake Bay in the northeast United States, and the East China Sea around Shanghai. For example, the number of Vibrio cases around the Baltic Sea has been found to increase in line with a rise in SST (Baker-Austin et al. 2012); during the summers of 1994, 2003, 2006, 2010, and 2014 elevated SST across much of the Baltic Sea was associated with reported Vibrio-associated illness (Andersson and Ekdahl 2006; Baker-Austin et al. 2016; Dalsgaard et al. 1996; Frank et al. 2006; Lukinmaa et al. 2006; Ruppert et al. 2004). In contrast, open ocean environments do not usually provide suitable growth conditions for these bacteria due to their high salinity, low temperature, and limited nutrient content.

Monitoring is critical, given the projected increase in SST in the future and the potential severity of Vibrio infections (Lindgren et al. 2012). More specifically, monitoring the environmental context for such infectious diseases can serve as an early warning system for public health (Nichols et al. 2014; Semenza et al. 2013; Semenza 2015). The European Centre for Disease Prevention and Control (ECDC) developed a quasi-real-time, Web-based platform, the ECDC Vibrio Map Viewer, to monitor environmentally suitable marine areas for Vibrio growth (ECDC 2016).

This paper presents evidence from marine environments around the world showing that the ECDC Vibrio Map Viewer can detect environmental changes that are of public health importance. …

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