Epidemiological characteristics of cases with V. vulnificus infection in Korea

Kim Jung-sook, Lee Eun-gyu
Division of Medical Science Knowledge Management, Center for Genome Science, KNIH, KCDC
Yoon Jae-won, Lee Dong-han
Division of Infectious Disease Control, Center for Infectious Disease Control, KCDC
Chun Byung-Chul
Department of Epidemiology and Medical Informatics, Graduate School of Public Health, Korea University, Seoul

V. vulnificus is a halophilic Gram-negative bacterial pathogen that belongs to the family Vibrionaceae. This bacterium is found in estuarine and coastal waters in warmer months of the year. V. vulnificus infections in humans result from the consumption of raw or under-cooked seafood, and from exposure to waters in which the organism is present. We analyzed the trends of incidence of V. vulnificus infection and the epidemiological characteristics of the cases in Korea. A total of 913 cases were reported to Korea National Infectious Disease Surveillance (NIDSS) between 2001 and 2016. Epidemiological investigations were conducted in 761 of these cases. The age-standardized incidence adjusted for the mid-year resident population in 2005, was the highest, at 0.18 per 100,000 in 2006, and the lowest, at 0.04 in 2009. The monthly cases occurrence was highest, with 375 cases in September. Cases showed seasonal occurrence mainly in August-October. The incidence rate per 100,000 population by region was the highest in Jeonnam (8.23) and the lowest in Gangwon (0.39). Males were most commonly infected (85.7%), and the most affected age ranged 40-64 (71.7%). The most common symptom was fever (48.2%), followed by chilliness (35.2%), and diarrhea (22.2%). The most common sign was hypotension (35.0%), followed by blister (29.8%), and cellulitis (22.5%) in order. Of the cases studied, 96.1% had a underlying disease. 374 cases (56.3%) had cirrhosis. The most common route of V. vulnificus was seafood consumption, which accounted for 590 cases (90.1%), followed by exposure to seawater (38, 5.8%), and seafood consumption and seawater exposure (27, 4.1%). he case-fatality rate of V. vulnificus infection was found to be 52.0%. V. vulnificus infection is a highly preventable infectious disease, with well-defined high risk group and routes of infection. People at high-risk, such as those with liver disease should avoid ingesting seafood, and care should be taken not to contact with the seawater when there is a wound on the skin.

Keywords: V. vulnificus infection, Incidence, Liver diseases