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Assessment of Regulatory Educational Strategies

Eric Mouzin, MD, MPH; Laurene Mascola, MD, MPH; Michael P. Tormey, MPH; David E. Dassey, MD, MPH

JAMA. 1997;278(7):576-578.

Abstract
Context.
—Vibrio vulnificus—related disease caused by eating contaminated raw oysters prompted California to implement regulatory educational initiatives in 1991.

Objective.
—To assess California guidelines and education efforts with regard to the prevention of V vulnificus infections in Los Angeles County and to evaluate compliance with state regulations mandating posting of warning signs concerning risks of eating raw oysters.

Design.
—Review of epidemiologic investigations of V vulnificus infections in Los Angeles County between 1993 and 1995; telephone interviews of patients or surrogates; and a survey of restaurants serving raw oysters in Los Angeles County.

Setting.
—General community.

Main Outcome Measures.
—Prior warning of patients and posting of warning signs in restaurants.

Results.
—Recent cases of V vulnificus infections in Los Angeles County suggest that a unique, vulnerable group (uninsured Hispanic men with viral or alcoholic liver disease) has not been reached through education efforts. Of a total of 11 cases, information regarding being warned about the hazard of eating raw shellfish was available for 8; of these, only 1 case was reported as having been warned, but he had misunderstood the preventive message. Warning signs were not posted adequately in more than 50% of restaurants surveyed and one third of these establishments had signs in English only. Warnings were never located on dining tables and rarely included in menus.

Conclusion.
—A more effective strategy is required to prevent V vulnificus infections in Los Angeles County.

Author Affiliations
From the Division of Applied Public Health Training, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Mouzin), and the Acute Communicable Disease Control Unit, Los Angeles County Department of Health Services, Los Angeles, Calif (Drs Mouzin, Mascola, and Dassey and Mr Tormey).

Footnotes
Reprints: Eric Mouzin, MD, MPH, Acute Communicable Disease Control, Los Angeles County Department of Health Services, 313 N Figueroa St, Room 212, Los Angeles, CA 90012 (e-mail: lmascola@dhs.co.la.ca.us).

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