Prevention of Vibrio vulnificus infections. Assessment of regulatory educational strategies
E. Mouzin, L. Mascola, M. P. Tormey and D. E. Dassey
Division of Applied Public Health Training, Centers for Disease Control and Prevention, Atlanta, Ga, USA.
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.
