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Several members of a family present to the cruise ship infirmary of an Alaskan cruise. They just ate a lunch consisting of tuna salad sandwiches. For breakfast they had a buffet of pancakes and waffles, and last night they ate a shellfish feast dinner which included raw oysters, crab, clams, scallops, and fish. For dessert they had ice cream. They have also been visiting the bar onboard. They are all experiencing abdominal cramping, nausea, vomiting, and frequent watery diarrhea. Some have low-grade fever and chills. Which meal most likely caused their symptoms?
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October 10, 2017 at 3:39 pm
D. Shellfish feast dinner
Vibrio parahaemolyticus is the leading cause of seafood-associated food poisoning gastroenteritis in the U.S. Vibrio infections are on the rise, possibly due to increased water temperature where shellfish are harvested (global warming). Infection comes from consumption of raw or undercooked shellfish: oysters, mussels, clams, crabs. Vibrio organisms are especially found in the Pacific Northwest, but are found worldwide. Outbreaks occur in May to October, when water temperatures are warmer. The average incubation period is 19 hours (12-52 hours). Patients may develop bloody diarrhea. Diagnosis is generally clinical, although rare septicemic patients may grow the organism in blood cultures. Treatment is supportive. The organism is sensitive to doxycycline and fluoroquinolones, but treatment does not shorten the course of disease.