Gastroenteritis due to non-agglutinable (non-cholera) vibrios

In-flight transmission of foodborne disease: How can airlines improve?

Food contamination during air travel presents unique risks to those affected. Foodborne pathogens can cause serious illness among all on board, and potentially jeopardize flight safety. These risks are likely to increase with current trends of "densification" and a predicted massive expansion of air travel. While aircraft are being equipped with ever newer designs with a focus on efficiency and comfort, regulations remained largely unmodified in terms of basic hygiene requirements. Strict guidelines for food hygiene exist for on-ground food settings and catering kitchens. There is uncertainty about hygiene standards on board commercial aircraft, and little regulatory oversight of what happens to food in-flight. In two hypothetical scenarios we indicate the potential risks associated with poor food handling practice onboard aircraft, with the ultimate aim of bringing aviation food safety in line with on-ground regulations. Changes in cabin design alongside adequate training in safe food handling have the potential to increase public health protection. We urge a review of existing in-flight hygiene protocols to better direct the development of regulation, prevention, and intervention measures for aviation food safety.

Nontoxigenic Vibrio cholerae non-O1/O139 isolate from a case of human gastroenteritis in the U.S. Gulf Coast

An occurrence of Vibrio cholerae non-O1/O139 gastroenteritis in the U.S. Gulf Coast is reported here. Genomic analysis revealed that the isolate lacked known virulence factors associated with the clinical outcome of a V. cholerae infection but did contain putative genomic islands and other accessory virulence factors. Many of these factors are widespread among environmental strains of V. cholerae, suggesting that there might be additional virulence factors in non-O1/O139 V. cholerae yet to be determined. Phylogenetic analysis revealed that the isolate belonged to a phyletic lineage of environmental V. cholerae isolates associated with sporadic cases of gastroenteritis in the Western Hemisphere, suggesting a need to monitor non-O1/O139 V. cholerae in the interest of public health.

Putative virulence traits and pathogenicity of Vibrio cholerae Non-O1, Non-O139 isolates from surface waters in Kolkata, India

Vibrio cholerae non-O1, non-O139 was isolated from natural surface waters from different sites sampled in diarrhea endemic zones in Kolkata, India. Twenty-one of these isolates were randomly selected and included in the characterization. The multiserogroup isolates were compared by their virulence traits with a group of clinical non-O1, non-O139 isolates from the same geographic area. Of the 21 environmental isolates, 6 and 14 strains belonged to Heiberg groups I and II, respectively. Three of the environmental isolates showed resistance to 2,2-diamine-6,7-diisopropylpteridine phosphate. All of the non-O1, non-O139 strains were positive for toxR, and except for one environmental isolate, none of them were positive for tcpA in the PCR assay. None of the isolates were positive for genes encoding cholera toxin (ctxA), heat-stable toxin (est), heat-labile toxin (elt), and Shiga toxin variants (stx) of Escherichia coli. Additionally, except for one environmental isolate (PC32), all were positive for the gene encoding El Tor hemolysin (hly). The culture supernatants of 86% (18 of 21) of the environmental isolates showed a distinct cytotoxic effect on HeLa cells, and some of these strains also produced cell-rounding factor. The lipase, protease, and cell-associated hemagglutination activities and serum resistance properties of the environmental and clinical isolates did not differ much. However, seven environmental isolates exhibited very high hemolytic activities (80 to 100%), while none of the clinical strains belonged to this group. The environmental isolates manifested three adherence patterns, namely, carpet-like, diffuse, and aggregative adherence, and the clinical isolates showed diffuse adherence on HeLa cells. Of the 11 environmental isolates tested for enteropathogenic potential, 8 (73%) induced positive fluid accumulation (>/=100) in a mouse model, and the reactivities of these isolates were comparable to those of clinical strains of non-O1, non-O139 and toxigenic O139 V. cholerae. Comparison of the counts of the colonized environmental and clinical strains in the mouse intestine showed that the organisms of both groups had similar colonizing efficiencies. These findings indicate the presence of potentially pathogenic V. cholerae non-O1, non-O139 strains in surface waters of the studied sites in Kolkata.

Putative virulence genes of Vibrio cholerae from seafoods and the coastal environment of Southwest India

Shrimp, clam and oysters were obtained at two fish markets and at a fish landing dock, and plankton, water and sediment samples were obtained from four river estuaries, in southern India. The samples were analyzed for Vibrio cholerae by conventional isolation techniques and by polymerase chain reaction (PCR) procedures. V. cholerae was isolated from 2 of 5 shrimp, 2 of 5 clam and 5 of 20 water samples. All biochemically confirmed isolates of V. cholerae were positive for toxR. For direct detection of V. cholerae in enrichment broths, PCR was performed using lysates from 0 and 6 h enrichments. All the V. cholerae isolates and enrichment broth lysates were subjected to PCR analysis for the detection of the genes toxR, ctxA, tcpA, ompU, hly, ace, Nag-ST (stn/sto), and ompU. Enrichment broths of all the samples which yielded V. cholerae were positive for toxR, OmpU and hlyA genes, while one of a fresh fish market sample was positive for the ace gene. Choleragenic V. cholerae were absent from all environmental samples and fresh fish from the markets, but one sample of shrimp was positive for V. cholerae O139.

Food-poisoning and commercial air travel

With the introduction of budget airlines and greater competitiveness amongst all airlines, air travel has now become an extremely popular form of travel, presenting its own unique set of risks from food poisoning. Foodborne illness associated with air travel is quite uncommon in the modern era. However, when it occurs, it may have serious implications for passengers and when crew are affected, has the potential to threaten safety. Quality, safe, in-flight catering relies on high standards of food preparation and storage; this applies at the airport kitchens (or at subcontractors' facilities), on the aircraft and in the transportation vehicles which carry the food from the ground source to the aircraft. This is especially challenging in certain countries. Several foodborne outbreaks have been recorded by the airline industry as a result of a number of different failures of these systems. These have provided an opportunity to learn from past mistakes and current practice has, therefore, reached such a standard so as to minimise risk of failures of this kind. This review examines: (i) the origin of food safety in modern commercial aviation; (ii) outbreaks which have occurred previously relating to aviation travel; (iii) the microbiological quality of food and water on board commercial aircraft; and (iv) how Hazard Analysis Critical Control Points may be employed to maintain food safety in aviation travel.

Distribution of virulence markers in clinical and environmental Vibrio cholerae non-O1/non-O139 strains isolated in Brazil from 1991 to 2000

One hundred seventy nine Vibrio cholerae non-O1/non-O139 strains from clinical and different environmental sources isolated in Brazil from 1991 to 2000 were serogrouped and screened for the presence of four different virulence factors. The Random Amplification of Polymorphic DNA (RAPD) technique was used to evaluate the genetic relatedness among strains. Fifty-four different serogroups were identified and V. cholerae O26 was the most common (7.8%). PCR analysis for three genes (ctxA, zot, ace) located of the CTX genetic element and one gene (tcpA) located on the VPI pathogenicity island showed that 27 strains harbored one or more of these genes. Eight (4.5%) strains possessed the complete set of CTX element genes and all but one of these belonged to the O26 serogroup suggesting that V. cholerae O26 has the potential to be an epidemic strain. The RAPD profiles revealed a wide variability among strains and no genetic correlation was observed.

Translocation of protein kinase-C with IP3-induced calcium mobilization by heat-stable enterotoxin of Vibrio cholerae non-O1 in isolated rat enterocytes

The activity of the calcium- and phospholipid-dependent enzyme protein kinase C (PKC) in response to heat-stable enterotoxin (NAG-ST) of Vibrio cholerae non-O1 was examined in isolated rat enterocytes. Optimal stimulation of the membrane-bound PKC activity (about 4.3-fold) was observed after 1 min of incubation of cells with 10 ng/ml toxin; and the effects were dose dependent. Following NAG-ST treatment an increase in PKC activity in the membrane fraction was found with a concomitant decrease in the cytosolic fraction suggesting the redistribution of the enzyme. The pronounced enzyme activity in presence of a classical pseudosubstrate and its complete inhibition by Gö 6976 suggested the involvement of a calcium-dependent isoform of PKC (PKC-alpha). A time course study employing an immunoblot assay provided evidence that NAG-ST led to almost complete translocation of PKC-alpha to the membrane. A 65% inhibition of enzyme activity in the membrane fraction and inhibition of its translocation to some extent by dantrolene treatment further suggested that the enzyme was translocated with the rise of intracellular calcium ([Ca2+]i). The phosphorylation of three membrane proteins by toxin-induced PKC in vitro and abolition of this phosphorylation by Gö 6976 demonstrated that phosphorylation of these membrane proteins was PKC-alpha mediated and might be involved in the alteration of membrane functions.

Genotypes associated with virulence in environmental isolates of Vibrio cholerae

Vibrio cholerae is an autochthonous inhabitant of riverine and estuarine environments and also is a facultative pathogen for humans. Genotyping can be useful in assessing the risk of contracting cholera, intestinal, or extraintestinal infections via drinking water and/or seafood. In this study, environmental isolates of V. cholerae were examined for the presence of ctxA, hlyA, ompU, stn/sto, tcpA, tcpI, toxR, and zot genes, using multiplex PCR. Based on tcpA and hlyA gene comparisons, the strains could be grouped into Classical and El Tor biotypes. The toxR, hlyA, and ompU genes were present in 100, 98.6, and 87.0% of the V. cholerae isolates, respectively. The CTX genetic element and toxin-coregulated pilus El Tor (tcpA ET) gene were present in all toxigenic V. cholerae O1 and V. cholerae O139 strains examined in this study. Three of four nontoxigenic V. cholerae O1 strains contained tcpA ET. Interestingly, among the isolates of V. cholerae non-O1/non-O139, two had tcpA Classical, nine contained tcpA El Tor, three showed homology with both biotype genes, and four carried the ctxA gene. The stn/sto genes were present in 28.2% of the non-O1/non-O139 strains, in 10.5% of the toxigenic V. cholerae O1, and in 14.3% of the O139 serogroups. Except for stn/sto genes, all of the other genes studied occurred with high frequency in toxigenic V. cholerae O1 and O139 strains. Based on results of this study, surveillance of non-O1/non-O139 V. cholerae in the aquatic environment, combined with genotype monitoring using ctxA, stn/sto, and tcpA ET genes, could be valuable in human health risk assessment.

An epidemic of cholera due to Vibrio cholerae O139 in Dhaka, Bangladesh: clinical and epidemiological features

We describe the disease spectrum and socio-demographic and epidemiological features of an epidemic of cholera due to a new pathogen, Vibrio cholerae O139, in patients attending a very large hospital in the metropolitan city of Dhaka, Bangladesh. This hospital treats 70,000-90,000 patients a year with diarrhoeal diseases. A 4% systematic sample of 1854 patients attending from January to April 1993 were studied. Five hundred and two (27%) of the 1854 patients were culture positive for V. cholerae O139 and 63 (3%) were culture positive for V. cholerae O1 biotype El Tor. Patients with V. cholerae O139 were mainly adults with a short history of watery diarrhoea. Eight-three percent of patients had moderate to severe dehydration. All recovered except one 80-year-old man with compromised renal function who died. Seventy-eight percent of patients required initial intravenous rehydration followed by oral rehydration therapy with rice ORS; they also received tetracycline to reduce diarrhoea severity. Most patients were from urban slums with inadequate sanitation facilities and hygiene practices. The newly recognized V. cholerae O139 infection produced an epidemic of severe dehydrating diarrhoea indistinguishable from clinical cholera in a population which experiences two epidemic peaks of cholera in a year due to V. cholerae O1. Infection with the latter does not appear to confer any cross-protection from V. cholerae O139. The new pathogen suppressed, albeit temporarily, V. cholerae O1. Unlike other non-O1 serogroups of V. cholerae this new serogroup appears to have epidemic potential.

Isolation of Vibrio cholerae O139 synonym Bengal from the aquatic environment in Bangladesh: implications for disease transmission

Currently, Bangladesh is experiencing an epidemic of acute watery diarrhea caused by Vibrio cholerae O139. Surface waters were collected and cultured for vibrious following enrichment. Twelve percent (11 of 92) of samples yielded V. cholerae O139, and all of them were positive for cholera toxin. The data suggest that V. cholerae O139 is easily culturable from surface water samples.

Immunochemical properties of Vibrio cholerae LPS

Immunochemical analysis of LPS isolated from Vibrio cholerae O1 and non O1 showed that this macromolecular complex shares common antigenic epitopes in the sugar moiety. The epitopes can be detected after mild alkaline hydrolysis of LPS in vitro. Membrane-associating activity of both O1 and non O1 LPS did not indicate any differences of the species.

Epidemic of diarrhea caused by Vibrio cholerae non-O1 that produced heat-stable toxin among Khmers in a camp in Thailand

An epidemic of a cholera-like disease occurred among Khmers in a camp in Aranyaprathet, Thailand, in May 1990. Of 215 patients with diarrhea, Vibrio cholerae O1 was isolated from 25 (12%) and V. cholerae non-O1 was isolated from 15 (7%). Five of 15 (33%) non-O1 V. cholerae isolates hybridized with two different oligonucleotide probes previously used to detect V. cholerae non-O1 that produces a heat-stable toxin. This is the first description of an epidemic of diarrhea caused by V. cholerae non-O1 that produces heat-stable toxin.

Gene encoding zonula occludens toxin (zot) does not occur independently from cholera enterotoxin genes (ctx) in Vibrio cholerae

Of 167 Vibrio cholerae isolates screened for sequences homologous with zonula occludens toxin (zot) or cholera toxin (ctx) genes, 3.0% of non-O1, 100.0% of clinical O1, and 0.0% of environmental O1 strains contained both zot and ctx. zot was present only in strains that were ctx positive; all ctx-positive strains carried zot. The absence of zot-positive, ctx-negative strains suggests ZOT is not an independent virulence factor for V. cholerae, although ZOT may play a role in the pathogenesis of toxigenic strains.

Non-O1 Vibrio cholerae intestinal pathology and invasion in the removable intestinal tie adult rabbit diarrhea model

A modified removable intestinal tie adult rabbit diarrhea (RITARD) model was used to investigate the intestinal pathology, intestinal bacterial colonization, intestinal fluid volume, and onset of diarrhea caused by non-O1 Vibrio cholerae. Three strains of non-O1 V. cholerae were studied. RITARD rabbits challenged with 10(3) CFU of strain NRT36S (a strain previously shown to cause diarrhea in volunteers) developed grade 3 diarrhea at 48 to 72 h. The mean counts of non-O1 V. cholerae isolated were 9.3 +/- 0.07 and 8.7 +/- 0.7 CFU/g from the small and large intestines, respectively. Histologic examination showed necrosis of the luminal epithelium in the colon and mild inflammatory cell infiltration in the adjacent lamina propria. The severity and extent of intestinal damage by strain NRT36S was dose dependent. Higher doses of strain NRT36S caused severe necrotizing colitis and enteritis, with bacteremia and mortality at less than 24 h in RITARD rabbits challenged with 10(9) CFU and at less than 48 h in RITARD rabbits challenged with 10(4) CFU. Electron and light microscopy demonstrated invasion of NRT36S into the luminal epithelial cells of the intestine. Challenge of RITARD rabbits with non-O1 V. cholerae A-5 and 2076-79 (strains which did not cause diarrhea in volunteers) did not cause diarrhea or intestinal pathology. Intestinal colonization was transient: at 72 h postchallenge, animals inoculated with strain A-5 were culture negative, while only low numbers of strain 2076-79 were detectable (approximately 0.4 to 0.8 CFU/g). Our data highlight the utility of the RITARD model, when combined with appropriate pathologic and bacteriologic studies, for obtaining insights into pathophysiologic mechanisms of enteric disease by non-O1 V. cholerae. In agreement with volunteer studies, non-O1 V. cholerae NRT36S is clearly pathogenic in this model; direct cell invasion may play a role in its ability to cause illness.

Cloning and nucleotide sequence of a heat-stable enterotoxin gene from Vibrio cholerae non-O1 isolated from a patient with traveler's diarrhea

We determined the nucleotide sequence of the heat-stable enterotoxin (STa) gene of the Vibrio cholerae non-O1 strain NRT36 isolated from a patient with traveler's diarrhea. The gene is chromosomally encoded and the presumed product is 78 amino acids in length, with a molecular weight of 8,814, though the genes of Escherichia coli STa(s) (STh and STp) are encoded in plasmid DNA and both products are 72 amino acids in length. The first 18 amino acids at the NH2 terminus were hydrophobic, suggesting that this region of the polypeptide acts as a signal sequence for the toxin. The last 17 amino acids at the COOH terminus were identical to those deduced from the toxin (NAG-ST) produced by V. cholerae non-O1 strain A-5 isolated from a frozen shrimp. The deduced amino acid sequence of the NAG-ST precursor had 50 and 46% homology to those of E. coli STh and STp, respectively. The hydropathy plot analysis of each predicted protein revealed similar profiles between them, suggesting that the NAG-ST precursor has structural similarity to those of E. coli STa(s).

Use of a synthetic oligonucleotide probe to detect strains of non-serovar O1 Vibrio cholerae carrying the gene for heat-stable enterotoxin (NAG-ST)

A synthetic oligonucleotide probe was developed to identify the gene for the heat-stable enterotoxin (NAG-ST) of non-serovar O1 Vibrio cholerae. Of 103 non-O1 V. cholerae isolates from Thailand, 31 isolates from Mexico, and 47 isolates from patients in the United States, only 7 (all from Thailand) hybridized with the probe. Probe-positive strains produced significantly higher fluid accumulations in infant mice than probe-negative strains.

Use of a synthetic oligonucleotide probe to detect strains of non-serovar O1 Vibrio cholerae carrying the gene for heat-stable enterotoxin (NAG-ST)

A synthetic oligonucleotide probe was developed to identify the gene for the heat-stable enterotoxin (NAG-ST) of non-serovar O1 Vibrio cholerae. Of 103 non-O1 V. cholerae isolates from Thailand, 31 isolates from Mexico, and 47 isolates from patients in the United States, only 7 (all from Thailand) hybridized with the probe. Probe-positive strains produced significantly higher fluid accumulations in infant mice than probe-negative strains.

Experimental non-O group 1 Vibrio cholerae gastroenteritis in humans

In this study, 27 volunteers received one of three non-O group 1 Vibrio cholerae strains in doses as high as 10(9) CFU. Only one strain (strain C) caused diarrhea: this strain was able to colonize the gastrointestinal tract, and produced a heat-stable enterotoxin (NAG-ST). Diarrhea was not seen with a strain (strain A) that colonized the intestine but did not produce NAG-ST, nor with a strain (strain B) that produced NAG-ST but did not colonize. Persons receiving strain C had diarrhea and abdominal cramps. Diarrheal stool volumes ranged from 154 to 5,397 ml; stool samples from the patient having 5,397 ml of diarrhea were tested and found to contain NAG-ST. The median incubation period for illness was 10 h. There was a suggestion that occurrence of diarrhea was dependent on inoculum size. Immune responses to homologous outer membrane proteins, lipopolysaccharide, and whole-cell lysates were demonstrable with all three strains. Our data demonstrate that V. cholerae of O groups other than 1 are able to cause severe diarrheal disease. However, not all strains are pathogenic for humans: virulence of strain C may be dependent on its ability both to colonize the intestine and to produce a toxin such as NAG-ST.

Comparative study of expression of hemagglutinins, hemolysins, and enterotoxins by clinical and environmental isolates of non-O1 Vibrio cholerae in relation to their enteropathogenicity

A comparative study was undertaken of clinical and environmental isolates of non-O1 Vibrio cholerae with respect to their hemagglutinating, hemolytic, enterotoxigenic, and enteropathogenic activities. Cell-associated hemagglutinin titers of the clinical and environmental isolates did not differ much, although the clinical isolates displayed higher cell-free hemagglutinin titers compared with those of environmental isolates. Culture supernatants of 61.5% (24 of 39) of clinical isolates showed hemolytic activity (greater than or equal to 10% lysis of rabbit erythrocytes), while only 33.3% (10 to 30) of the environmental group had such activity. Furthermore, hemolytic activities of the clinical isolates showed a good correlation with their cell-associated hemagglutinin titers which was not true for the environmental group. Culture supernatants of 45.8% (11 of 25) of the clinical and 20% (2 of 10) of the environmental isolates exhibited enterotoxigenic activity in the rabbit ileal loop assay. Such activity was mediated mainly by cholera toxin-like substances, although some of the isolates produced fluid-accumulating factors unrelated to cholera toxin. Experimental animal studies demonstrated that the enteropathogenic potential of the environmental isolates was significantly lower than that of the clinical group. Further analysis of our data showed that phenotypic expression of cholera toxin-like products by the non-O1 V. cholerae isolates was accompanied by their enteropathogenicity. The latter effect was also noted with some of the cholera toxin-negative isolates, particularly in those having high hemagglutinating and hemolytic titers.

Enterotoxigenicity of clinical isolates of non-O1 Vibrio cholerae

Whole cultures, but not culture supernatant fluids, of 21 isolates of non-O1 V. cholerae from patients with diarrhea were shown to induce positive fluid accumulation in infant mice. CHO cell assays demonstrated the elaboration of heat-labile cytotonic, cytotoxic or both factors from most isolates when grown under optimal culture conditions. These factors were not neutralized by anti-cholera toxin serum. Also genetic studies performed on 9 vibrio isolates using a DNA hybridization probe failed to detect gene sequences homologous with cholera toxin. ELISA assays recognized six isolates which produced a cell-associated substance which immunologically cross-reacted with cholera toxin. Enzymatic profiles of the vibrio isolates did not correlate with the production of any toxic factor. The results indicate that mainly heat-labile and cell-associated cytotonic and cytotoxic factors appear to influence the enterotoxigenic potential of this heterogenous group of non-O1 vibrios.

Epidemiological features of an outbreak of gastroenteritis/cholera in Katsina, Northern Nigeria

In April 1982, Katsina, in Northern Nigeria, was affected by an outbreak of gastroenteritis associated with Vibrio cholerae serotype 'Ogawa' and 662 patients were admitted to the Katsina General Hospital during a 16-week period. The outbreak affected all ages and both sexes and all parts of the town and its immediate surroundings except the Government Residential Area (GRA). The overall case fatality rate was 7.7%. Male specific case fatality and female specific case fatality rates were 9.7 and 6.2% respectively. 'Adults' and those in the 11-20 and 21-30 age groups accounted for most of the cases. The epidemic curve was of a propagated and protracted nature. About 51.7% of all the patients spent between 2 and 5 days in the hospital. A similar pattern was observed for all age groups regardless of sex. Cholera vibrio 'Ogawa', Shigella spp., Salmonella spp., Proteus spp. and Escherichia coli were isolated from 16 patients. All well-water samples obtained from the compounds of the cases were contaminated with MPN/100 ml index ranging from 540 to greater than 2400. All samples were positive for faecal coliforms. Salmonella spp., Shigella spp., Proteus spp. and non-O, group 1 (non-O 1) V. cholerae were isolated. Water sellers probably facilitated the spread of the outbreak.

Studies on well water and possible health risks in Katsina, Nigeria

Well water was sampled from all four major wards in Katsina town. All 20 samples taken showed high coliform counts. Sixty-five per cent contained greater than or equal to 2400 coliforms per 100 ml while the remainder had counts ranging from 79 to 920. Faecal coliforms and non-cholera vibrios were detected in all samples. There was no significant relationship between the coliform counts and the distances of latrines to wells, water table to ground level, slope relationship between wells and latrines, the pH of water and whether the wells were left permanently open or not. Salmonella sp., Enterobacter sp. and Pseudomonas sp. were each isolated from about 10% of the samples, while Proteus sp. was isolated from 40%, Citrobacter sp. 15%, Alcaligenes sp. 5% and an unidentified Gram-negative rod from 5%. Only 2 (10%) of the sampled households, representing 23 (9.6%) of the 239 people exposed to well-water had pipeborne water in addition. It was concluded that well water in Katsina town could be a human health hazard.

Vibrio metschnikovii bacteremia in a patient with cholecystitis

Vibrio metschnikovii was isolated from the blood of an 82-year-old patient with peritonitis and an inflamed gallbladder. This is probably the first clinically significant isolate of this new vibrio.

Fulminating systemic infection caused by Vibrio cholerae species which does not agglutinate with 0-1 V. cholerae antiserum

A case of fatal septicaemia caused by Vibrio cholerae which did not agglutinate with 0 group 1 V. cholerae antiserum is presented. The illness occurred in a 64-year-old Aboriginal woman from Aurukun Mission in Cape York. The organism was isolated from multiple blood cultures and urine during life, and froma a large hepatic abscess found post mortem. The pathogenicity and epidemiology of the organism is discussed.

Survival and growth of non-cholera vibrios in various foods

A study was made of the growth of three strains of non-cholera vibrio in a range of foodstuffs and of the effect of temperatures and pH on their ability to grow. Growth was tested at 4 degrees, 10 degrees, 22 degrees, 30 degrees, 37 degrees and 43 degrees C in a range of foods likely to be incorporated into cold hors d'oeuvres, e.g. egg, cream, rice, cold meat, seafood, aspic and mayonnaise. Non-cholera vibrios grew well in all these foods except mayonnaise, the rate of growth increasing with increased temperature of storage. At acid pH values the organisms died or grew very poorly but growth improved as the pH became more alkaline. None of the three strains showed any resistance to heat, an initial inoculum of greater than 10(7) organisms/g was reduced to less than 100 organisms/g in 2--3 min at 55 degrees C.

Prevalence of non-cholera vibrios in cavum nasi and pharynx of ducks

Investigations among ducks on ten different farms showed a high prevalence of Vibrio cholerae in cavum nasi and Pharynx after the ducks were admitted to the open field. In no case was Vibrio cholerae isolated from ducks which had never been outside the houses. At least six serovars were isolated, 0:54 being the most prevalent. All the strains isolated produced a distinctive cytotoxic effect in YI adrenal cells and caused fluid accumulation in rabbit gut loops. Migratory birds were incriminated as the source of initial contamination.

A case of non-agglutinable vibrio gastroenteritis with anuria

A case of non-agglutinable vibrio (Heiberg Group II) gastroenteritis is presented. The patient, an alcoholic, acquired this infection in Australia and recovered fully. The need to use selective vibrio media when diarrhoeal stools are cultured is emphasized.

Staphylococcal food poisoning aboard a commercial aircraft

On Feb. 3, 1975, 196 (57%) of 344 passengers and 1 steward aboard a commercial aircraft contracted a gastrointestinal illness characterised by nausea, vomiting, abdominal cramps, and diarrhoea; 142 passengers and the steward were admitted to hospital. Symptoms developed shortly after a ham and omelette breakfast had been served. An investigation strongly incriminated ham as the vehicle of the outbreak, and the source seems to have been a cook with lesions on his fingers. The attack-rate was 86% for passengers who ate the ham handled by this cook and 0% for passengers who ate ham handled exclusively by another food preparer. Before being served, the ham and omelette had been held at room temperature for 14 h and at 10 degrees C (50 degrees F) for 14 1/2 h Specimens of stool and vomitus from ill passengers, left-over food, and the finger lesions of the cook were positive for Staphylococcus aureus of identical phage types and antibiotic sensitivities. Preformed enterotoxin was detected in the left-over ham and omelette. This outbreak re-emphasises that people with infected lesion should not handle food and that foods must be stored at temperatures low enough to inhibit the growth of bacteria. To ensure against a common foodborne illness incapacitating the entire flight crew, cockpit crew members should eat different meals prepared by different cooks.