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Climate change makes European shellfish dangerous

According to a recently published assessment by the European Food Safety Authority (EFSA), climate change puts Europeans at increased risk of contracting infections from Vibrio.

Warming sea temperatures are expected to increase the prevalence of the bacteria in seafood, particularly in low-salinity or brackish waters, with an increase in antimicrobial resistance among species posing a cause for concern additional.

Bacteria Vibriotraditionally a problem in tropical and subtropical regions, can cause a range of illnesses, from mild gastroenteritis and ear infections to life-threatening conditions such as sepsis.

European experts call for adequate monitoring, research funding and public awareness campaigns.

What is the Vibrio ?

The species of Vibrio are Gram-negative bacteria typically found in warm marine waters. The most clinically significant strains are Vibrio choleraeinfamous for causing cholera, V. parahaemolyticuscommonly associated with seafood consumption, and V. vulnificusthe most dangerous, often linked to wound infections which can quickly lead to necrotizing fasciitis or sepsis, particularly in immunocompromised people.

Infection in humans by Vibrio usually occurs through ingestion of contaminated seafood, especially raw or undercooked shellfish such as oysters, or through open wounds exposed to seawater. People with liver disease , diabetes or those with a weakened immune system are particularly vulnerable to more serious infections, particularly V. vulnificus.

Dr. Niall Conroy, Master of Public Health

« Vibriosis is uncommon but not rare. says Dr. Niall Conroy, Master of Public Health and Associate Professor of Public Health at University College Cork, Cork, Ireland.

« Infections with Vibrio Non-cholera cases are not reportable in most EU countries. In contrast, in the United States, there are generally between 2,000 and 4,000 cases of human infection per year. “, he declared to Medscape Medical News.

Infections with Vibrio peak during the summer months, when swimming and seafood consumption also peak. “ Sea water temperature is one of the most important factors in determining the concentration of Vibrio in seafood samples. As water temperatures increase, the likelihood of ingesting contaminated seafood increases “, explained Niall Conroy.

Impact of climate change

« Europe has seen an increase in infections Vibrio over the past 20 years due to an increase in extreme weather events, such as heat waves. Warming coastal waters have led to an expansion of areas where bacteria Vibrio can multiply, leading to an increased risk of infections due to the consumption of contaminated seafood “, declared to Medscape Medical News Dr Winy Messens, PhD and expert in food microbiology at EFSA. “ To reduce risks, it is essential that seafood is handled and cooked correctly, especially for vulnerable populations. »

Winy Messens, Ph.D.

The Baltic Sea, the North Sea and the coastal areas of the Mediterranean have been identified as high risk areas for the proliferation of Vibriowith cases reported as far north as Scandinavia. The Baltic Sea and the North Sea are the fastest warming seas in Europe, and because the Baltic Sea is brackish, it is becoming increasingly conducive to the proliferation of Vibrionoted the European Environment Agency (European Environment Agency).

This year, Europe experienced the highest summer temperatures on record. According to the European Center for Disease Prevention and Control (ECDC), these environmental changes are likely to cause infections to occur. Vibrio a recurring seasonal health risk across the continent.

What does the data say?

The increasing prevalence of infections Vibrioespecially in northern European countries that are not accustomed to caring for them, places new demands on health systems, with urgent care centers and infectious disease specialists increasingly susceptible to encounter cases, we learned at the annual congress of the European Society of Clinical Microbiology and Infectious Diseases earlier this year. Clinicians must therefore be vigilant and recognize the symptoms of infections. Vibrioparticularly in patients with sepsis or necrotizing fasciitis after maritime exposure.

However, due to the under-reporting of vibriosis, which is not subject to a reporting obligation in Europe, and the lack of precise epidemiological data, such as date of infection and place of exposure, the the real extent of infections Vibrio in the region is unclear.

« We know that there is a hidden epidemiology of infections Vibrio a Europe said Jaime Martinez-Urtaza, PhD, professor in the Department of Genetics and Microbiology at the Autonomous University of Barcelona, ​​Barcelona, ​​Spain, a leading expert and published researcher on bacteria Vibrio. « Cases go unreported, but occur everywhere when conditions are favorable for the bacteria. We have launched various studies in regions where infections Vibrio had not been previously reported, and we identified infections with Vibrio when cases were reviewed retrospectively. »

Jaime Martinez-Urtaza, Ph.D.

Most major outbreaks of disease Vibrio have been associated with foreign strains and genetic variants that were introduced to the region long ago. These strains remained hidden in coastal areas until environmental conditions changed enough to cause blooms of Vibriofollowed by the detection of infections, Jaime Martinez-Urtaza told Medscape Medical News. « This is a common pattern in Europe and other parts of the world where large outbreaks and outbreaks have been detected recently, mainly associated with conditions induced by climate change: warming and falling salinity caused by extreme weather events. »

Many countries along the Baltic Sea coast have their own national vibriosis surveillance systems, including Denmark, Estonia, Finland, Germany and Sweden. In regions with a good reporting system, the trend is clearly toward increasing cases, said Jaime Martinez-Urtaza.

Various studies using available data have confirmed that Europe has seen an alarming increase in infections Vibrio over the last few years.

According to the recent EFSA analysis published in July, 32 outbreaks caused by bacteria Vibrio in seafood were reported in the European Union between 2010 and 2021, causing 221 cases, of which 57 resulted in hospitalization.

A significant spike in infections Vibrio was recorded in Germany in 2018 and 2019 during major heat waves, with water temperatures in the Baltic Sea rising above 20°C, creating perfect conditions for the bacteria to flourish.

A study published in August in the journal Eurosurveillance revealed an increase in cases of vibriosis recorded between 1994 and 2021, as well as a widespread presence of bacteria Vibrio in the Baltic Sea countries that collect data. More than 1,500 cases were recorded in the study.

The study authors’ prediction model suggests that infections with Vibrio may be underestimated in countries that lack official monitoring, so the health risks to visitors to coastal areas remain unknown.

However, ECDC monitors the growth of bacteria Vibrio in the Baltic Sea during summer using a near real-time model. If and when the risk of bacteria development Vibrio is determined to be medium or above, notifications are issued in the weekly threat reports, a spokesperson told Medscape Medical News.

Antimicrobial resistance and risk of new variants

Another area of ​​concern is the emergence, over the last two decades, of bacterial resistance Vibrio to various antibiotics, including ampicillins, tetracyclines and carbapenems. It is therefore becoming increasingly important to monitor the antibiotic resistance profiles of species Vibrio clinical and environmental.

« Data on the preponderance of resistance genes in isolates of Vibrio are somewhat limited, but they tend to be fairly consistent “, said Niall Conroy. “ We are seeing resistance patterns that extend across a range of important antibiotics, including those that would have traditionally been used to treat antibiotic-resistant infections. This situation is obviously worrying. All of this shows the interdependence between things like the rational use of antibiotics, climate awareness, and the safety of our food and water. An approach One Health (one health) against threats such as vibriosis is necessary. »

Jaime Martinez-Urtaza echoed these concerns. “ Bacteria Vibrio are very active in terms of biological innovation and evolution and there is a risk of emergence of new variants with pandemic potential, in particular with major pathogenic species such as V. cholerae et V. parahaemolyticus. »

What happens next?

The increasing incidence of infections Vibrio requires a greater public health response and increased awareness efforts, experts told Medscape Medical News.There is a need for improved bacteria monitoring and alerts Vibrioto make it compulsory to report infections linked to these bacteria and to finance research.Public health campaigns warning vulnerable populations, such as people with chronic liver disease or diabetes, about the dangers of eating raw shellfish and exposing wounds to water of sea have also been suggested.

This article was translated from Medscape.co.uk using multiple editorial tools, including AI, in the process. The content was reviewed by the editorial staff before publication.

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