SeaFoodPoisining

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The incidence of seafood poisoning, as a subset of food poisoning, is increasing. In the United States, fish, shellfish, and other marine organisms are responsible for at least 1 in 6 food poisoning outbreaks with a known etiology, and for 15% of the deaths associated with these particular outbreaks. In other parts of the world, the impact of seafood poisoning is even greater. From 1971-1990, seafood was the single most important vehicle in food poisoning outbreaks in Korea (32%) and Japan (22%). Therefore, international travelers are at particular risk for seafood poisoning.

As with general food poisoning, seafood poisonings share the following epidemiologic characteristics: ingestion as the primary route of exposure, a wide variety of etiologies (bacterial, viral, parasitic, and toxin), significant under-reporting, and an apparently increasing incidence in human populations. Seafood poisonings also have a similar approach to treatment, diagnosis and prevention as general food poisoning episodes, with some specific exceptions.

General Epidemiologic Issues of Seafood Poisoning Seafood poisonings, as with most foodborne diseases, are under-diagnosed and underreported. They tend to occur in disease clusters due to both cultural eating habits (ie. eating in families) and commerce (ie eating in restaurants). Meanwhile seafood consumption is increasing worldwide.

As with other foodborne pathogens, the internationalization of the food supply -- over 50% of the commercial seafood eaten in the U.S. is imported -- has greatly facilitated the transmission of seafood pathogens. National and international commerce allows for the rapid and wide geographic spread of contaminated seafood. Examples range from cholera on international airplanes to Norwalk-like gastroenteritis in 5 different states associated with the same contaminated collection site. The pathogenic organisms themselves can cross national and international boundaries, as seen with the spread of bacterial and dinoflagellate species through the dumping of ballast and bilge water from international shipping.

Seafood poisoning has certain transmission mechanisms in common with all foodborne illness. One is improper food handling. In 1992, the Centers for Disease Control and Prevention (CDC) recported contributing factors for foodborne outbreaks including: improper holding temperatures (62%), inadequate cooking (29%), contaminated equipment (18%), food from unsafe source (7%), and poor personal hygiene (29%). For seafood as for other types of food, the relative importance of restaurant and other commercial establishments versus private food sources in the epidemiology of food poisoning is unclear. In the US, 20% of the seafood consumed is derived from recreational and/or subsistence fishing outside most public health controls. A further