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March 17, 1993

Warning About Vibrio Infections and Raw Molluscan Shellfish Consumption

JAMA. 1993;269(11):1361. doi:10.1001/jama.1993.03500110025007

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Because of continued reports of illness and death linked to raw oyster-associated Vibrio infections, the FDA is urging physicians and other health professionals to warn certain high-risk patients not to eat molluscan shellfish (oysters, mussels, and clams) raw or partially cooked. These patients include individuals with the following conditions:

  • liver disease, such as alcoholic liver disease, hemochromatosis, malignancy, or liver disease resulting from viral hepatitis infections;

  • impaired immune systems resulting from conditions such as malignancy or HIV infection, or that require longterm treatment with systemic corticosteroid drugs;

  • diabetes mellitus; and

  • gastrointestinal disorders, including achlorhydria.

Recent data from Florida, illustrating the serious problem of Vibrio infections in high-risk individuals, indicate that nine people died from the infection after eating raw oysters in the period from April through December, 1992. All but one of the individuals were known to have had liver disease.

To help in warning patients, the FDA has