Prevention of Vibrio vulnificus infections - Assessment of regulatory educational strategies

Context.-Vibrio vulnificus-related disease caused by eating contaminated raw oysters prompted California to implement regulatory educational initiatives in 1991. Objective.-To assess California guidelines and education efforts with regard to the prevention of V vulnificus infections in Los Angeles County and to evaluate compliance with state regulations mandating posting of warning signs concerning risks of eating raw oysters. Design.-Review of epidemiologic investigations of V vulnificus infections in Los Angeles County between 1993 and 1995; telephone interviews of patients or surrogates; and a survey of restaurants serving raw oysters in Los Angeles County. Setting-General community. Main Outcome Measures.-Prior warning of patients and posting of warning signs in restaurants. Results.-Recent cases of V vulnificus infections in Los Angeles County suggest that a unique, vulnerable group (uninsured Hispanic men with viral or alcoholic liver disease) has not been reached through education efforts. Of a total of 11 cases, information regarding being warned about the hazard of eating raw shellfish was available for 8; of these, only 1 case was reported as having been warned, but he had misunderstood the preventive message. Warning signs were not posted adequately in more than 50% of restaurants surveyed and one third of these establishments had signs in English only. Warnings were never located on dining tables and rarely included in menus. Conclusion.-A more effective strategy is required to prevent V vulnificus infections in Los Angeles County.