RAW SHELLFISH CONSUMPTION AMONG RENAL-DISEASE PATIENTS - A RISK FACTOR FOR SEVERE VIBRIO-VULNIFICUS INFECTION

Background: Raw shellfish-associated Vibrio vulnificus septicemia, wit h a case-fatality rate of nearly 50%, occurs most commonly in immunoco mpromised patients or those with liver disease. Methods: Sixty patient s with renal disease treated with hemodialysis at The George Washingto n University and a awaiting renal transplantation completed an initial survey that assessed their ra iv shellfish eating habits and knowledg e regarding the pathogen V. vulnificus. Patients were then given educa tional materials describing the risks of eating raw shellfish and, one month later, completed a second sun ey that assessed their knowledge retention and intent to eat or not eat raw shellfish in the future. Re sults: Sixty of 68 (88%) eligible patients completed the survey. Forty -eight percent of patients reported having eaten raw shellfish after b eing diagnosed with kidney disease, with the highest rates reported am ong subjects less than or equal to 49 years old and subjects with more than a high school education. Prior to receiving the educational mate rials, no patient had heard of the pathogen I: vulnificus. Three quart ers of patients reported never having been advised by a physician to a void eating raw shellfish. One month after reading the educational mat erials, 75% of patients said they would refrain from eating raw shellf ish in the future. Conclusion: In view of their immunocompromised stat us, patients with end-stage renal disease should be counseled to absta in from eating raw shellfish.