PREVENTION OF VIBRIO-VULNIFICUS INFECTIONS - ASSESSMENT OF REGULATORYEDUCATIONAL-STRATEGIES

Context.-Vibrio vulnificus-related disease caused by eating contaminat ed raw oysters prompted California to implement regulatory educational initiatives in 1991. Objective.-To assess California guidelines and e ducation efforts with regard to the prevention of V vulnificus infecti ons in Los Angeles County and to evaluate compliance with state regula tions mandating posting of warning signs concerning risks of eating ra w oysters. Design.-Review of epidemiologic investigations of V vulnifi cus infections in Los Angeles County between 1993 and 1995; telephone interviews of patients or surrogates; and a survey of restaurants serv ing raw oysters in Los Angeles County. Setting-General community. Main Outcome Measures.-Prior warning of patients and posting of warning si gns in restaurants. Results.-Recent cases of V vulnificus infections i n Los Angeles County suggest that a unique, vulnerable group (uninsure d Hispanic men with viral or alcoholic liver disease) has not been rea ched through education efforts. Of a total of 11 cases, information re garding being warned about the hazard of eating raw shellfish was avai lable for 8; of these, only 1 case was reported as having been warned, but he had misunderstood the preventive message. Warning signs were n ot 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. Conclusi on.-A more effective strategy is required to prevent V vulnificus infe ctions in Los Angeles County.