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. 2022 Jul;27(28):2101088.
doi: 10.2807/1560-7917.ES.2022.27.28.2101088.

Epidemiological and microbiological investigation of a large increase in vibriosis, northern Europe, 2018

Ettore Amato  1   2 , Maximilian Riess  3   2 , Daniel Thomas-Lopez  4   2 , Marius Linkevicius  5   2 , Tarja Pitkänen  6   7 , Tomasz Wołkowicz  8 , Jelena Rjabinina  9 , Cecilia Jernberg  3 , Marika Hjertqvist  10 , Emily MacDonald  1 , Jeevan Karloss Antony-Samy  1 , Karsten Dalsgaard Bjerre  11 , Saara Salmenlinna  5 , Kurt Fuursted  4 , Anette Hansen  10 , Umaer Naseer  1
Affiliations

Epidemiological and microbiological investigation of a large increase in vibriosis, northern Europe, 2018

Ettore Amato et al. Euro Surveill. 2022 Jul.

Abstract

BackgroundVibriosis cases in Northern European countries and countries bordering the Baltic Sea increased during heatwaves in 2014 and 2018.AimWe describe the epidemiology of vibriosis and the genetic diversity of Vibrio spp. isolates from Norway, Sweden, Denmark, Finland, Poland and Estonia in 2018, a year with an exceptionally warm summer.MethodsIn a retrospective study, we analysed demographics, geographical distribution, seasonality, causative species and severity of non-travel-related vibriosis cases in 2018. Data sources included surveillance systems, national laboratory notification databases and/or nationwide surveys to public health microbiology laboratories. Moreover, we performed whole genome sequencing and multilocus sequence typing of available isolates from 2014 to 2018 to map their genetic diversity.ResultsIn 2018, we identified 445 non-travel-related vibriosis cases in the study countries, considerably more than the median of 126 cases between 2014 and 2017 (range: 87-272). The main reported mode of transmission was exposure to seawater. We observed a species-specific geographical disparity of vibriosis cases across the Nordic-Baltic region. Severe vibriosis was associated with infections caused by Vibrio vulnificus (adjOR: 17.2; 95% CI: 3.3-90.5) or Vibrio parahaemolyticus (adjOR: 2.1; 95% CI: 1.0-4.5), age ≥ 65 years (65-79 years: adjOR: 3.9; 95% CI: 1.7-8.7; ≥ 80 years: adjOR: 15.5; 95% CI: 4.4-54.3) or acquiring infections during summer (adjOR: 5.1; 95% CI: 2.4-10.9). Although phylogenetic analysis revealed diversity between Vibrio spp. isolates, two V. vulnificus clusters were identified.ConclusionShared sentinel surveillance for vibriosis during summer may be valuable to monitor this emerging public health issue.

Keywords: emerging pathogens; global warming; heatwaves; seawater; vibriosis.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Occurrence of vibriosis cases in study countries during 2014–2018 and distribution of cases by age and sex, northern Europe, 2018 (n = 445)
Figure 2
Figure 2
Geographical distribution (NUTS3 level) of vibriosis cases, by identified species, in the study countries, northern Europe, 2018 (n = 445)
Figure 3
Figure 3
Severity of vibriosis cases in the study countries, northern Europe, 2018 (n = 445)
Figure 4
Figure 4
Single nucleotide polymorphism-based phylogeny of non-toxigenic Vibrio cholerae genomes from the study countries, northern Europe, 2015–2018 (n = 100)
Figure 5
Figure 5
Single nucleotide polymorphism-based phylogeny of Vibrio vulnificus genomes from the study countries, northern Europe, 2018 (n = 27)
See this image and copyright information in PMC

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