Emergence of Human Disease Caused by the Fish Pathogen
Streptococcus iniae
Our group was the first to identify
S.iniae as an emerging pathogen in humans. Between December
1995 and March 1996, invasive S.iniae disease was reported
in four patients in a local Toronto hospital. The majority of patients
reported a skin puncture on their hands from a tilapia bone, dorsal
fin or the knife being used to clean the fish, and were admitted
to hospital with upper limb cellulitis originating from the focus
of injury. One patient developed endocarditis, meningitis and septic
arthritis. We conducted a prospective and retrospective community-based
surveillance for cases of S. iniae infection in humans. During one
year, our surveillance identified a total of nine patients with
invasive S. iniae infection (cellulitis of the hand in eight and
endocarditis in one). All the patients had handled live or freshly
killed fish, and eight had percutaneous injuries. Six of the nine
fish were tilapia, which are commonly used in Asian cooking.
Illness due to this organism is likely to increase with
increasing demand for tilapia. This was of concern since, 55,000
lbs of tilapia per month are imported into Toronto alone and there
is an interest in developing tilapia culture in Ontario for commercial
purposes.
Further studies have focussed on identifying fish handling
procedures in the fish markets of the Toronto area, determining
virulence factors for this organism and their role in the disease
process, as well as developing the PCR primers for a simple diagnostic
test for S.iniae.
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