Between August and September 1999, a total of 64 cases of illness were identified in three episodes of acute gastroenteritis associated with the consumption of live oysters from a typical outdoor street market in Galicia (northwest Spain). Nine case patients were hospitalized and analysis of their stool samples revealed the presence of Vibrio parahaemolyticus. The strains isolated from two stool samples were studied for antibiotic susceptibility, biochemical characteristics and presence of virulence factors. Both isolates were Kanagawa phenomenon positive and produced thermostable direct hemolysin, which is related to pathogenicity in humans. These results show the presence of pathogenic V. parahaemolyticus in mollusks harvested in Europe and reveal the risk of illness associated with their consumption, suggesting the revision of V. parahaemolyticus risk assessment associated with consumption of raw live shellfish.

BACKGROUND:The spread of human immunodeficiency virus infection to impaired groups has intensified the challenge for its prevention; control of the epidemic now requires behavioral change among persons with limited ability to sustain attention and learn. In this randomized clinical trial, we tested an intervention to reduce sexual risk behaviors among homeless men with severe mental illness.METHODS:Men were recruited from a psychiatric program in a homeless shelter. Of 116 eligible men, 97 (83.6%) participated. Most were African American and had a chronic psychotic disorder and a comorbid substance use disorder. Participants were assigned to a 15-session experimental group intervention or to a 2-session control intervention and observed for 18 months. The 59 participants sexually active before the trial were the main target of the intervention. Sexual risk behavior was the primary outcome.RESULTS:Among the 59 sexually active men, follow-up data were obtained on 59 (100%) for the initial 6-month follow-up and on 56 (95%) for the remainder of the 18-month follow-up. The mean score on a sexual risk index for the experimental group was 3 times lower than for the control group (1.0 vs 3.1; P=.01) during the initial 6-month follow-up and 2 times lower during the remainder of the 18-month follow-up.CONCLUSIONS:This intervention successfully reduced sexual risk behaviors of homeless men with mental illness. The effect diminished over 18 months but did not disappear. Similar approaches may be effective in other impaired high-risk groups.

In this paper, we describe an intervention to reduce sexual risk behaviours for HIV transmission among homeless men with mental illness. In some urban areas of North America, 10± 20% of homeless mentally ill men are infected with HIV1,2. Yet, HIV prevention has been neglected in this population. There have been only limited attempts to offer HIV prevention in the settings where these men reside; and research in this ® eld has been minimal. Available data indicate that sexual behaviours Ð as well as drug use behaviours Ð contribute to the contraction and transmission of HIV in this population. Our previous studies found that both were important factors in HIV contraction3,4. Because more men currently practice unsafe sex than inject drugs, unsafe sexual behaviour may be the most important factor leading to further HIV transmission. While the need for sexual risk reduction in this population is clear, it presents a daunting challenge. Little is known about the sexual lives of homeless mentally ill men. Methods for changing behaviour (of any kind) among the chronic mentally ill have yet to be fully developed and tested. Finally, virtually no research has been conducted on behaviour change among destitute mentally ill people who also drink and use drugs. The present intervention drew on available theories of behaviour change from the ® eld of HIV prevention and psychiatric rehabilitation5± 15. In addition, we relied heavily on our clinical experience14± 18. Thus, application of these theories was considerably adapted for homeless mentally ill men. Below we describe, ® rst, the setting in which the intervention was developed. Second, we provide an overview of the philosophy and approaches that guided the intervention. Third, we discuss some of our ongoing work in this ® eld. THE SETTING