Background
Vibrio vulnificus (V. vulnificus) is a seafood-borne infectious pathogen that can be lethal to humans. The infection has been correlated with pre-existing liver disease, particularly liver cirrhosis. Awareness of V. vulnificus infection among Japanese citizens is low, despite the increasing number of patients with hepatocellular carcinoma (HCC). The present study was conducted to assess the level of knowledge of patients with liver disease regarding V. vulnificus infection.
Material and Method
Questionnaires were sent to patients with chronic liver disease who had been treated by liver specialists at 14 medical institutes.
Results
Of 1,336 patients, 304 (22.8%) had liver cirrhosis, and 732 (54.8%) had comorbidities of this disease. Only 14.5% (194/1,336) of patients had knowledge of V. vulnificus infection. Of 304 patients with liver cirrhosis, 17.4% (53/304) of the patients had knowledge of V. vulnificus infection. Of 60 patients with liver cirrhosis and diabetes mellitus, 11 (18.3%) patients had knowledge of V. vulnificus infections. Even when the patients with high risk factors such as liver cirrhosis and diabetes mellitus had knowledge of V. vulnificus infections, most ate raw seafood without regard to season.
Conclusions
Patients with chronic liver diseases and their physicians need to be better educated about V. vulnificus infection and its prevention.

Keywords: Vibrio Infections - complications, Shellfish, Seawater, Questionnaires, Prospective Studies, Liver Diseases - microbiology, Liver Cirrhosis - complications, Knowledge, Hygiene, Feeding Behavior, Diabetes Mellitus - microbiology, Vibrio vulnificus - physiology