Hepcidin: the Missing Link between Hemochromatosis andInfections

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Abstract
The aphrodisiacal potential of oysters is the stuff of maritime folklore, having roots in tales of Aphrodite (literally "foam born"), the goddess of love, said to have arisen from the sea on an oyster shell. However, mariners' tales chronicling oysters' lethal potential, despite having abounded since the 5th century B.C., have received less attention. Vibrio vulnificus, originally described in 1979 (6; J. J. Farmer III, Letter, Lancet ii:903, 1979), is a particularly virulent, lactose-fermenting, motile gram-negative halophilic bacterium that inhabits temperate coastal waters, notably of the Gulf of Mexico. V. vulnificus is concentrated in fish and filter feeders such as oysters and clams (up to 50% culture positive) and crabs (up to 11% culture positive) (18, 72), and infection associated with exposure to this organism may range from wound infections to fatal septi- cemic shock (38, 69). Moreover, as probably the leading cause of seafood-associated fatalities in the United States, this or- ganism is considered a significant public health hazard, since despite early recognition, aggressive antibiotic therapy, and surgical debridement, the morbidity, mortality, and cost asso- ciated with V. vulnificus infections remain substantial (48, 49). Risk factors for V. vulnificus infection include the V. vulni- ficus subtype (various genetically distinct subgroups of biotype 1 identified by randomly amplified polymorphic DNA PCR appear to be especially virulent), immunocompromised state (human immunodeficiency virus, cancer, bone marrow sup- pression, achlorhydria, and diabetes), end-stage renal impair-