Three biotypes of V. vulnificus are known to cause severe human disease. Biotype 1 is found worldwide in salt or brackish
water. Biotype 2 occupies a more specific niche and is found in saltwater used for eel (genus Anguilla) farming in the Far East and Western Europe.6,7 Biotype 3 is the strain associated with freshwater fish farming in Israel. Genomic analyses of biotype 3 indicate it is a hybrid of biotypes 1 and 2.9 Biotype 1 is the most common strain and is responsible for the entire spectrum of illness, including the primary sepsis associated with the oftenquoted fatality rate in excess of 50%. Biotype 2 is usually a serious pathogen of eels, but on rare occasions may cause wound infections in humans.3,6,7 Although biotype 3 can cause severe soft-tissue infections requiring amputation, the mortality rate appears to be less than 8%.