Ciguatera fish poisoning in the Pacific Islands (1998 to 2008)
PLOS Neglected Tropical Diseases
Public Library of Science
© 2011 Skinner et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
BACKGROUND: Ciguatera is a type of fish poisoning that occurs throughout the tropics, particularly in vulnerable island communities such as the developing Pacific Island Countries and Territories (PICTs). After consuming ciguatoxin-contaminated fish, people report a range of acute neurologic, gastrointestinal, and cardiac symptoms, with some experiencing chronic neurologic symptoms lasting weeks to months. Unfortunately, the true extent of illness and its impact on human communities and ecosystem health are still poorly understood. METHODS: A questionnaire was emailed to the Health and Fisheries Authorities of the PICTs to quantify the extent of ciguatera. The data were analyzed using t-test, incidence rate ratios, ranked correlation, and regression analysis. RESULTS: There were 39,677 reported cases from 17 PICTs, with a mean annual incidence of 194 cases per 100,000 people across the region from 1998-2008 compared to the reported annual incidence of 104/100,000 from 1973-1983. There has been a 60% increase in the annual incidence of ciguatera between the two time periods based on PICTs that reported for both time periods. Taking into account under-reporting, in the last 35 years an estimated 500,000 Pacific islanders might have suffered from ciguatera. CONCLUSIONS: This level of incidence exceeds prior ciguatera estimates locally and globally, and raises the status of ciguatera to an acute and chronic illness with major public health significance. To address this significant public health problem, which is expected to increase in parallel with environmental change, well-funded multidisciplinary research teams are needed to translate research advances into practical management solutions.
This study was funded in part by the Australian Research Council Centre of Excellence for Coral Reef Studies (Tom Brewer) and the European Union Convergence Funding to the European Centre of Environment and Human Health (Lora Fleming), Peninsula College of Medicine and Dentistry, University of Exeter, Truro, Cornwall, UK. Richard Lewis is an NHMRC (www.nhmrc.gov.au) Research Fellow.
This is the final version of the article. Available from Public Library of Science via the DOI in this record.
Vol. 5 (12), article e1416
Place of publication