Incidence and clinical characteristics of ciguatera fish poisoning in Guadeloupe (French West Indies) between 2013 and 2016: a retrospective cases-series

Abstract

This retrospective case study analysed the incidence and symptoms of ciguatera fish poisoning (ciguatera) in Guadeloupe (French West Indies) between 2013 and 2016. Cases attending the emergency departments of the two public hospitals and the reports received by the regional health authority in charge of monitoring (ARS) were compiled. Two hundred and thirty-four cases of poisoning were observed, with a mean annual incidence of 1.47/10,000 (95% CI): 1.29–1.66), i.e 5 times higher than the previously reported incidence (1996–2006). The main species described as being responsible for poisoning were fish from the Carangidae family (n = 47) (jack), followed by fish from the Lutjanidae family (n = 27) (snapper), Serranidae family (n = 15) (grouper), Sphyraenidae family (n = 12) (barracuda), and Mullidae family (n = 12) (goatfish). One case of lionfish ciguatera was observed. 93.9% of patients experienced gastrointestinal symptoms, 76.0% presented neurological signs (mainly paresthesia, dysesthesia and pruritus) and 40.3% presented cardiovascular symptoms (bradycardia and/or hypotension). A high frequency (61.4%) of hypothermia (body temperature <36.5 °C) was observed. This study reports for the first time the relatively high frequency of cardiac symptoms and low body temperature. The monitoring of ciguatera poisoning throughout the Caribbean region must be improved, notably after reef disturbance due to Irma and Maria major cyclones.

Human Poisoning from Marine Toxins: Unknowns for Optimal Consumer Protection

“…One of the more frequent and characteristic neurological symptoms is cold allodynia, a misperception in which contact with cold surfaces triggers a burning or painful sensation. Other neurological signs associated with ciguatera include hand, feet or perioral paresthesias, dizziness, pruritus, taste alterations, arthralgia, myalgia, hypothermia, and headache [ 62 , 80 , 84 ]. Dental pain or loose teeth sensation have also been reported.…”

“…Alterations of the cardiovascular function consistent of hypotension and bradycardia may also be present concurrently with gastrointestinal and neurologic signs during the acute phase. Although cardiovascular symptoms are considered indicative of severe intoxication [ 87 , 88 ], recent retrospective studies suggest that their incidence is probably higher than initially reported [ 84 ].…”

Fish Hybridization Leads to Uncertainty Regarding Ciguatera Fish Poisoning Risk; Confirmation of Hybridization and Ciguatoxin Accumulation with Implications for Stakeholders

“…180 nautical miles to the southeast of the study location) has implemented measures to protect the population against the threat of CFP posed by L. apodus, and 15 other species, through a Prefectural order (N • 2002-1249) restricting their harvest and sale. O. chrysurus have no sales restrictions regarding CFP [17,18]. According to hospital emergency department cases and regional monitoring networks in Guadeloupe, there were 16 cases of CFP between 2013-2016 where either L. jocu or L. apodus were implicated in the poisoning (species confirmation was unavailable due to a lack of genetic identification) [18].…”

“…O. chrysurus have no sales restrictions regarding CFP [17,18]. According to hospital emergency department cases and regional monitoring networks in Guadeloupe, there were 16 cases of CFP between 2013-2016 where either L. jocu or L. apodus were implicated in the poisoning (species confirmation was unavailable due to a lack of genetic identification) [18]. O. chrysurus was implicated in only one case of CFP out of 234, however, genetic confirmation was not performed and this species was labeled as 'not considered to be responsible for CFP at the time of reporting' [18].…”

“…According to hospital emergency department cases and regional monitoring networks in Guadeloupe, there were 16 cases of CFP between 2013-2016 where either L. jocu or L. apodus were implicated in the poisoning (species confirmation was unavailable due to a lack of genetic identification) [18]. O. chrysurus was implicated in only one case of CFP out of 234, however, genetic confirmation was not performed and this species was labeled as 'not considered to be responsible for CFP at the time of reporting' [18]. To prevent misidentification for CFP outbreaks, it is important to identify what species are responsible for episodes of CFP in order to build the library of CFP vector information required to inform decision makers regarding the risks a given species may present.…”