Two Clusters of Ciguatera Fish Poisoning in Paris, France, Related to Tropical Fish Imported From the French Caribbean by Travelers

Abstract

CFP may be seen in non-traveler patients outside endemic countries resulting from imported species of fish. Thus, CFP may be undiagnosed as physicians are not aware of this tropical disease outside endemic countries. The detection of ciguatoxins by MBA in the French National Reference Laboratory is useful in the confirmation of the diagnosis.

An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management

“…For instance, two recent CFP clusters in France involved 10 people who consumed barracuda ( Sphyraena barracuda ) and grey snapper ( Lutjanus griseus ), which they had brought back from their travels in Guadalupe [33]. The United Nations World Tourism Organization estimated that there were 1.2 billion “international tourist arrivals” in 2015, which has increased by 4.4% or more every year since 2010 [296].…”

“…Historically, CFP was associated with isolated island communities that relied heavily on subsistence fishing for their food supply [31,32], but the geographic reach of CFP has expanded due to international seafood trade and travel [33,34,35,36,37]. In addition, people consuming fish from areas previously free of CFP may be at risk when such areas become prone to CFP [38,39,40] due to changes in the aquatic environment.…”

Ciguatera, an Emerging Human Poisoning in Europe

“…These poisoning outbreaks described reinforce the idea of the geographical spread of ciguatera endemic areas worldwide [17]. CFP outbreaks that occurs outside of endemic areasare often linked to consumption of imported toxic fish or in travelers returning from endemic CFP areas [6,17] as recently there have been reports of ciguatera poisoning in New York, Germany [11] and France [19].…”

“…CFP is a major public health problem in the Pacific and Caribbean tropical areas where the pathology is known to most of the physicians and where the prevention is regularly performed to inform the population and particularly the fishermen about the risk of consumption some carnivorous fish [19]. To reduce the potential hazard of CFP, for example, the U.S. Food and Drug Administration (FDA) recommend that primary processors obtain information about harvest location and species of fish to determine the risk of contamination.…”

Ciguatoxin and Ciguatera

“…A definitive explanation for such variability remains elusive, but these events presumably directly correlate with the temporal and spatial patchiness of blooms of ciguatoxin-producing Gambierdiscus species. More recently, a number of ciguatera cases associated with import of contaminated fish have occurred in non-endemic areas, including New York, San Francisco, Canada, Germany, and France (Geller et al 1991;Pilon et al 2000;Epelboin et al 2014;Zimmermann et al 2015). Increasing global trade and travel will likely see a further increase in the global spread of ciguatera, highlighting the significant public health implications.…”