Ciguatera fish poisoning in Brazilian traveler to Caribbean

ABSTRACT Ciguatera poisoning is the most common form of non-bacterial food-poisoning from fish worldwide. The incidence among Brazilians returning from high-risk regions is unclear because it is not a mandatory reportable disease. We describe a previously healthy 53-year-old Brazilian woman developed Ciguatera fish poisoning while traveling to Havana, Cuba. Physicians and health care professionals should advise travelers to avoid eating ciguatoxic fish species and potentially toxic fish species in the Caribbean islands. Despite the prognosis for most cases is good with a short duration of self-limited symptoms, early recognition of the identifying clinical features of ciguatera can result in improved patient care.

An Outbreak of Scombroid Fish Poisoning Associated with Consumption of Yellowtail Fish in Seoul, Korea

BACKGROUND: In November 2016, an outbreak of scombroid fish poisoning occurred among elementary school students in Seoul, Korea. An epidemiological investigation was conducted to identify the cause and source of the illness. METHODS: A case-control study was conducted among school members who had eaten lunch in the school. The histamine level in the suspect food item (yellowtail steak) was measured. RESULTS: Fifty-five (5.4%) of 1,017 school members who consumed fish for lunch fell ill. The principal symptoms were flushing (100%) and headache (72.7%); the median incubation period was 40 minutes. All had consumed yellowtail steak (odds ratio, 9.24; 95% confidence interval, 1.22–69.91). Leftover steak had an elevated histamine level (293 mg/kg), higher than the allowed 200 mg/kg. CONCLUSION: An outbreak of scombroid fish poisoning was confirmed; this is the first such report in Korea. Detailed food safety guidelines must be established.

Impact of fishing with Tephrosia candida (Fabaceae) on diversity and abundance of fish in the streams at the boundary of Sinharaja Man and Biosphere Forest Reserve, Sri Lanka / Impacto en la diversidad y abundancia de peces en riachuelos de la frontera de la Reserva Forestal de Sinharaja, Sri Lanka al pescar con Tephrosia candida (Fabaceae)

AbstractLocal communities in some Asian, African and American countries, use plant toxins in fish poisoning for fishing activities; however, the effects of this practice on the particular wild fish assemblages is unknown. This study was conducted with the aim to investigate the effects of fish poisoning using Tephrosia candida, on freshwater fish diversity and abundance in streams at the boundary of the World Natural Heritage site, Sinharaja Forest Reserve, Sri Lanka. A total of seven field trips were undertaken on a bimonthly basis, from May 2013 to June 2014. We surveyed five streams with similar environmental and climatological conditions at the boundary of Sinharaja forest. We selected three streams with active fish poisoning practices as treatments, and two streams with no fish poisoning as controls. Physico-chemical parameters and flow rate of water in selected streams were also measured at bimonthly intervals. Fish were sampled by electrofishing and nets in three randomly selected confined locations (6 x 2 m stretch) along every stream. Fish species were identified, their abundances were recorded, and Shannon-Weiner diversity index was calculated for each stream. Streams were clustered based on the Bray-Curtis similarity matrix for fish composition and abundance. Physico-chemical parameters of water were not significantly different among streams (P > 0.05). A total of 15 fish species belonging to four different orders Cypriniformes, Cyprinodontiformes, Perciformes and Siluriformes were collected; nine species (60 %) were endemic, and six (40 %) were native species. From these, 13 fish species were recorded in streams with no poisoning, while five species were recorded in streams where poisoning was practiced. Four endemic and one native fish species were locally extinct in streams where fish poisoning was active. Fish abundance was significantly higher in control streams (32-39/m2) when compared to treatment streams (5-9/m2) (P < 0.05). We concluded that fish poisoning with T. candida may have resulted in a significant reduction in species richness, total abundance and Shannon-Weiner diversity index of fish species in the studied streams at the boundary of Sinharaja forest. We recommend that this fishing practice should be strictly regulated, and to inform local communities about the legal status of fish poisoning, its consequences and the importance of fish diversity for local livelihoods and conservation purposes. Rev. Biol. Trop. 64 (3): 1129-1141. Epub 2016 September 01.

ResumenLas comunidades de algunos países asiáticos, africanos y americanos utilizan las toxinas de las plantas para pescar, sin embargo, los efectos de esta práctica en grupos de peces silvestres son desconocidos. Este estudio se llevó acabo con el objetivo de investigar los efectos del envenenamiento de peces con Tephrosia candida en la diversidad y abundancia de peces de agua dulce en riachuelos de la frontera la Reserva Sinharaja en Sri Lanka. En total se realizaron siete giras bimensuales al campo de mayo 2013 a junio 2014. Se muestrearon cinco riachuelos con condiciones ambientales y climáticas similares en la frontera de la reserva de Sinharaja. Como tratamientos se seleccionaron tres riachuelos con práctica activa de envenenamiento de peces y dos riachuelos sin envenenamiento de peces como controles. También, en intervalos bimensuales, se midieron los parámetros físico-químicos y de corriente del agua en riachuelos seleccionados. Se utilizó la electropesca y redes en tres sitios (6 x 2 m) seleccionados al azar a lo largo de cada riachuelo para el muestreo de peces. Se identificaron los peces a nivel de especie, se anotó su abundancia y se calculó el índice de diversidad de Shannon-Weiner para cada riachuelo. Con base en la matriz de similitud de Bray-Curtis se agruparon los riachuelos para composición y abundancia de peces. Los parámetros físicoquímicos del agua fueron no significativamente distintos entre los riachuelos (P > 0.05). Se recolectó un total de 15 especies de peces que pertenecen a cuatro órdenes: Cypriniformes, Cyprinodontiformes, Perciformes y Siluriformes; nueve especies (60 %) fueron endémicas y seis (40 %) nativas. Trece especies se encontraron en riachuelos donde no se practica el envenenamiento mientras que cinco especies se encontraron en riachuelos donde sí se daba esta práctica. Cuatro especies endémicas y una nativa estaban extintas en riachuelos donde la práctica del envenenamiento era activa. La abundancia de peces fue significativamente alta en los riachuelos control (32-39/m2) al compararse con los tratamientos (5-9/m2) (P < 0.05). Se concluye que el envenenamiento de peces con T. candida puede haber resultado en una reducción significativa de la riqueza de especies, la abundancia total y el índice de diversidad de Shannon-Weiner de las especies de peces en los riachuelos estudiados en la frontera de la reserva Sinharaja. Se recomienda que esta práctica de pesca sea estrictamente regulada y que se informe a las comunidades locales acerca del estado legal del envenenamiento de peces, sus consecuencias y de la importancia de la diversidad de peces para el sustento local y para propósitos de conservación.

Dinámica de la bio-acumulación de las ciguatoxinas en una cadena alimentaria / Dynamics of the bioaccumulation of ciguatoxins in a food chain

Introducción: frecuentemente en las regiones insulares de países tropicales se reportan casos de intoxicación por ciguatera, los cuales se asocian al consumo de ciertos tipos de peces que se alimentan de algas tóxicas. Debido a que la aparición de la intoxicación es impredecible, y que los peces portadores de la ciguatoxinas presentan sabor y olor como los peces no contaminados, existen grandes dificultades en la prevención de esta enfermedad, ocacionando serios problemas socio-económicos en las comunidades que habitan estas regiones. Objetivo: con el propósito de entender la bio-acumulación de las ciguatoxinas en la cadena alimentaria marina, se propone un sistema no lineal de ecuaciones diferenciales que puede ser utilizado como herramienta en la determinación de tiempos de veda en el consumo de peces y mitigar los riesgos de intoxicación. Métodos: se analiza la estabilidad de la solución de equilibrio del sistema que tienen sentido ecológico y se presentan y discuten simulaciones numéricas para diferentes escenarios de brotes de las ciguatoxinas. Resultados: los resultados indican que la evolución del sistema de transporte y bio-acumulación de toxina depende de la dinámica del sistema poblacional. Conclusiones: El modelo puede convertirse en una orientación para los ecólogos que investigan en actividades de campo relacionadas con la enfermedad, ya que sugiere algunas medidas importantes que son necesarias para calibrar el modelo y hacer de él una herramienta valiosa en la toma de decisiones por las autoridades encargadas del tema de salud pública en zonas costeras caribeñas donde la enfermedad sea endémica.

Introduction: Island regions in tropical countries often report cases of ciguatera fish poisoning associated with consumption of certain types of fish feeding on toxic algae. The emergence of intoxication is unpredictable, and fish carrying ciguatoxins taste and smell just like uncontaminated fish. Therefore, it is very difficult to prevent this disease, which causes serious socio-economic problems in the communities inhabiting these regions. Objective: with the purpose of understanding the bioaccumulation of ciguatoxins in the marine food chain, a proposal is made of a non-linear system of differential equations which may be used as a tool to lay down closed seasons in fish consumption and thus mitigate poisoning risks. Methods: an analysis is conducted of the stability of the equilibrium solution of the system which makes ecological sense, and a presentation and discussion are provided of numerical simulations for various scenarios of ciguatoxin outbreaks. Results: results show that evolution of the toxin transport and bioaccumulation system depends on the dynamics of the population system. Conclusions: the model may be used as a guideline for ecologists carrying out field research into the disease, since important measures are suggested which are required to calibrate the model and turn it into a valuable tool for the taking of decisions by public health authorities in Caribbean coastal areas where the disease is endemic.

Ciguatera Fish Poisoning on Kakeroma Island, Kagoshima Prefecture, Japan

In this paper we report two incidents of ciguatera fish poisoning (CFP) that occurred in 2008 on Kakeroma Island in Kagoshima Prefecture, Japan. A family consisting of father (42 y.o.), mother (39 y.o.), daughter (11 y.o.) and son (6 y.o.), as well as a friend of the family (male, 78 y.o.) consumed sliced flesh (sashimi) and developed typical symptoms of CPF 4-5 h later: diarrhea, vomiting, and paresthesia of the extremities. Additionally, the two male adults (42 and 78 y.o.) developed mild hypotention (84/48 and 94/40 mmHg, respectively) and bradycardia (36 and 50 bpm, respectively) and were rushed to the ER of the nearest hospital, located on an adjacent island. The implicated fish were caught together off the west coast of the island and were identified as <i>Variola louti</i> and <i>Lutjanus monostigma</i> based on analysis of 16S rRNA gene coded on mtDNA. Remnants of the implicated fish and other fish caught on the same occasion were examined by the official mouse bioassay method (MBA), which defines the minimum amount of CFP toxin needed to kill a male mouse of ddY strain of 20 g body weight within 24 h as one mouse unit (MU). A significantly high toxicity was detected in the <i>V. louti</i> (0.2 MU/g) eaten by the family and the <i>L. monostigma</i> (0.8 MU/g) eaten by the elderly man. Other specimens of <i>Lethrinus nebulosus</i>, <i>Variola albimarginata</i>, <i>Lutjanus gibbus</i> (2 specimens), <i>Aphareus rutilans</i>, and <i>Sphyraena forsteri</i> (2 specimens) were found to be nontoxic (< 0.025 MU/g).<br> The medical records regarding island inhabitants (ca. 1,500) kept at Kakeroma Tokushukai Clinic, the only medical facility on the Island, and also at Setouchi Tokushukai Hospital, a nearest hospital on an adjacent island (Amami) revealed 6 CFP outbreaks involving 13 cases between 2005 and 2008. The estimated frequency of CFP was 10.0 incidents/10,000 persons/year and the morbidity rate was 21.7 cases/10,000 persons/year. The symptoms and signs observed in the patients and the implicated fish species, <i>L. monostigma</i> and<i> V. louti</i>, were typical of CFP in this region.

Ciguatera, presentación de un caso / Sea water fish poisoning, case presentation

Se reportó un caso de un paciente masculino de 34 años de edad con antecedentes personales de buena salud, que acudió al Cuerpo de Guardia del Hospital de Gibara, Provincia de Holguín, intoxicado por el consumo de pescado fresco, específicamente el conocido como Sierra (Perticnis Pertinata). Durante la Colonia, un hacendado inglés se intoxicó tras la ingestión de algún pescado que no recoge la Historia, así como varios de sus familiares y colonos; uno de los colonos, criollo, lo oyó llamar este cuadro como sea water fish poisoning, lo que devino después en "Ciguatera", nunca antes reconocida ni diagnosticada en Cuba. Se describieron las características clínicas de la enfermedad, su etiología, y evolución, así como la conducta asumida. Su proceso correspondió al diagnóstico de Ciguatera. Para la confección del trabajo se revisaron fuentes bibliográficas disponibles, además de las búsquedas en bases de datos de Infomed; como resultados más relevantes, obtuvimos la presentación de manifestaciones clínicas atípicas, así como elementos coincidentes con la bibliografía revisada. Se describieron las características clínicas de la enfermedad, su etiología y evolución, así como la conducta asumida.

A case of 34 years old male patient is presented that went to the department of the Gibara Hospital, Holguin County intoxicated specifically by the consumption of fresh fish known as Sierra (perticnis Pertinata), the process corresponded with the diagnosis of Ciguatera. During colonization a farmowner described his disease after eating a coast fish as "Sea Water poisoning", and one of his apprentice man(also sick) named the disease ( Ciguatera)" as a Creole name for it, never known or recognized in Cuba For the creation of this article, available bibliography sources were revised in our libraries, as well as the databases in infomed, as a results: Outstanding atypical clinical manifestations of the illness and other are described with the revised bibliography, as well as its genesis and evolution.

Situation of Puffer fish poisoning treated at the Intensive care unit of Hue Central hospital for 5 years (from 2000 to 2004)

For 5 years, the Intensive care unit of Hue central hospital treated 24 patients suffering from Puffer fish poisoning. Puffer fish are found in seas and rivers. 24 These 24 cases occurred in the sea areas of Thua Thien Hue province. Puffer fish contains Tetrodotoxin which is a potent neurotoxin. The specific clinical symptoms at admission: paresthetic tongue and lips (24 patients), paresthetic limbs, abdomen and chest (21 patients), abdominal pain and vomiting (20 patients), sweating (8 patients), headache (7 patients), bradycardia (7 patients), respiratory muscle paralysis must be artificial ventilation (1 patient). Treatment with gastric lavage, then ingestion of activated charcoal plus sorbitol is effective method. There was no deaths.

Tetrodotoxin poisoning from Gobius criniger in Julugan, Tanza, Cavite: a report of the lst documented case in the Philippines

Thirty four (34) patients, upon ingesting of the fish Gobius criniger manifested neurologic and gastrointestinal symptoms, resulting in four (4) mortalities due to respiratory paralysis. Two (2) victims were admitted and successfully treated at our hospital. One patient presented with respiratory insufficiency, therefore he was hooked up to a mechanical ventilator. To document the poisoning, analysis of fish samples for toxin isolations was done in Japan, using the High Performance Liquid Chromatography (HPLC) revealing the identity of Tetrodotoxin. Bioassay in rats was done at the Bureau of Food and Drugs (BFAD) confirming the high level of toxicity. This report was the first documented case of fish poisoning due to Tetrodotoxin in the country. Close monitoring regarding the toxicity level of the Goby fish should be done in Julugan, Tanza, Cavite, during the spawning period in September to April of each year, when poisoning is observed to be rampant. (Author)