Family tetrodotoxin poisoning in Reunion Island (Southwest Indian Ocean) following the consumption of Lagocephalus sceleratus (Pufferfish).

Pufferfish poisoning has rarely been reported in the southwestern Indian Ocean and in the French overseas territories. In Reunion Island, the last notified documented case occurred in 1989 and people are no longer aware of the potential toxicity of pufferfish. We report a family hospitalized for a tetrodotoxin poisoning following the consumption of Lagocephalus sceleratus caught on the coast of Reunion Island in September 2013. Two patients presenting acute vital functions failures were admitted in an ICU. Ten people were admitted simultaneously to the emergency department after consuming L. sceleratus with signs of toxicity appearing within 2 hours. Treatment was supportive, but included the need for mechanical ventilation for two patients. All those affected had complete and uneventful recoveries within a few days. The fish consumed was identified as L. sceleratus, a species known to contain tetrodotoxin. The diagnosis of tetrodotoxin poisoning was suggested by typical clinical manifestations together with the history of very recent consumption of tetrodotoxin-containing fish. Tetrodotoxin was later detected at high levels in food remnants. To the best of our knowledge, there has been no documented case series of tetrodotoxin poisoning reported from Reunion Island for the last 25 years and from the entire Indian Ocean area since 1998. Pufferfish intoxication is one of the most common causes of poisoning among people in coastal regions of Asia but it has also recently been reported in areas where it was previously unknown, particularly along the Mediterranean shores and in Spain. Public health education in French overseas territories and along the Mediterranean shores should be adapted to include increased awareness of the danger of consuming pufferfish. Health teams must be aware of such clinical presentations.

Morphological and toxicological variability of Prorocentrum lima clones isolated from four locations in the south-west Indian Ocean.

Eight clones of the toxic dinoflagellate Prorocentrum lima (Ehrenberg) Dodge from four sites (two clones per site) on the coral reef of La Réunion, Mayotte, Europa, and Mauritius Islands in the SW Indian Ocean were isolated and cultivated under the same conditions. Morphological features of each clone, including cell size and valve and marginal pore numbers, were examined by scanning electron microscopy. The toxic potential of each clone was determined by protein phosphatase type 2A (PP2A) inhibition test and fibroblast cell line FR3T3 bioassay. Scanning electron microscopy showed that variation in morphological features of clones within and between sites was minimal and not significant. However, equivalent okadaic acid content, determined by PP2A assay, was different within and between clones isolated from the four islands. Cytotoxicity bioassay with the FR3T3 cell line confirmed the variation on global toxic potential within and between the eight P. lima clones. This test also suggested the presence of other toxic compounds without PP2A inhibiting activity in crude extracts of some clones.

Okadaic acid production from the marine benthic dinoflagellate Prorocentrum arenarium Faust (Dinophyceae) isolated from Europa Island coral reef ecosystem (SW Indian Ocean).

Okadaic acid was isolated from a strain of Prorocentrum arenarium Faust (Prorocentrales, Dinophyceae) collected from Europa Island (40 degrees 22'E, 22 degrees 20'S, SW Indian Ocean). The presence of okadaic acid in the algal extract was suspected after cytotoxicity and phosphatase 2A inhibition testing. It was confirmed by ADAM derivatization, immunoaffinity extraction and liquid chromatography with fluorimetric detection analysis as well as by liquid microchromatography with mass spectrometric detection. Results indicate that the P. arenarium strain was toxinogenic and could be potentially involved in the toxin production associated with the human diseases, diarrhetic shellfish poisoning and possibly ciguatera fish poisoning in the SW Indian Ocean area.

Ciguatera in Réunion Island (SW Indian Ocean): epidemiology and clinical patterns.

One hundred and fifty-nine ichtyosarcotoxic outbreaks, including 477 people, were recorded in the island of Réunion (SW Indian ocean) between 1986 and 1994. Ciguatera outbreaks represented 78.6% of the total cases and its annual incidence rate was estimated to be 0.78/10,000 residents. Symptoms caused by ciguatera poisoning are not different from those reported in Pacific and Caribbean islands, except for the additional symptoms of hallucinatory poisoning in 16% of the patients. Serranidae fish, including species of great commercial value, were the most commonly incriminated accounting for 50% of the outbreaks.