Abstract
Ciguatera fish poisoning (CFP) is the most prevalent non-bacterial food-borne form of poisoning in French Polynesia, which results from the consumption of coral reef fish naturally contaminated with ciguatoxins produced by dinoflagellates in the genus Gambierdiscus. Since the early 2000s, this French territory has also witnessed the emergence of atypical forms of ciguatera, known as ciguatera shellfish poisoning (CSP), associated with the consumption of marine invertebrates. In June 2014, nine tourists simultaneously developed a major and persistent poisoning syndrome following the consumption of the gastropod Tectus niloticus collected in Anaho, a secluded bay of Nuku Hiva Island (Marquesas Archipelago, French Polynesia). The unusual nature and severity of this event prompted a multidisciplinary investigation in order to characterize the etiology and document the short/long-term health consequences of this mass-poisoning event. This paper presents the results of clinical investigations based on hospital medical records, medical follow-up conducted six and 20 months post-poisoning, including a case description. This study is the first to describe the medical signature of T. niloticus poisoning in French Polynesia and contributed to alerting local authorities about the potential health hazards associated with the consumption of this gastropod, which is highly prized by local communities in Pacific island countries and territories.
Highlights
Marine products represent a major subsistence resource for many Pacific Island countries and territories (PICTs) where the risk of seafood poisoning is likely to pose significant health and economicToxins 2018, 10, 102; doi:10.3390/toxins10030102 www.mdpi.com/journal/toxinsToxins 2018, 10, 102 issues to local populations [1]
Ciguatera fish poisoning (CFP) is related to the consumption of coral reef fish from tropical and subtropical regions that are contaminated by ciguatoxins (CTXs), a family of neurotoxins produced by discoid-shaped benthic dinoflagellates of the genus Gambierdiscus [2]
CFP is the most prevalent ichthyosarcotoxism reported in French Polynesia [3,4] with an annual average incidence rate of 19/10,000 inhabitants, this number may reach 1700/10,000 inhabitants in the most severely affected islands
Summary
Marine products represent a major subsistence resource for many Pacific Island countries and territories (PICTs) where the risk of seafood poisoning is likely to pose significant health and economicToxins 2018, 10, 102; doi:10.3390/toxins10030102 www.mdpi.com/journal/toxinsToxins 2018, 10, 102 issues to local populations [1]. Marine products represent a major subsistence resource for many Pacific Island countries and territories (PICTs) where the risk of seafood poisoning is likely to pose significant health and economic. Recent indigenous CFP cases have been reported in Spain (Canary Islands) [7], temperate areas of Japan, South Korea [8,9], and CTX-containing marine organisms have been reported in the Madeira Archipelago and Israeli coast [10,11], reflecting a progressive expansion of the ciguatoxic risk at a global scale. Due to the increase in the international fish trade, tourism, and interest in exotic products, non-endemic regions, such as Europe or North America, are currently facing an increase in imported CFP cases [12,13,14], raising new concerns about fish import regulations, medical professional outreach, and management of a new category of patients
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