Collective poisoning from sea turtle consumption in Mahajanga Madagascar, May 2014

Poisoning from eating sea turtles, medically known as chelonitoxism, is seen especially in coastal areas. It remains a public health problem in Madagascar, despite a ban on hunting these animals. The objective of this study was to describe its epidemiological and clinical aspects and outcome to improve knowledge and prevention of this type of poisoning. Chelonitoxism occurred in May 2014, affecting the population in Antsanitia, a fishing village in northwest Mahajanga, Madagascar. All patients came first to the CSB I basic health center in Antsanitia and were subsequently hospitalized at the Mahajanga CHU Pzaga, 51 in the adult emergency department and 25 in the pediatrics department. These 76 patients ranged in age from 3 months to 79 years. The predominant clinical signs were gastrointestinal and neurological disorders. ENT-oral signs characterized the poisoning. Ingestion of the turtle fat caused intermediate and severe disease forms in adults. Breastfeeding was a prognostic factor in children. Signs of severity appeared within 72 hours in adults. After intensive resuscitation, the signs of poisoning disappeared after 12 days. The severe form predominated in children; death was either early or delayed to the second to sixth day after consumption. It is essential to develop awareness of this danger among the entire coastal population of Madagascar to prevent this kind of poisoning.