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Severe ciguatera poisoning in Madagascar: a case report
G G Habermehl1, H C Krebs, P Rasoanaivo
1Department of Chemistry, School of Veterinary Medicine (University), Hannover, Germany.
Summary
A shark flesh outbreak in Madagascar poisoned over 500 people with ciguatera toxins, resulting in 98 deaths. This severe incident marks the first shark-related ciguatera poisoning with a 20% mortality rate.
Area of Science:
- Marine toxicology
- Foodborne illness epidemiology
- Public health
Background:
- Ciguatera fish poisoning (CFP) is a significant public health concern globally, primarily associated with tropical and subtropical reef fish.
- Sharks are known to bioaccumulate ciguatoxins, but severe outbreaks linked to shark consumption are rare.
Observation:
- An unprecedented outbreak of poisoning occurred on the East coast of Madagascar, affecting over 500 individuals.
- The outbreak was definitively linked to the consumption of shark flesh, identified as Carcharhinus amboinensis.
- Clinical manifestations strongly indicated ciguatera toxins as the causative agent.
Findings:
- This event represents the first documented severe outbreak of ciguatera poisoning attributed to shark consumption.
- The outbreak recorded a high mortality rate of approximately 20% (98 deaths out of >500 cases).
- The specific shark species, Carcharhinus amboinensis, was identified as the source of the ciguatoxins.
Implications:
- Highlights the potential for sharks to act as significant vectors for ciguatera toxins in severe poisoning events.
- Underscores the need for enhanced surveillance and public awareness regarding shark consumption in endemic regions.
- Emphasizes the critical importance of identifying toxic fish species to prevent future ciguatera poisoning outbreaks and reduce mortality.