Study of factors that influence the clinical response to ciguatera fish poisoning

A 1-year observational study of all standardized medical records of ciguatera fish poisoning notified cases was conducted in French Polynesia. The objective was to determine the factors that influence the clinical response to ciguatera fish poisoning. During the year 1991, there were 551 cases notified on standardized code sheets by physicians (notification rate 276 per 100,000). The mean age was 36.6 years (S.D. 15.6). The largest age group was that between 30 and 49 years old (notification rate 562 per 100,000). The gender ratio (M/F) was 1.6. Of the 551 cases, 257 (47%) presented with a history of a previous attack. A clinical score was calculated to assess the outcome for each case. The adjusted odds ratio (OR) for a severe disease (33% with a score greater than 5) was significantly increased when the fish ingested was carnivorous (OR = 1.62, P = 0.02) and when a history of a previous attack was reported (OR = 1.71, P = 0.006). The increased severity of multiple episodes and the increase of the notification rate with age suggest a possible accumulation of toxin in the human organism.