Ciguatera fish poisoning: Incidence, health costs and risk perception on Moorea Island (Society archipelago, French Polynesia)

International audienceCiguatera Fish Poisoning (CFP) is a non-bacterial seafood poisoning well characterized in the remote archipelagos of French Polynesia, yet poorly documented in the Society archipelago, most notably on Moorea, the second most populated island in French Polynesia, which counts a high proportion of fishermen fishing on a regular basis. To address this knowledge gap, a holistic study of the ciguatera issue was conducted on Moorea. First, ciguatera risk was analysed in terms of incidence rate, fish species most commonly involved and risk stratification in Moorea lagoon based on 2007–2013 epidemiological data. A mean incidence rate of 8 cases per 10,000 inhabitants for the study period and an average under-reporting rate of 54% were found. Taking into account hospitalization and medication fees, and loss of productive days, the health-related costs due to CFP were estimated to be USD $1613 and$749 for each reported and unreported case, respectively, with an overall cost of USD $241,847 for the study period. Comparison of the present status of CFP on Moorea with a risk map established in the late 1970’s showed that the spatial distribution of the risk has stayed relatively stable in time, with the north shore of the island remaining the most prone to ciguatera. Evaluation of the current knowledge on CFP among different populations groups, i.e. fishermen, residents and visitors, was also conducted through direct and indirect interviews. About half of the fishermen interviewed were actually able to identify risky fishing areas. While, overall, the CFP risk perception in the fishing community of Moorea seemed accurate, although not scientifically complete, it was sufficient for the safe practice of their fishing activities. This may be due in part to adaptive responses adopted by 36% of the fishermen interviewed, such as the avoidance of either high-risk fishing sites or toxic species. At the residents and visitors’ level, the study points out a striking lack of awareness of the CFP issue among visitors, as compared to local residents. Indeed, less than 25% of Moorea visitors vs. an average of 98% in residents were aware of CFP or of its presence on the island. Interestingly, evaluation of the fish consumption preferences showed that 70% of visitors do not consume lagoon fish during their stay, not for fear of CFP, but mainly due to the lack of availability of these species in recreational facilities or because they have nutritional preference for pelagic fish. This lack of awareness, along with the report by several CFP patients of the consumption of fish species yet banned for sale, stress the need for improved communication efforts on this critical issue among both residents and visitors on Moorea. The implementation of a public outreach strategy is proposed, based on both existing information networks and low-cost communication actions through information displays at various strategic locations, e.g. Tahiti-Faa’a international airport, the ferry boat station, recreational facilities, as well as the major trading points on Moorea Island

Ciguatéra : aspects écologiques, biologiques et toxicologiques

La ciguatéra est une intoxication résultant de la consommation de produits marins d'ambiance corallienne contaminés par des toxines marines, les ciguatoxines (CTXs), qui agissent préférentiellement sur les canaux sodiques dépendants du potentiel d'action. Cette pathologie, hautement prévalente dans les régions tropicales et intertropicales du globe, se caractérise par des troubles digestifs, neurologiques, cutanés, cardiovasculaires et respiratoires d'intensité variable, parfois compliqués par la survenue de cas chroniques et l'absence de traitement réellement efficace, sauf peut-être au sein de la pharmacopée traditionnelle. Le principal agent causal de cette pathologie est un dinoflagellé benthique, Gambierdiscus spp., qui se caractérise par une diversité morphologique et moléculaire remarquable (11 espèces connues à ce jour) et une très large répartition géographique. Plus récemment, l'implication potentielle de cyanobactéries marines dans des formes atypiques de ciguatéra a également été documentée. Les perturbations environnementales (e.g. températures élevées) et d'origine anthropique infligées aux écosystèmes coralliens sont autant de facteurs déclenchant des flambées ciguatériques. Seules certaines lignées de Gambierdiscus sont génétiquement capables de produire des CTXs. Ces dernières se répartissent en 3 grandes familles correspondant aux 3 zones d'endémie de la maladie (i.e. Pacifique, Caraïbes et Océan Indien), soit plus d'une quarantaine d'analogues chimiques. En dépit de la large panoplie de tests de détection déjà disponibles (tests in vivo, in vitro voire même traditionnels), il n'existe actuellement aucun test de référence dûment validé, ce qui constitue un obstacle majeur à l'exploitation durable des ressources pisciaires

Screening for Predictors of Chronic Ciguatera Poisoning: An Exploratory Analysis among Hospitalized Cases from French Polynesia.

Ciguatera poisoning is a globally occurring seafood disease caused by the ingestion of marine products contaminated with dinoflagellate produced neurotoxins. Persistent forms of ciguatera, which prove to be highly debilitating, are poorly studied and represent a significant medical issue. The present study aims to better understand chronic ciguatera manifestations and identify potential predictive factors for their duration. Medical files of 49 patients were analyzed, and the post-hospitalization evolution of the disease assessed through a follow-up questionnaire. A rigorous logistic lasso regression model was applied to select significant predictors from a list of 37 patient characteristics potentially predictive of having chronic symptoms. Missing data were handled by complete case analysis, and a survival analysis was implemented. All models used standardized variables, and multiple comparisons in the survival analyses were handled by Bonferroni correction. Among all studied variables, five significant predictors of having symptoms lasting ≥3 months were identified: age, tobacco consumption, acute bradycardia, laboratory measures of urea, and neutrophils. This exploratory, hypothesis-generating study contributes to the development of ciguatera epidemiology by narrowing the list from 37 possible predictors to a list of five predictors that seem worth further investigation as candidate risk factors in more targeted studies of ciguatera symptom duration

Epididymal proteome, transcriptome, what else

International audienc

A framework for mapping local knowledge on ciguatera and artisanal fisheries to inform systematic conservation planning

Millions of people’s livelihoods rely on artisanal fisheries. However, in many regions fishers are increasingly facing ciguatera poisoning, a seafood-borne illness. The toxin, produced by benthic dinoflagellates, can spread through marine food webs and to humans by direct consumption. Ciguatera risk can play a major role in fisher’s activities but has never been considered in any marine spatial plans thus far. To fill this gap, we examined if integrating ciguatera in systematic conservation plans could affect these decisions. We developed through map-based interviews, a novel seven-step framework to collect and map local knowledge on ciguatera risk and fisheries activities with two innovations: (i) better mapping of fishing grounds by combining geomorphological habitat and fishing gear information, and (ii) integrating ciguatera risk directly into systematic spatial planning designs and scenarios conceived to maximize benthic habitat conservation while minimizing impacts to fishers. The approach is illustrated for Raivavae Island, in French Polynesia, Pacific Ocean. We found that integrating ciguatera significantly improved prioritization solutions with a 24–38% decrease of costs to fishers compared with scenarios based solely on fishery data. This framework was designed for scientists and managers to optimize the implementation of conservation plans and could be generalized to ciguatera-prone areas

Extraction differentielle des protéines membranaires de spermatozoides pour l'obtention de marqueurs de maturation

National audienc

Screening for Predictors of Chronic Ciguatera Poisoning: An Exploratory Analysis among Hospitalized Cases from French Polynesia

Ciguatera poisoning is a globally occurring seafood disease caused by the ingestion of marine products contaminated with dinoflagellate produced neurotoxins. Persistent forms of ciguatera, which prove to be highly debilitating, are poorly studied and represent a significant medical issue. The present study aims to better understand chronic ciguatera manifestations and identify potential predictive factors for their duration. Medical files of 49 patients were analyzed, and the post-hospitalization evolution of the disease assessed through a follow-up questionnaire. A rigorous logistic lasso regression model was applied to select significant predictors from a list of 37 patient characteristics potentially predictive of having chronic symptoms. Missing data were handled by complete case analysis, and a survival analysis was implemented. All models used standardized variables, and multiple comparisons in the survival analyses were handled by Bonferroni correction. Among all studied variables, five significant predictors of having symptoms lasting ≥3 months were identified: age, tobacco consumption, acute bradycardia, laboratory measures of urea, and neutrophils. This exploratory, hypothesis-generating study contributes to the development of ciguatera epidemiology by narrowing the list from 37 possible predictors to a list of five predictors that seem worth further investigation as candidate risk factors in more targeted studies of ciguatera symptom duratio

Spatial Solutions and Their Impacts When Reshuffling Coastal Management Priorities in Small Islands with Limited Diversification Opportunities

In small islands, the potential for new coastal activities and management options are often spatially limited. To reduce dependence on external factors and increase the resilience of populations to global changes and fluctuations in international markets, a recommended pathway is to diversify activities. We used a systematic prioritization tool with single and multiobjective zoning to explore the feasibility of scenarios at various levels of spatial diversification in the Gambier lagoon (French Polynesia), where black pearl culture is economically and spatially dominant. Local managers are committed to economic, livelihood, and environmental sustainability and agree that prioritizing both artisanal fisheries, which provide local food security, and ecosystem conservation should also be considered. Diversification options included the optimized reallocation of farming concessions and the identification of different types of conservation areas while taking into account traditional management areas. The scenarios were set to minimize surface areas and loss of access to existing fishing grounds. The solutions were compared between the scenarios with different cost metrics, allowing further discussions with stakeholders and managers. The Gambier case study shows that exploring diversification options in small islands using systematic prioritization tools can provide local managers with tailor-made plans adapted to island development question

Tetrodotoxin Poisoning in Mainland France and French Overseas Territories: A Review of Published and Unpublished Cases

Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number (n) = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found (n = 17). All cases happened in overseas territories: French Guyana (n = 7), New Caledonia (n = 11), Reunion (n = 35) and French Polynesia (n = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential