Clinical Characteristics of Ciguatera Poisoning in Martinique, French West Indies—A Case Series
Abstract
:1. Introduction
2. Results
3. Discussion
3.1. Incidence of CP in the World
3.2. Clinical Characteristics of CP
3.3. Fish Involved in CP
3.4. Study Limitations
4. Conclusions
5. Materials and Methods
5.1. Study Design and Data Collection
5.2. Statistical Analysis
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Region | Period | Incidence (/10,000 Patient-Years) | Reference |
---|---|---|---|
Martinique | 1996–2006 | 0.20 | [5] |
Reunion (Indian Ocean) | 2000–2010 | 0.20 | [6] |
Guadeloupe | 1996–2006 | 0.30 | [5] |
Guadeloupe | 2013–2016 | 1.47 | [7] |
Florida | 2000–2011 | 5.6 | [8] |
French Polynesia (Pacific Ocean) | 2016 | 18.0 | [9] |
Virgin Islands | 1996–2006 | 19.9 | [5] |
Antigua | 1996–2006 | 34.4 | [5] |
Montserrat | 1996–2006 | 58.6 | [5] |
Pacific Island Countries and Territories | 1998–2008 | 194 | [10] |
Appendix B
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Clinical Characteristics | Prevalence or Value |
---|---|
General manifestations | 135/149 (91%) |
Body temperature † | 37.0 °C (36.0–37.1) |
Myalgia | 94/149 (63%) |
Pruritus | 94/149 (63%) |
Asthenia | 61/149 (41%) |
Hypothermia (temperature ≤36.5 °C) * | 26/66 (39%) |
Arthralgia | 54/149 (36%) |
Chills | 49/149 (33%) |
Headaches | 42/149 (28%) |
Dizziness | 34/149 (23%) |
Malaise | 28/149 (19%) |
Sweating | 6/149 (4%) |
Dyspnea | 5/149 (3%) |
Limb edema | 5/149 (3%) |
Gastrointestinal manifestations | 134/149 (90%) |
Diarrhea | 119/149 (80% |
Abdominal pain | 102/149 (69%) |
Nausea | 88/149 (59%) |
Vomiting | 80/149 (54%) |
Neurological manifestations | 108/149 (72%) |
Paresthesia | 77/149 (52%) |
Dysgeusia | 45/149 (30%) |
Impairment of feeling of hot and cold | 40/149 (27%) |
Touch disorder | 37/149 (25%) |
Dysuria | 25/149 (17%) |
Reversal of hot and cold | 24/149 (16%) |
Balance/coordination/language impairment | 24/149 (16%) |
Visual disturbance | 23/149 (15%) |
Behavioral disorder | 17/149 (11%) |
Pain in cold | 11/149 (7%) |
Cardiovascular manifestations | 33/149 (22%) |
Heart rate † | 69 bpm (50–87) |
Systolic blood pressure † | 112 mmHg (97–130) |
Diastolic blood pressure † | 68 mmHg (59–78) |
Bradycardia (heart rate <60 bpm) * | 24/66 (36%) |
Hypotension (systolic blood pressure <90 mmHg) * | 10/66 (15%) |
ECG abnormalities * | 10/66 (15%) |
Severe cardiovascular features #,* | 8/66 (12%) |
Palpitations | 5/149 (3%) |
Chronic manifestations ** | 31/77 (40%) |
Chronic pain | 20/77 (26%) |
Chronic neurological manifestations | 15/77 (20%) |
Chronic asthenia | 11/77 (14%) |
Chronic pruritus | 10/77 (13%) |
Management at the Emergency Department | Prevalence or Value |
---|---|
Supportive care | 42/66 (64%) |
Fluids (0.9% NaCl) | 11/66 (17%) |
20% mannitol infusion | 11/66 (17%) |
Intravenous atropine administration | 10/66 (15%) |
Hospitalization | 24/149 (16%) |
Length of hospital stay † | 1 days (1–2) |
Follow-up at the clinical toxicology consultation | 39/66 (59%) |
Incriminated Fish | Number of Incriminated Fish (N = 85) | Number of Intoxicated Patients (N = 149) |
---|---|---|
Carangidae (trevallies) | 50 | 87 |
Lutjanus buccanella (snapper) | 14 | 19 |
Scomberomorus regalis (king mackerel) | 4 | 10 |
Gymnothorax funebris (moray eel) | 3 | 4 |
Thunnus atlanticus (tuna) | 2 | 6 |
Coryphaena hippurus (sea bream) | 2 | 3 |
Syphyraena barracuda (barracuda) | 1 | 9 |
Epinephelus morio (grouper) | 1 | 1 |
Strobus gigas (spider conchs) | 1 | 1 |
Salmo salar (salmon) | 1 | 1 |
Mixed fish | 1 | 4 |
Not described | 4 | 4 |
Clinical Characteristics | Patients Intoxicated by Trevallies (Carangidae) (n = 87) | Patients Intoxicated by Other Fish Species (n = 58) | p-Value |
---|---|---|---|
Fish head or viscera ingestion (N = 144) | 20/86 (24%) | 5/58 (9%) | 0.03 |
Acute vomiting (N = 145) | 64/87 (74%) | 23/58 (40%) | <0.0001 |
Acute nausea (N = 145) | 61/87 (70%) | 24/58 (41%) | 0.001 |
Acute abdominal pain (N = 145) | 68/87 (78%) | 31/58 (53%) | 0.002 |
Acute hypotension (N = 64) | 14/35 (40%) | 5/29 (17%) | 0.05 |
Mannitol administration (N = 63) | 8/33 (24%) | 2/30 (6%) | 0.09 |
Persistent symptoms (N = 74) | 19/36 (50%) | 9/36 (25%) | 0.03 |
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Résière, D.; Florentin, J.; Mehdaoui, H.; Mahi, Z.; Gueye, P.; Hommel, D.; Pujo, J.; NKontcho, F.; Portecop, P.; Nevière, R.; et al. Clinical Characteristics of Ciguatera Poisoning in Martinique, French West Indies—A Case Series. Toxins 2022, 14, 535. https://doi.org/10.3390/toxins14080535
Résière D, Florentin J, Mehdaoui H, Mahi Z, Gueye P, Hommel D, Pujo J, NKontcho F, Portecop P, Nevière R, et al. Clinical Characteristics of Ciguatera Poisoning in Martinique, French West Indies—A Case Series. Toxins. 2022; 14(8):535. https://doi.org/10.3390/toxins14080535
Chicago/Turabian StyleRésière, Dabor, Jonathan Florentin, Hossein Mehdaoui, Zakaria Mahi, Papa Gueye, Didier Hommel, Jean Pujo, Flaubert NKontcho, Patrick Portecop, Rémi Nevière, and et al. 2022. "Clinical Characteristics of Ciguatera Poisoning in Martinique, French West Indies—A Case Series" Toxins 14, no. 8: 535. https://doi.org/10.3390/toxins14080535
APA StyleRésière, D., Florentin, J., Mehdaoui, H., Mahi, Z., Gueye, P., Hommel, D., Pujo, J., NKontcho, F., Portecop, P., Nevière, R., Kallel, H., & Mégarbane, B. (2022). Clinical Characteristics of Ciguatera Poisoning in Martinique, French West Indies—A Case Series. Toxins, 14(8), 535. https://doi.org/10.3390/toxins14080535