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Epidemiology and Clinical Features of Ciguatera Fish Poisoning in Hong Kong

1
Division of Clinical Pharmacology and Drug and Poisons Information Bureau, Department of Medicine and Therapeutics, Faculty of Medicine, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
2
Centre for Food and Drug Safety, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China
Toxins 2014, 6(10), 2989-2997; https://doi.org/10.3390/toxins6102989
Received: 25 August 2014 / Revised: 9 October 2014 / Accepted: 14 October 2014 / Published: 20 October 2014
(This article belongs to the Section Marine and Freshwater Toxins)
In the present review, the main objective was to describe the epidemiology and clinical features of ciguatera fish poisoning in Hong Kong. From 1989 to 2008, the annual incidence of ciguatera varied between 3.3 and 64.9 (median 10.2) per million people. The groupers have replaced the snappers as the most important cause of ciguatera. Pacific-ciguatoxins (CTX) are most commonly present in reef fish samples implicated in ciguatera outbreaks. In affected subjects, the gastrointestinal symptoms often subside within days, whereas the neurological symptoms can persist for weeks or even months. Bradycardia and hypotension, which can be life-threatening, are common. Treatment of ciguatera is primarily supportive and symptomatic. Intravenous mannitol (1 g/kg) has also been suggested. To prevent ciguatera outbreaks, the public should be educated to avoid eating large coral reef fishes, especially the CTX-rich parts. A Code of Practice on Import and Sale of Live Marine Fish for Human Consumption for Prevention and Control of Ciguatera Fish Poisoning was introduced from 2004 to 2013. The Food Safety Ordinance with a tracing mechanism came into full effect in February 2012. The Government would be able to trace the sources of the fishes more effectively and take prompt action when dealing with ciguatera incidents. View Full-Text
Keywords: ciguatera; ciguatoxins; groupers; Hong Kong ciguatera; ciguatoxins; groupers; Hong Kong
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Chan, T.Y.K. Epidemiology and Clinical Features of Ciguatera Fish Poisoning in Hong Kong. Toxins 2014, 6, 2989-2997.

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