Ciguatera: a review.Hawaii Med J. 1992 Apr; 51(4):91-9.HM
Hawaii State Department of Health epidemiological records were reviewed for cases of ciguatera poisoning for the entire state, from January 1984 through December 1988. During the 5 year interval, the numbers of ciguatera poisoning incidents, number of cases, and date of onset were recorded, as well as age and sex of individuals involved. The place of catch of each fish was noted as well as whether or not the fish was obtained commercially. The parts of the fish consumed were also recorded. A total of 150 ciguatera incidents occurred during this period, involving 462 individuals for an average annual incidence rate of 8.7/100,000 population. The 3 most frequently implicated species of fish were the Carangoides species (jack or papio or ulua), Ctenochaetus strigosus (surgeon fish or kole), and Aphareus furcatus (fork-tailed snapper or waha nui); however, more than 50 species of fish had caused one or more outbreaks. The most frequently implicated areas of the toxic fish were the Kona coast as well as the South Point of the island of Hawaii, and the Napali coast of the island of Kauai. Of the 150 outbreaks, 32 (21%) were related to commercial fish. The rest were related to sportfishing.