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Outbreak of ciguatera fish poisoning on a cargo ship in the port of hamburg.
J Travel Med. 2012 Jul; 19(4):238-42.JT

Abstract

BACKGROUND

Ciguatera fish poisoning is a travel-related illness characterized by a combination of gastrointestinal and neurological symptoms in persons who eat ciguatoxic seafood in endemic areas.

METHODS

In 2009, an outbreak of the disease on a refrigerator vessel in the port of Hamburg was investigated. The ship's crew fell ill after they ate fish from a catch in the Caribbean 2 weeks earlier. All 15 sailors on board were examined by port medical officers. Samples of blood and stool specimens were taken from symptomatic sailors. The frozen fish was secured for the prevention of further disease spreading and additional diagnostic tests.

RESULTS

All but one sailor ate the fish. The intoxication resulted in gastrointestinal or neurological symptoms in all 14 sailors who consumed the fish and persisted in varying degrees in 93% of sailors over at least 14 days. No fatality occurred, but two seamen were "unfit for duty" on the ship due to severity of symptoms. The diagnosis was supported by the fact that all seafarers who consumed the same reef fish, experienced typical signs, symptoms, and time course consistent with ciguatera fish poisoning. The fish from the catch in the Caribbean was identified as Caranx sexfasciatus (Bigeye Trevally) and Cephalopholis miniata (Red Grouper). An experimental assay later confirmed presence of the ciguatoxin in the fish.

CONCLUSIONS

Sailors are an occupational group at risk for ciguatera fish poisoning due to potentially unsafe food sources during international travel. Even if no fatality occurred, the disease affected marine operations due to high attack rates and chronicity of symptoms. Medical doctors must be aware that ciguatera fish poisoning is a risk for seafarers traveling in tropical and subtropical areas. Stocking of food in affected ports from safe sources, adequate training of ship cooks, and informing sailors about the risk of fishing are needed to prevent disease occurrence in seafarers in international trade and traffic.

Authors+Show Affiliations

Hamburg Port Health Center, Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstraβe 10, Hamburg, Germany. Clara.Schlaich@jhu.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22776385

Citation

Schlaich, Clara, et al. "Outbreak of Ciguatera Fish Poisoning On a Cargo Ship in the Port of Hamburg." Journal of Travel Medicine, vol. 19, no. 4, 2012, pp. 238-42.
Schlaich C, Hagelstein JG, Burchard GD, et al. Outbreak of ciguatera fish poisoning on a cargo ship in the port of hamburg. J Travel Med. 2012;19(4):238-42.
Schlaich, C., Hagelstein, J. G., Burchard, G. D., & Schmiedel, S. (2012). Outbreak of ciguatera fish poisoning on a cargo ship in the port of hamburg. Journal of Travel Medicine, 19(4), 238-42. https://doi.org/10.1111/j.1708-8305.2012.00619.x
Schlaich C, et al. Outbreak of Ciguatera Fish Poisoning On a Cargo Ship in the Port of Hamburg. J Travel Med. 2012;19(4):238-42. PubMed PMID: 22776385.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outbreak of ciguatera fish poisoning on a cargo ship in the port of hamburg. AU - Schlaich,Clara, AU - Hagelstein,Jan-Gerd, AU - Burchard,Gerd-Dieter, AU - Schmiedel,Stefan, PY - 2012/7/11/entrez PY - 2012/7/11/pubmed PY - 2013/5/29/medline SP - 238 EP - 42 JF - Journal of travel medicine JO - J Travel Med VL - 19 IS - 4 N2 - BACKGROUND: Ciguatera fish poisoning is a travel-related illness characterized by a combination of gastrointestinal and neurological symptoms in persons who eat ciguatoxic seafood in endemic areas. METHODS: In 2009, an outbreak of the disease on a refrigerator vessel in the port of Hamburg was investigated. The ship's crew fell ill after they ate fish from a catch in the Caribbean 2 weeks earlier. All 15 sailors on board were examined by port medical officers. Samples of blood and stool specimens were taken from symptomatic sailors. The frozen fish was secured for the prevention of further disease spreading and additional diagnostic tests. RESULTS: All but one sailor ate the fish. The intoxication resulted in gastrointestinal or neurological symptoms in all 14 sailors who consumed the fish and persisted in varying degrees in 93% of sailors over at least 14 days. No fatality occurred, but two seamen were "unfit for duty" on the ship due to severity of symptoms. The diagnosis was supported by the fact that all seafarers who consumed the same reef fish, experienced typical signs, symptoms, and time course consistent with ciguatera fish poisoning. The fish from the catch in the Caribbean was identified as Caranx sexfasciatus (Bigeye Trevally) and Cephalopholis miniata (Red Grouper). An experimental assay later confirmed presence of the ciguatoxin in the fish. CONCLUSIONS: Sailors are an occupational group at risk for ciguatera fish poisoning due to potentially unsafe food sources during international travel. Even if no fatality occurred, the disease affected marine operations due to high attack rates and chronicity of symptoms. Medical doctors must be aware that ciguatera fish poisoning is a risk for seafarers traveling in tropical and subtropical areas. Stocking of food in affected ports from safe sources, adequate training of ship cooks, and informing sailors about the risk of fishing are needed to prevent disease occurrence in seafarers in international trade and traffic. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/22776385/Outbreak_of_ciguatera_fish_poisoning_on_a_cargo_ship_in_the_port_of_hamburg_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/j.1708-8305.2012.00619.x DB - PRIME DP - Unbound Medicine ER -