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Ciguatera and scombroid fish poisoning in the United States.
Foodborne Pathog Dis. 2013 Dec; 10(12):1059-66.FP

Abstract

BACKGROUND

Ciguatera and scombroid fish poisonings are common causes of fish-related foodborne illness in the United States; however, existing surveillance systems underestimate the overall human health impact.

OBJECTIVES

This study aimed to describe existing data on ciguatera and scombroid fish poisonings from outbreak and poison control center reports and to estimate the overall number of ciguatera and scombroid fish-poisoning illnesses, hospitalizations, and deaths in the United States.

METHODS

We analyzed outbreak data from the Foodborne Disease Outbreak Surveillance Systems (FDOSS) from 2000 to 2007 and poison control center call data from the National Poison Data System (NPDS) from 2005 to 2009 for reports of ciguatera and scombroid fish poisonings. Using a statistical model with many inputs, we adjusted the outbreak data for undercounting due to underreporting and underdiagnosis to generate estimates. Underreporting and underdiagnosis multipliers were derived from the poison control call data and the published literature.

RESULTS

Annually, an average of 15 ciguatera and 28 scombroid fish-poisoning outbreaks, involving a total of 60 and 108 ill persons, respectively, were reported to FDOSS (2000-2007). NPDS reported an average of 173 exposure calls for ciguatoxin and 200 exposure calls for scombroid fish poisoning annually (2005-2009). After adjusting for undercounting, we estimated 15,910 (90% credible interval [CrI] 4140-37,408) ciguatera fish-poisoning illnesses annually, resulting in 343 (90% CrI 69-851) hospitalizations and three deaths (90% CrI 1-7). We estimated 35,142 (90% CrI: 10,496-78,128) scombroid fish-poisoning illnesses, resulting in 162 (90% CrI 0-558) hospitalizations and 0 deaths.

CONCLUSIONS

Ciguatera and scombroid fish poisonings affect more Americans than reported in surveillance systems. Although additional data can improve these assessments, the estimated number of illnesses caused by seafood intoxication illuminates this public health problem. Efforts, including education, can reduce ciguatera and scombroid fish poisonings.

Authors+Show Affiliations

1 National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention , Atlanta, Georgia .No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24093307

Citation

Pennotti, Radha, et al. "Ciguatera and Scombroid Fish Poisoning in the United States." Foodborne Pathogens and Disease, vol. 10, no. 12, 2013, pp. 1059-66.
Pennotti R, Scallan E, Backer L, et al. Ciguatera and scombroid fish poisoning in the United States. Foodborne Pathog Dis. 2013;10(12):1059-66.
Pennotti, R., Scallan, E., Backer, L., Thomas, J., & Angulo, F. J. (2013). Ciguatera and scombroid fish poisoning in the United States. Foodborne Pathogens and Disease, 10(12), 1059-66. https://doi.org/10.1089/fpd.2013.1514
Pennotti R, et al. Ciguatera and Scombroid Fish Poisoning in the United States. Foodborne Pathog Dis. 2013;10(12):1059-66. PubMed PMID: 24093307.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ciguatera and scombroid fish poisoning in the United States. AU - Pennotti,Radha, AU - Scallan,Elaine, AU - Backer,Lorraine, AU - Thomas,Jerry, AU - Angulo,Frederick J, Y1 - 2013/10/05/ PY - 2013/10/8/entrez PY - 2013/10/8/pubmed PY - 2015/4/17/medline SP - 1059 EP - 66 JF - Foodborne pathogens and disease JO - Foodborne Pathog Dis VL - 10 IS - 12 N2 - BACKGROUND: Ciguatera and scombroid fish poisonings are common causes of fish-related foodborne illness in the United States; however, existing surveillance systems underestimate the overall human health impact. OBJECTIVES: This study aimed to describe existing data on ciguatera and scombroid fish poisonings from outbreak and poison control center reports and to estimate the overall number of ciguatera and scombroid fish-poisoning illnesses, hospitalizations, and deaths in the United States. METHODS: We analyzed outbreak data from the Foodborne Disease Outbreak Surveillance Systems (FDOSS) from 2000 to 2007 and poison control center call data from the National Poison Data System (NPDS) from 2005 to 2009 for reports of ciguatera and scombroid fish poisonings. Using a statistical model with many inputs, we adjusted the outbreak data for undercounting due to underreporting and underdiagnosis to generate estimates. Underreporting and underdiagnosis multipliers were derived from the poison control call data and the published literature. RESULTS: Annually, an average of 15 ciguatera and 28 scombroid fish-poisoning outbreaks, involving a total of 60 and 108 ill persons, respectively, were reported to FDOSS (2000-2007). NPDS reported an average of 173 exposure calls for ciguatoxin and 200 exposure calls for scombroid fish poisoning annually (2005-2009). After adjusting for undercounting, we estimated 15,910 (90% credible interval [CrI] 4140-37,408) ciguatera fish-poisoning illnesses annually, resulting in 343 (90% CrI 69-851) hospitalizations and three deaths (90% CrI 1-7). We estimated 35,142 (90% CrI: 10,496-78,128) scombroid fish-poisoning illnesses, resulting in 162 (90% CrI 0-558) hospitalizations and 0 deaths. CONCLUSIONS: Ciguatera and scombroid fish poisonings affect more Americans than reported in surveillance systems. Although additional data can improve these assessments, the estimated number of illnesses caused by seafood intoxication illuminates this public health problem. Efforts, including education, can reduce ciguatera and scombroid fish poisonings. SN - 1556-7125 UR - https://www.unboundmedicine.com/medline/citation/24093307/Ciguatera_and_scombroid_fish_poisoning_in_the_United_States_ L2 - https://www.liebertpub.com/doi/10.1089/fpd.2013.1514?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -