Tags

Type your tag names separated by a space and hit enter

[First ciguatera outbreak in Germany in 2012].

Abstract

In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year. Two of them reported further neuropathies over almost three years. This is the first time that long-term persistence of symptoms has been documented in detail. Outbreak cases were allocated to eight clusters in seven German cities. A further cluster was prevented by the successful recall of ciguatoxic fish. Three clusters were confirmed by the detection of ciguatoxin in samples of suspicious and recalled fish. An extrapolation on the basis of ciguatoxic samples revealed twenty prevented cases of ciguatera. Further officially unknown cases should be assumed. During the outbreak investigations, inadvertently falsely labelled fish species and fishing capture areas on import and retail level documents were observed. The ascertainment of cases and the outbreak investigations proved to be difficult due to inconsistent case reports to poisons centers, local health and veterinary authorities. In Germany, many physicians are unaware of the disease pattern of ciguatera and the risks caused by tropical fish. The occurrence of further outbreaks during the following years emphasizes the increasing significance of ciguatera in Germany.

Authors+Show Affiliations

Dokumentation und Bewertung von Vergiftungen, Bundesinstitut für Risikobewertung (BfR), Diedersdorfer Weg 1, 12277, Berlin, Deutschland. miriam.friedemann@bfr.bund.de.

Pub Type(s)

Journal Article

Language

ger

PubMed ID

27778083

Citation

Friedemann, Miriam. "[First Ciguatera Outbreak in Germany in 2012]." Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, vol. 59, no. 12, 2016, pp. 1556-1565.
Friedemann M. [First ciguatera outbreak in Germany in 2012]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016;59(12):1556-1565.
Friedemann, M. (2016). [First ciguatera outbreak in Germany in 2012]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 59(12), 1556-1565.
Friedemann M. [First Ciguatera Outbreak in Germany in 2012]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016;59(12):1556-1565. PubMed PMID: 27778083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [First ciguatera outbreak in Germany in 2012]. A1 - Friedemann,Miriam, PY - 2016/10/26/pubmed PY - 2017/5/19/medline PY - 2016/10/26/entrez KW - Ciguatera KW - Ciguatoxin KW - Lutjanus malabaricus KW - Outbreak KW - Red snapper SP - 1556 EP - 1565 JF - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz JO - Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz VL - 59 IS - 12 N2 - In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year. Two of them reported further neuropathies over almost three years. This is the first time that long-term persistence of symptoms has been documented in detail. Outbreak cases were allocated to eight clusters in seven German cities. A further cluster was prevented by the successful recall of ciguatoxic fish. Three clusters were confirmed by the detection of ciguatoxin in samples of suspicious and recalled fish. An extrapolation on the basis of ciguatoxic samples revealed twenty prevented cases of ciguatera. Further officially unknown cases should be assumed. During the outbreak investigations, inadvertently falsely labelled fish species and fishing capture areas on import and retail level documents were observed. The ascertainment of cases and the outbreak investigations proved to be difficult due to inconsistent case reports to poisons centers, local health and veterinary authorities. In Germany, many physicians are unaware of the disease pattern of ciguatera and the risks caused by tropical fish. The occurrence of further outbreaks during the following years emphasizes the increasing significance of ciguatera in Germany. SN - 1437-1588 UR - https://www.unboundmedicine.com/medline/citation/27778083/[First_ciguatera_outbreak_in_Germany_in_2012]_ L2 - https://dx.doi.org/10.1007/s00103-016-2456-y DB - PRIME DP - Unbound Medicine ER -