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Ciguatera on Kauai: investigation of factors associated with severity of illness.
Katz, A R; Terrell-Perica, S; Sasaki, D M.
Afiliação
  • Katz AR; Department of Public Health Sciences, University of Hawaii School of Public Health, Honolulu.
Am J Trop Med Hyg ; 49(4): 448-54, 1993 Oct.
Article em En | MEDLINE | ID: mdl-8214273
Epidemiologic characterization of ciguatera fish poisoning has been limited by lack of laboratory confirmation, absence of prospective follow-up, and incomplete analysis of age-related factors. A 1985 outbreak on the island of Kauai in the state of Hawaii that involved 15 persons of various ages was investigated to determine factors associated with disease severity. The presence of ciguatoxin was detected in leftover portions of the implicated fish by enzyme immunoassay. All cases were medically and epidemiologically investigated and followed prospectively. Ten of the 15 cases demonstrated bradycardia; seven were hospitalized, including two requiring placement in intensive care. Bradycardia was associated with increasing age and body weight (P < 0.01 and < 0.05, respectively) as well as the amount of toxic fish consumed (P < 0.01). Duration of illness ranged from two to 132 days. Increasing duration of illness was correlated with both increasing age and weight (rs = 0.64 and rs = 0.72, respectively, both P < 0.01) and was independent of amount and components of toxic fish consumed. The correlation between increasing age and weight with duration and severity of symptoms may be explained by prior subclinical toxin exposure and is consistent with the observation that repeated ciguatoxin exposures are associated with more severe illness. The association between amount of toxic fish consumed and bradycardia is consistent with an increased dose of ciguatoxin. The findings of this outbreak investigation support previously unconfirmed observations.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Surtos de Doenças / Ciguatera / Doenças Transmitidas por Alimentos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Animals / Child / Child, preschool / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Am J Trop Med Hyg Ano de publicação: 1993 Tipo de documento: Article País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Surtos de Doenças / Ciguatera / Doenças Transmitidas por Alimentos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Animals / Child / Child, preschool / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Am J Trop Med Hyg Ano de publicação: 1993 Tipo de documento: Article País de publicação: Estados Unidos