HISTORICAL ANALYSIS OF CIGUATERA INCIDENCE IN THE CARIBBEAN ISLANDS DURING 31 YEARS: 1980-2010

Abstract

Ciguatera fih poisoning is a seafood-borne illness caused by the consumption of fih that have accumulated lipid-soluble ciguatoxins, produced by dinoflgellates of the genera Gambierdiscus, Ostreopsis, Coolia and Prorocentrum. The true extent of the disease and its impact on tourism and public health on the Caribbean islands is poorly understood. For this reason, we analyze the incidence of ciguatera in the Caribbean states (CS) and San Andrés Island (SAI), seeking spatial and temporal trends. Through epidemiological reports obtained from the Caribbean Epidemiology Centre (CAREC) and the Departmental Health Secretariat of SAI, the per capita incidence of ciguatera has been calculated for the periods 1980 to 2010 and 2007 to 2011, respectively. Subsequently the data were analyzed using t tests, incidence rate ratio and rank correlation. The data show that, over the period 1980-2010, there were 10 710 cases reported from 18 CAREC countries, with an average annual incidence of 42/100 000. There was an increase between the periods 1980-1990 and 2000-2010 with annual averages calculated from reported cases of 34.2 and 45.2 / 100 000 respectively. The island of Montserrat presented the highest incidence in the region, 350 / 100 000 while SAI showed an incidence of 25/100 000 inhabitants, occupying the eighth position among the analyzed islands. The rate ratio (average annual incidence 2000-2010 / average annual incidence 1980-1990) was 1.36, so there was a 32% increase in the average annual incidence among CAREC countries and almost 300% between the two time periods. The ciguatera incidence level in the Caribbean has increased over the last 31 years, mainly in the Eastern Caribbean. The Bahamas, Antigua and Barbuda contribute greatly to the reported increase. Considering that the development model of much of the region is based on the tourism industry and that fih is a major protein source for Caribbean communities, it can be concluded that ciguatera is a growing problem which is expected to increase in parallel with environmental change.