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Prevalence of Chronic Symptoms of Ciguatera Disease in French Polynesian Adults

Ciguatera is a tropical disease caused by seafood poisoning, for which the duration of symptoms remains to be determined. The objectives of this prospective study were to determine the prevalence of symptoms at different time points and to identify factors associated with chronic symptoms observed in adults suffering from this disease. At the time of onset, we observed a dose–response relationship including a strong association between the delay of appearance of symptoms and a severity index (P < 0.001). Our results confirmed the key role of fish organs in the risk of contracting a more severe form of ciguatera. In the chronic stage, only the severity score based on information recorded in the acute phase is related to the persistence of symptoms (P < 0.001). Our findings suggest that several symptoms observed in the acute phase of the disease are still experienced 15 days after onset. This supports previous observations based on isolated case reports.

Received May 26, 2005. Accepted for publication August 15, 2007.

Acknowledgments: The authors thank the Centers for Disease Control and Prevention (CDC) and Pan American Health Organization (PAHO) for financial support of the study. We are grateful to local general practitioners for their participation to this study, to patients for their cooperation, and to ILM’s research nurses for their help. We also thank Ms. Susan Gingras and Mr. Elhadji A. Laouan Sidi for their expert advice on statistical analysis.

^* Address correspondence to Eric Dewailly, Public Health Research Unit, Laval University Medical Research Center, CHUL, CHUQ, Québec, Canada. E-mail: eric.dewailly{at}crchul.ulaval.ca

Authors’ addresses: Eric Dewailly and Marie-Ludivine Chateau-Degat, Public Health Research Unit, Laval University Hospital Research Centre (CHUQ), 945 Avenue Wolfe, 2nd floor, Sainte-Foy, Québec G1V 5B3, Canada, Telephone: +1 (418) 650-5115, ext. 5240, Fax: +1 (418) 654-3132. Marie-Odile Huin-Blondey, Direction de la Santé Service de Protection Maternelle, BP 527 Papeete, Tahiti, French Polynesia, Telephone/Fax: +689-81-29-92. Mireille Chinain and Taiana Darius, Laboratoire Microalgues Toxiques, Institut Louis Malardé, BP 30, 98713 Papeete, Tahiti, French Polynesia, Telephone: +689-41-64-58, Fax: +689-43-15-90. Anne-Marie Legrand and René Chansin, Institut Louis Malardé, BP 30, 98713 Papeete, Tahiti, French Polynesia, Telephone: +689-41-64-60, Fax: +689-43-15-90. Ngoc Lam Nguyen, Centre de Consultation Médicale et d’Investigation Epidémiologique, Institut Louis Malardé, BP 30, 98713 Papeete, Tahiti, French Polynesia, Telephone: +689-41-64-53, Fax: +689-43-15-90. François Laudon, Direction de la Santé Service de Protection Maternelle, BP5287- 98716, Pirea, Tahiti, Telephone: +689-50-91-75, Fax: +689-3-67-35.