Study of factors that influence the clinical response to ciguatera fish poisoning.

A one-year observational study of all standardized medical records of ciguatera fish poisoning notified cases was conducted in French Polynesia. The objective was to determine the factors that influence the clinical response to ciguatera fish poisoning. During the year 1991, there were 551 cases notified on standardized code sheets by physicians (notification rate 276 per 100,000). The mean age was 36.6 years (SD 15.6). The largest age group was the 30- to 39-year-old one (138 cases, notification rate 970 per 100,000). Sex ratio (M/F) was 1.6. A clinical score was calculated to assess the outcome for each case. The adjusted odds ratio (OR) for a severe disease (33.2% with a score > 5) were significantly increased when the fish ingested was carnivorous (OR = 1.62, 95% Confidence Interval (CI): 1.07-2.45) and when a history of a previous attack was reported (OR = 1.71, 95% CI: 1.17-2.5). Men aged 30-39 years are at a higher risk to get ciguatera fish poisoning, whatever its severity. Severe diseases were observed when the ingested fish was carnivorous and in patients experiencing their second or more attack. This later finding could be related to an accumulation of toxin in the human organism.