Table 1.
Outbreaks of ciguatera in the coastal cities of southern China.
| City (Reference) | Period | Sex | Age (year) d | Details |
|---|---|---|---|---|
| Xiamen | ||||
| [15] a | 2/2005 | 29M/F c | (9–66) | 3 outbreaks (n = 6–11 in each), after eating portions of large tiger grouper, fish size reflected by the weight of left-over portions (~5 kg), 16 subjects hospitalized |
| Dongguan | ||||
| [16] | 10/2004 | 6M7F | (23–66) | 1 outbreak (n = 14), after sharing a reef fish, 13 subjects admitted to hospital after eating the flesh with skin plus fish head (n = 4), fish belly (n = 8) or fish viscera (n = 4), 1 subject who ate only the flesh had minimal symptoms |
| Foshan | ||||
| [17] | 2004 | 20M/F c | - c | 1 outbreak (n = 20), after sharing a grouper (11.5 kg), 2 subjects hospitalized in cardiac center |
| [18] | 11/2004 | 12M29F | 42(21–92) | 1 outbreak (n = 41), after eating giant grouper, all 41 subjects hospitalized |
| [19] a | 11/2004 | 17M27F | (11–64) | 1 outbreak (n > 100), after eating tiger grouper in a banquet, 44 subjects admitted to this hospital |
| [20] | 11/2004 | 1M1F | (44–47) | 1 outbreak (n > 10), after sharing a grouper, 2 subjects admitted to this hospital |
| [21] | 1/2004–12/2006 | 16M26F | 41(11–60) | 3 outbreaks (n = 42), after eating tiger grouper or leopard coral grouper, all 42 subjects hospitalized |
| Guangzhou | ||||
| [22] | 1–4/1999 | 4M5F | 45(5–80) | 9 subjects hospitalized, after eating moray eel (flesh or viscera) |
| Shantou | ||||
| [23] | 3/1998–4/1999 | 18M7F | (1.4–58) | 6 (4 in 1998, 2 in 1999) outbreaks (n = 3–6 in each), after eating tiger grouper (n = 4) or sea bass (n = 2), 25 subjects hospitalized |
| [24] | 6/2000–12/2004 | 61M21F | (3–68) | 82 subjects hospitalized, after eating humphead wrasse, tiger grouper, flowery grouper, areolated coral grouper, etc. |
| [25,26] a | 8/2004 | 48M16F | (4–76) | 1 outbreak (n = 64), after sharing 2 tiger groupers (>7 kg each), all 64 subjects hospitalized, concomitant alcohol consumption (23 out of 59 subjects) increased the risk of bradycardia (78% vs. 19%), hypotension (48% vs. 14%) and altered skin sensation (96% vs. 42%) |
| Shenzhen | ||||
| [11] b | 10/2003–10/2004 | 14M18F | 45(12–68) | 32 subjects hospitalized (n = 2–16 in each outbreak), after eating humphead wrasse |
| [27] | 1–12/2004 | - c | - c | 4 outbreaks, 60 subjects affected, caused by humphead wrasse (n = 3) or leopard coral grouper (n = 1) |
| [28] b | 10/2004 | 18M8F | 46(21–62) | 26 subjects hospitalized, after sharing a humphead wrasse (14.5 kg) |
| [29] b | 10/2004 | 24M15F | (2–78) | 7 outbreaks (n = 3–12 in each), after eating humphead wrasse |
| [30] | 1/2005–12/2006 | - c | - c | 3 outbreaks, 36 subjects affected, caused by humphead wrasse (n = 2) or leopard coral grouper (n = 1) |
| Yangjiang | ||||
| [31] | 4/2005–12/2008 | 10M7F | 30(13–60) | 4 outbreaks, caused by humphead wrasse, leopard coral grouper or tiger grouper, size 2.0–4.3 kg, 17 subjects with cardiovascular features hospitalized |
| Zhongshan | ||||
| [12] | 4/1994–12/2003 | 33M53F | 38(8–87) | 86 out of 358 subjects with cardiovascular features, after eating tiger grouper, leopard coral grouper or sea bass, size 1.5–2.5 kg, concomitant alcohol consumption in 85% of males |
| [32] | 11/2004 | 54M78F | 43 | 1 outbreak, after eating reef fish (tiger grouper e) in a banquet, 132 subjects admitted to this hospital |
| [33] a | 11/2004 | 36M27F | 43(23–70) | 1 outbreak (n > 200), after eating tiger grouper in a banquet, 63 subjects admitted to this hospital |
| Zhuhai | ||||
| [34] | 5–7/2004 | 9M6F | 42(26–73) | 15 subjects hospitalized, after eating flowery grouper (n = 10) or grouper (n = 5) |
| [35] | 6/2005 | 1M1F | (36–41) | 2 subjects hospitalized, after eating humphead wrasse (flesh and viscera) |
Refer to references a [2] and b [3] for details on signs and symptoms of ciguatera; All were hospital-based studies, except reports [15], [27] and [30] from the local health authorities with incomplete data; c The sex or age distribution was not stated; d Age as mean (range), except for median (range) for report [12]; eThe fish species involved was not specified, but according to [33], it was tiger grouper.