Incidence and epidemiological characteristics of ciguatera cases in Europe
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Abstract
The present document corresponds to the final report (deliverable No. 7) of the specific agreement (SA 2) “To determine the incidence and epidemiological characteristics of ciguatera cases in Europe” within the Framework Partnership Agreement GP/EFSA/AFSCO/2015/03 “Risk characterization of ciguatera food poisoning in Europe”. This report summarises the activities performed, results and conclusions obtained in the specific agreement. The objective of the SA2 was to estimate the incidence and to describe the epidemiological characteristics of ciguatera in the EU/EEA. A protocol for a harmonized ciguatera surveillance in the European Union (EU)/Economic European Area (EEA) was elaborated. The protocol includes a ciguatera case definition and questionnaires for collecting information on ciguatera cases or outbreak. Around half of the countries answered the data call for reporting cases. Four countries reported 34 outbreaks from 2012 to 2019. Spain and Portugal reported outbreaks due to consumption of fish captured in the Canary Islands and Madeira (autochthonous outbreaks), mainly due to consumption of Seriola spp. and Ephinephelus spp. In more than half of these outbreaks, the fish was captured by sport fishing. Germany and France reported outbreaks due to consumption of fish imported from outside the EU (imported outbreaks, mainly Lutjanus spp). Spain, Germany and France reported outbreaks in travellers to tropical endemic territories (travel related outbreaks). All the outbreaks cases presented neurological symptoms, most of them had also gastrointestinal symptoms and few outbreak cases mentioned cardiovascular symptoms. Six countries (Austria, France, Germany, Portugal, Spain and Switzerland) reported 34 single cases. The incidence rate in the EU/EEA was very low (0.0054 cases per 100.000 inhabitants per year). The incidence rate in the Canary Islands was higher 0.47 cases/100.000 inhabitants.