{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:00:30Z","timestamp":1792692030880,"version":"4.5.0"},"reference-count":25,"publisher":"American Chemical Society (ACS)","issue":"4","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":2166,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Although ciguatera fish poisoning (CFP) is the most common seafood intoxication worldwide, its burden has been difficult to establish because there are no biomarkers to diagnose human exposure.<\/jats:p>\n                  <jats:p>Objective: We explored the incidence of CFP, percentage of CFP case-patients with laboratory-confirmed ciguatoxic meal remnants, cost of CFP illness, and potential risk factors for CFP.<\/jats:p>\n                  <jats:p>Methods: During 2005 and again during 2006, we conducted a census of all occupied households on the island of Culebra, Puerto Rico, where locally caught fish are a staple food. We defined CFP case-patients as persons with gastrointestinal symptoms (abdominal pain, vomiting, diarrhea, or nausea) and neurological symptoms (extremity paresthesia, arthralgia, myalgia, malaise, pruritus, headache, dizziness, metallic taste, visual disturbance, circumoral paresthesia, temperature reversal, or toothache) or systemic symptoms (e.g., bradycardia) within 72 hr of eating fish during the previous year. Participants were asked to save fish remnants eaten by case-patients for ciguatoxin analysis at the Food and Drug Administration laboratory in Dauphin Island, Alabama (USA).<\/jats:p>\n                  <jats:p>Results: We surveyed 340 households during 2005 and 335 households during 2006. The estimated annual incidence of possible CFP was 4.0 per 1,000 person-years, and that of probable CFP was 7.5 per 1,000 person-years. One of three fish samples submitted by probable case-patients was positive for ciguatoxins. None of the case-patients required respiratory support. Households that typically consumed barracuda were more likely to report CFP (p = 0.02).<\/jats:p>\n                  <jats:p>Conclusions: Our estimates, which are consistent with previous studies using similar case findings, contribute to the overall information available to support public health decision making about CFP prevention.<\/jats:p>","DOI":"10.1289\/ehp.1104003","type":"journal-article","created":{"date-parts":[[2012,1,24]],"date-time":"2012-01-24T13:27:50Z","timestamp":1327411670000},"page":"526-529","source":"Crossref","is-referenced-by-count":19,"title":["Assessing the Incidence of Ciguatera Fish Poisoning with Two Surveys Conducted in Culebra, Puerto Rico, during 2005 and 2006"],"prefix":"10.1021","volume":"120","author":[{"given":"Eduardo","family":"Azziz-Baumgartner","sequence":"first","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Luber","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Conklin","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Tosteson","sequence":"additional","affiliation":[{"name":"University of Puerto Rico, Mayag\u00fcez, Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hudson R.","family":"Granade","sequence":"additional","affiliation":[{"name":"Food and Drug Administration Gulf Coast Seafood Laboratory, Dauphin Island, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W.","family":"Dickey","sequence":"additional","affiliation":[{"name":"Food and Drug Administration Gulf Coast Seafood Laboratory, Dauphin Island, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine C.","family":"Backer","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2012,1,24]]},"reference":[{"key":"2026080314055929700_micit1","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0041-0101(80)90074-4","article-title":"Origins of ciguatera fish poisoning: a new dinoflagellate Gambierdicsus toxicus Adachi and Fukuyo definitively involved as a causal agent.","volume":"18","author":"Bagnis","year":"1980","journal-title":"Toxicon"},{"key":"2026080314055929700_micit2","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.4269\/ajtmh.1979.28.1067","article-title":"Clinical observations on 3,009 cases of ciguatera (fish poisoning) in the South Pacific.","volume":"28","author":"Bagnis","year":"1979","journal-title":"Am J Trop Med Hyg"},{"key":"2026080314055929700_micit3","first-page":"465","article-title":"Mannitol therapy for acute and chronic ciguatera fish poisoning.","volume":"34","author":"Blythe","year":"1994","journal-title":"Mem Queensland Mus"},{"key":"2026080314055929700_micit4","article-title":"The medical management of seafood poisoning","author":"Blythe","year":"2001"},{"key":"2026080314055929700_micit5","first-page":"283","article-title":"Cluster of ciguatera fish poisoning in North Carolina, 2007.","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026080314055929700_micit6","doi-asserted-by":"crossref","DOI":"10.1201\/9781420007541.ch22","article-title":"Ciguatera toxins: chemistry, toxicology and detection","author":"Dickey","year":"2008"},{"key":"2026080314055929700_micit7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.toxicon.2009.09.008","article-title":"Ciguatera: a public health perspective.","volume":"56","author":"Dickey","year":"2010","journal-title":"Toxicon"},{"key":"2026080314055929700_micit8","first-page":"14","article-title":"Identification and epidemiological analysis of ciguatera cases in Puerto Rico.","volume":"48","author":"Escalona de Motta","year":"1986","journal-title":"Mar Fish Rev"},{"key":"2026080314055929700_micit9","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3390\/md6030456","article-title":"Ciguatera fish poisoning: treatment, prevention and management.","volume":"6","author":"Friedman","year":"2008","journal-title":"Mar Drugs"},{"key":"2026080314055929700_micit10","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1289\/ehp.1002575","article-title":"Critical issues in the development of health information systems in supporting environmental health: a case study of ciguatera.","volume":"119","author":"Goater","year":"2011","journal-title":"Environ Health Perspect"},{"key":"2026080314055929700_micit11","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1001\/jama.1981.03310300020008","article-title":"Ciguatera fish poisoning in the Virgin Islands","volume":"245","author":"Hanno","year":"1981","journal-title":"JAMA"},{"key":"2026080314055929700_micit12","first-page":"177","article-title":"An analysis of poison control center reports of ciguatera toxicity in Puerto Rico for one year.","volume":"22","author":"Holt","year":"1984","journal-title":"Clin Toxicol"},{"key":"2026080314055929700_micit13","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1001\/jama.1980.03310030030021","article-title":"Ciguatera fish poisoning in Miami.","volume":"244","author":"Lawrence","year":"1980","journal-title":"JAMA"},{"key":"2026080314055929700_micit14","first-page":"138","article-title":"Ciguatera fish poisoning\u2014St. Croix, Virgin Islands of the United States.","volume":"30","author":"Lewis","year":"1981","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026080314055929700_micit15","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0041-0101(00)00161-6","article-title":"The changing face of ciguatera.","volume":"39","author":"Lewis","year":"2001","journal-title":"Toxicon"},{"key":"2026080314055929700_micit16","article-title":"Physician diagnosis and reporting of ciguatera fish poisoning in an endemic area","author":"McKee","year":"2001"},{"key":"2026080314055929700_micit17","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0733-8627(05)70289-3","article-title":"Poisonings food, fish, shellfish.","volume":"15","author":"Mines","year":"1997","journal-title":"Emerg Med Clin North 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Profiles of General Demographic Characteristics: 2000 Census of Population and Housing. Table DP-1. Profile of General Demographic Characteristics: 2000; Geographic Area: Culebra Municipio, Puerto Rico. Washington, DC:U.S. Department of Commerce.Available: http:\/\/www.census.gov\/prod\/cen2000\/dp1\/2kh72.pdf [accessed 4 October 2010]."},{"key":"2026080314055929700_micit23","unstructured":"U.S. Department of Labor\n          . 2005. Labor Force Statistics from the Current Population Survey.Available: http:\/\/www.bls.gov\/cps\/minwage2004.htm [accessed 4 October 2010]."},{"key":"2026080314055929700_micit24","doi-asserted-by":"crossref","first-page":"S127","DOI":"10.1086\/381578","article-title":"FoodNet estimate of the burden of illness caused by nontyphoidal salmonella infections in the United States.","volume":"38","author":"Voetsch","year":"2004","journal-title":"Clin Infect Dis"},{"key":"2026080314055929700_micit25","unstructured":"World Health Organization\n          . 2010. CHOosing Interventions that are Cost Effective (WHO-CHOICE).Available: http:\/\/www.who.int\/choice\/en\/ [accessed 5 October 2010]."}],"container-title":["Environmental Health Perspectives"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pubs.acs.org\/evhpaz\/article-pdf\/120\/4\/526\/66374100\/ehp.1104003.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/pubs.acs.org\/evhpaz\/article-pdf\/120\/4\/526\/66374100\/ehp.1104003.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:56:42Z","timestamp":1786629402000},"score":1,"resource":{"primary":{"URL":"https:\/\/pubs.acs.org\/evhpaz\/article-lookup\/doi\/10.1289\/ehp.1104003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1,24]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2012,1,24]]},"published-print":{"date-parts":[[2012,4,1]]}},"URL":"https:\/\/doi.org\/10.1289\/ehp.1104003","relation":{},"ISSN":["0091-6765","1552-9924"],"issn-type":[{"value":"0091-6765","type":"print"},{"value":"1552-9924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1,24]]}}}