O-54 Clinical features and management of acute Ciguatera poisoning in the French Caribbean territories: a case series.

Methods: Observational, retrospective, single-center study covering ten years (October 2012 to November 2022), including all patients reported for Ciguatera intoxication following microalgae-infected fish ingestion. Patients were identified through admissions to the University Hospital of Martinique or case reporting to the Regional Health Agency.

Results: 223 patients were treated for acute Ciguatera poisoning in the emergency room and intensive care unit of the University Hospital of Martinique (mean age 48 ± 3 years, 58% women), with an incidence rate of 0.60 cases per 10,000 patient-years over the study period. The average time between meal ingestion and symptom onset was 9 ± 3 hours. Clinical presentation was: 90% gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain), 83% neurological disorders, and 42% emergencies with cardiovascular complications (bradycardia, hypotension, interventricular block). 39% of patients also had hypothermia. Ingestion of jackfish (Carangidae) was related to abnormal abdominal symptomatology and significant risk of chronic signs, with respective odds ratios [95% Confidence Intervals] of 3.2 [1.5 - 6.6] and 3 [1.2 - 8.0].

Conclusion: Ciguatera intoxication is a public health problem to be increasingly reckoned. Its clinical presentation in Martinique (mainly defined by digestive, followed by peripheral neurological disorders and cardiovascular symptoms) presents similarities with that of other Caribbean islands, as opposed to intoxication cases observed in the Pacific (predominant peripheral neurological disorders). In endemic inter-tropical areas, the general population, medical community, and public health organizations must be better informed of ciguatoxin risks. Physicians should be particularly aware of the potential risk of significant cardiovascular complications of ciguatera poisoning.