Acquired knowledge about Ciguatera Fish Poisoning in the Canary Islands population
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1
Management of the Rural Environment of Canarias SAU, Spain
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2
Department of Sociology and Anthropology, University of La Laguna, Spain
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3
Independent researcher, Spain
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4
Canary Islands Government, Spain
Introduction
Ciguatera Fish Poisoning (CFP) is a human food poisoning caused by the consumption of fish that have toxins, commonly known as ciguatoxins. The precursors of these toxins are naturally present in the marine environment inside certain microscopic algae (dinoflagellates) and are transferred to the fish through the food chain. These toxins are not eliminated by any preservation or cooking technique. The only way to know if a fish is a carrier is through laboratory analysis (few days). According to Friedman et al. (2017) the CFP is the main disease caused by marine toxins worldwide. It is estimated that between 20,000 and 50,000 people suffer CFP annually (Marcus, 2018) although it is believed that there are many more because it is difficult to diagnose due to the variety of symptoms that presents (gastrointestinal, neurological and cardiovascular symptoms). The treatment is symptomatic and the patient improves in days or weeks, sometimes persists months or even years, death is rare. In Europe until 2004 the CFP was only related to imported cases (travelers or fish from other latitudes). From 2004 to 2018 one hundred and twenty-two CFP have been reported in the Canary Islands (CI) (Spain). Madeira and the Selvagens Islands (Portugal) have also reported human cases (Vale, 2011). In the CI the CFP is considered an emergent notifiable disease although the risk is small due the low annual sick rate (Nuñez et al., 2012). In the CI since 2009 the catches of professional fishermen are being monitored for certain species and weights while in Madeira and Selvagens Islands some fishing restrictions have been implemented. Also since 2009 in the CI several projects and initiatives are being developed. These try to provide knowledge on CFP human epidemiology, ecology of microalgae, potentially affected fish, toxin detection methods, etc. According to Sanchez-Henao et al. (2019) the CI is already an area of endemic expansion of the CFP.
Educating society is a critical component in the prevention of CFP, as it improves the ability to diagnose cases in humans (Friedman et al., 2017) and allows consumers to make informed decisions about food choices (FAO/WHO, 2016). The objective of this study was to assess the knowledge and perceptions of the CI population about CFP.
Methodology
The universe was the CI population. A not proportional allocation sample to the population size of each island was selected to reduce the level of error in the non-capital islands and to guarantee the reliability of the data in the estimates at the island level. Telephone surveys (n 1825) were conducted in 2018 (July, August and September) by sex, age and municipality quotas (error 2.3%, confidence level 95.5%).
Results
87.2% of the population consumes fish on a regular basis. Fresh fish (multi-response) is the most consumed (81.2%), then frozen fish (53.6%). Fish caught by non-professional fishermen is consumed by 14.1% (some islands 40% is reached), of these, 79.4% do not consider the consumption of fish from this source as a health risk. To the question 'do you know what ciguatera is?' 89.6% of the population (n 1825) points out 'does not know or has not heard' of the ciguatera, the 3.8% 'do not know, but have heard' and 6.6% say 'yes'. From the interviewees who report knowing or having heard about, that is 10.4% of the total: 65.8% state that they have no information on human cases, 56.5% state that CFP have relevance in public health, 44.6% indicate that the cause is because the fish consume toxic algae while the rest declare not knowing or give wrong answers, 11.5% declare that the ciguatera can be eliminated (open answer) being freezing the main choice (55.2%), 12.9% notes that exist regulation to comply. 82% of the total (n 1825) wishes to receive more information about the ciguatera.
According to the Regulation (EC) No 178/2002 about food law and safety the ‘risk analysis’ means a process consisting of three interconnected components - risk assessment, risk management and risk communication - and it applies to global food security manner. Among others, the objective of ‘risk communication’ is to improve the effectiveness of the risk analysis process among all interested parties. The monitoring and evaluation of the effectiveness of the communication of risks in food security is essential to knowing if the audience receives, understands and responds adequately. One of the methods of monitoring established by FAO/WHO (2016) is through targeted surveys. Therefore, this work can be an instrument to know the impact on public opinion of the communication actions that several entities develop in the CI.
Conclusion
After 10 years of starting various projects and initiatives related to CFP only 4.7% of the population shows some valid knowledge of how ciguatera is produced, 3.6% declare to have knowledge about human cases and 1.3% declares that there are regulations to apply. Therefore, in the framework of risk communication it is necessary to design a program to achieve a successful implementation based on risk analysis considering the main stakeholders (of course including consumers). It is necessary that the different institutions work together (EFSA, 2017).
Acknowledgements
This work was developed within the framework of the MIMAR Project (MAC/4.6d/066), with the support of the European Union (EU) and co-financed by the European Regional Development Fund (EDRF) and the INTERREG V-A Spain-Portugal MAC 2014-2020 (Madeira-Azores-Canarias).
References
EFSA (2017) When food is cooking up a storm. Proven recipes for risk communications. Parma. doi: 10.2805/119491.
FAO/WHO (2016) Risk communication applied to food safety. Rome. Available at: http://www.fao.org/3/a-i5863e.pdf.
Friedman, M. A. et al. (2017) ‘An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management’, Marine Drugs, 15 (3)(72), p. 41. doi: 10.3390/md15030072.
Marcus, E. N. (2018) ‘Ciguatera fish poisoning’, UpToDate. Available at: https://www.uptodate.com/contents/ciguatera-fish-poisoning (Accessed: 8 May 2019).
Nuñez, D. et al. (2012) ‘Outbreak of ciguatera food poisoning by consumption of amberjack (Seriola spp.) in the Canary Islands, May 2012’, Eurosurveillance, 17(23), pp. 1–3.
Sanchez-Henao, J. A. et al. (2019) ‘Predictive score and probability of CTX-like toxicity in fish samples from the official control of ciguatera in the Canary Islands’, Science of the Total Environment. Elsevier B.V., 673, pp. 576–584. doi: 10.1016/j.scitotenv.2019.03.445.
Vale, P. (2011) ‘Biotoxinas emergentes em águas europeias e novos riscos para a saúde pública’, Revista portuguesa de saúde pública, 29(1), pp. 77–87. doi: 10.1016/S0870-9025(11)70010-4.
Keywords:
Ciguatera fish poisoning (CFP),
Acquired knowledge,
Telephone survey research,
Risk Communication,
Canary Islands - Spain
Conference:
XX Iberian Symposium on Marine Biology Studies (SIEBM XX) , Braga, Portugal, 9 Sep - 12 Sep, 2019.
Presentation Type:
Oral Presentation
Topic:
Ecotourism, Environmental Education, Citizen Science and Dissemination of Science
Citation:
Bilbao-Sieyro
A,
Pérez-González
Y,
Pavón-Salas
N,
De La Cruz-Modino
R,
Chinea-Mederos
I,
Tabares-Santos
JL and
Cabrera-Suárez
F
(2019). Acquired knowledge about Ciguatera Fish Poisoning in the Canary Islands population.
Front. Mar. Sci.
Conference Abstract:
XX Iberian Symposium on Marine Biology Studies (SIEBM XX) .
doi: 10.3389/conf.fmars.2019.08.00034
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Received:
14 May 2019;
Published Online:
27 Sep 2019.
*
Correspondence:
Mr. Alberto Bilbao-Sieyro, Management of the Rural Environment of Canarias SAU, Agüimes, Spain, albertobs@gmrcanarias.com