Lewis R J
Southern Fisheries Centre, QDPI, Qld, Australia.
Bull Soc Pathol Exot. 1992;85(5 Pt 2):427-34.
The inshore fisheries resource is important to the health and culture of many of the inhabitants of Pacific Island countries (PIC). Ciguateric fishes (mainly demersal reef fishes) cause a range of distressing and often debilitating gastrointestinal neurological and cardiovascular disturbances. Consequently, ciguatera limits the utilisation of this otherwise over-exploited resource. For many victims, the symptoms suffered during the chronic phase of ciguatera (lasting weeks, months and occasionally years) are exacerbated upon consumption of certain foods, particularly non-toxic fishes. After each outbreak, victims and members of their social-network experience a transient increase in perception of the risk of eating reef fish. The impact of ciguatera is greatest in atoll island countries where fish is the primary source of protein (it also has a major impact and to facilitate the management of ciguatera in PIC, regular information is required that quantifies: (i) the true incidence of ciguatera; (ii) the extent and way in which different communities avoid ciguatera; and (iii) the adverse impact ciguatera has on health, the workforce, trade and tourism. Over the last 15 years (based on SPEHIS data to 1990), some countries recorded a decrease in the ciguatera problem (New Caledonia, Marshall Is.), other countries an increase (Kirbati, Tuvalu, French Polynesia), while still other countries recorded an increase followed by a decrease in ciguatera (Tokelau, American Samoa, Western Samoa, Fiji and Vanuatu). There may also be seasonal trends in the incidence of ciguatera in some countries e.g. Fiji. Management options presently implementable in PIC include: (i) treatment with i.v. mannitol; (ii) provision of timely advise on the location and status of ciguatera "hot spots" in each country that would allow affected communities to react objectively to the risk posed by ciguatera; and (iii) modification of human behaviour and aspirations to reduce the impact of increasing population, pollution and development (e.g. causeways) pressures.(ABSTRACT TRUNCATED AT 250 WORDS)
近海渔业资源对许多太平洋岛国居民的健康和文化至关重要。雪卡毒鱼（主要是底栖珊瑚礁鱼类）会引发一系列令人痛苦且往往使人衰弱的胃肠道、神经和心血管紊乱。因此，雪卡毒素限制了这种本就过度开发的资源的利用。对许多受害者来说，雪卡病慢性阶段（持续数周、数月，偶尔数年）所遭受的症状，在食用某些食物，尤其是无毒鱼类后会加剧。每次疫情爆发后，受害者及其社交网络成员对食用珊瑚礁鱼风险的认知会短暂上升。雪卡病在以鱼类为主要蛋白质来源的环礁岛国影响最大（它也有重大影响）。为便于太平洋岛国对雪卡病进行管理，需要定期提供量化信息：（i）雪卡病的真实发病率；（ii）不同社区避免雪卡病的程度和方式；（iii）雪卡病对健康、劳动力、贸易和旅游业的不利影响。在过去15年里（基于截至1990年的SPEHIS数据），一些国家雪卡病问题有所减少（新喀里多尼亚、马绍尔群岛），其他国家有所增加（基里巴斯、图瓦卢、法属波利尼西亚），而还有其他国家雪卡病先是增加后又减少（托克劳、美属萨摩亚、西萨摩亚、斐济和瓦努阿图）。在一些国家，如雪卡病发病率可能也存在季节性趋势。目前太平洋岛国可实施的管理办法包括：（i）静脉注射甘露醇治疗；（ii）及时提供每个国家雪卡病“热点”的位置和状况信息，使受影响社区能够客观应对雪卡病带来的风险；（iii）改变人类行为和期望，以减少人口增长、污染和发展（如堤道）压力带来的影响。（摘要截选至250词）
