汉堡港一艘货轮上发生雪卡鱼中毒疫情。

Outbreak of ciguatera fish poisoning on a cargo ship in the port of hamburg.

机构信息

Hamburg Port Health Center, Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstraße 10, Hamburg, Germany.

出版信息

J Travel Med. 2012 Jul;19(4):238-42. doi: 10.1111/j.1708-8305.2012.00619.x.

DOI:10.1111/j.1708-8305.2012.00619.x

PMID:22776385

Abstract

BACKGROUND

Ciguatera fish poisoning is a travel-related illness characterized by a combination of gastrointestinal and neurological symptoms in persons who eat ciguatoxic seafood in endemic areas.

METHODS

In 2009, an outbreak of the disease on a refrigerator vessel in the port of Hamburg was investigated. The ship's crew fell ill after they ate fish from a catch in the Caribbean 2 weeks earlier. All 15 sailors on board were examined by port medical officers. Samples of blood and stool specimens were taken from symptomatic sailors. The frozen fish was secured for the prevention of further disease spreading and additional diagnostic tests.

RESULTS

All but one sailor ate the fish. The intoxication resulted in gastrointestinal or neurological symptoms in all 14 sailors who consumed the fish and persisted in varying degrees in 93% of sailors over at least 14 days. No fatality occurred, but two seamen were "unfit for duty" on the ship due to severity of symptoms. The diagnosis was supported by the fact that all seafarers who consumed the same reef fish, experienced typical signs, symptoms, and time course consistent with ciguatera fish poisoning. The fish from the catch in the Caribbean was identified as Caranx sexfasciatus (Bigeye Trevally) and Cephalopholis miniata (Red Grouper). An experimental assay later confirmed presence of the ciguatoxin in the fish.

CONCLUSIONS

Sailors are an occupational group at risk for ciguatera fish poisoning due to potentially unsafe food sources during international travel. Even if no fatality occurred, the disease affected marine operations due to high attack rates and chronicity of symptoms. Medical doctors must be aware that ciguatera fish poisoning is a risk for seafarers traveling in tropical and subtropical areas. Stocking of food in affected ports from safe sources, adequate training of ship cooks, and informing sailors about the risk of fishing are needed to prevent disease occurrence in seafarers in international trade and traffic.

摘要

背景

赤潮鱼中毒是一种与旅行相关的疾病，其特征是在地方性流行地区食用赤潮毒素海鲜的人群中出现胃肠道和神经系统症状的组合。

方法

2009 年，在汉堡港的一艘冷藏船上发生了一起疾病暴发。两周前，船员在加勒比海域捕鱼后食用了这些鱼，随后开始发病。船上的 15 名海员都接受了港口医务人员的检查。对有症状的海员采集了血液和粪便样本。为防止进一步疾病传播和进行额外的诊断测试，将冷冻鱼封存。

结果

除了一名海员外，其余 14 名海员都食用了这些鱼。所有食用鱼的海员均出现胃肠道或神经系统症状，其中 14 名海员的症状持续了不同程度的时间，在 93%的海员中持续了至少 14 天。没有死亡病例，但由于症状严重，有两名海员在船上“不适合执行任务”。所有食用同一种珊瑚鱼的海员都出现了典型的体征、症状和时间进程，这支持了赤潮鱼中毒的诊断。来自加勒比地区渔获的鱼被鉴定为 Caranx sexfasciatus（大眼鲷）和 Cephalopholis miniata（红鳍石斑鱼）。后来的实验检测证实了鱼体内存在赤潮毒素。

结论

由于国际旅行期间潜在的不安全食物来源，海员是赤潮鱼中毒的高危职业群体。即使没有死亡病例，由于高发病率和症状的慢性，这种疾病也会影响海洋作业。医生必须意识到赤潮鱼中毒是在热带和亚热带地区旅行的海员的风险。在受影响的港口从安全来源储存食物、充分培训船员和告知海员捕鱼的风险，这些都是预防国际贸易和运输中海员患病所必需的。