Pennotti Radha, Scallan Elaine, Backer Lorraine, Thomas Jerry, Angulo Frederick J
1 National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention , Atlanta, Georgia .
Foodborne Pathog Dis. 2013 Dec;10(12):1059-66. doi: 10.1089/fpd.2013.1514. Epub 2013 Oct 5.
Ciguatera and scombroid fish poisonings are common causes of fish-related foodborne illness in the United States; however, existing surveillance systems underestimate the overall human health impact.
This study aimed to describe existing data on ciguatera and scombroid fish poisonings from outbreak and poison control center reports and to estimate the overall number of ciguatera and scombroid fish-poisoning illnesses, hospitalizations, and deaths in the United States.
We analyzed outbreak data from the Foodborne Disease Outbreak Surveillance Systems (FDOSS) from 2000 to 2007 and poison control center call data from the National Poison Data System (NPDS) from 2005 to 2009 for reports of ciguatera and scombroid fish poisonings. Using a statistical model with many inputs, we adjusted the outbreak data for undercounting due to underreporting and underdiagnosis to generate estimates. Underreporting and underdiagnosis multipliers were derived from the poison control call data and the published literature.
Annually, an average of 15 ciguatera and 28 scombroid fish-poisoning outbreaks, involving a total of 60 and 108 ill persons, respectively, were reported to FDOSS (2000-2007). NPDS reported an average of 173 exposure calls for ciguatoxin and 200 exposure calls for scombroid fish poisoning annually (2005-2009). After adjusting for undercounting, we estimated 15,910 (90% credible interval [CrI] 4140-37,408) ciguatera fish-poisoning illnesses annually, resulting in 343 (90% CrI 69-851) hospitalizations and three deaths (90% CrI 1-7). We estimated 35,142 (90% CrI: 10,496-78,128) scombroid fish-poisoning illnesses, resulting in 162 (90% CrI 0-558) hospitalizations and 0 deaths.
Ciguatera and scombroid fish poisonings affect more Americans than reported in surveillance systems. Although additional data can improve these assessments, the estimated number of illnesses caused by seafood intoxication illuminates this public health problem. Efforts, including education, can reduce ciguatera and scombroid fish poisonings.
雪卡毒素中毒和组胺中毒是美国鱼类相关食源性疾病的常见病因；然而，现有的监测系统低估了对人类健康的总体影响。
本研究旨在描述来自疫情报告和中毒控制中心报告的雪卡毒素中毒和组胺中毒的现有数据，并估计美国雪卡毒素中毒和组胺中毒疾病、住院人数及死亡人数的总体情况。
我们分析了2000年至2007年食源性疾病疫情监测系统（FDOSS）的疫情数据，以及2005年至2009年国家中毒数据系统（NPDS）的中毒控制中心呼叫数据，以获取雪卡毒素中毒和组胺中毒的报告。我们使用一个包含多个输入项的统计模型，对因报告不足和诊断不足导致的漏报情况进行调整，以生成估计值。漏报和诊断不足乘数来自中毒控制呼叫数据和已发表的文献。
2000年至2007年期间，FDOSS每年平均报告15起雪卡毒素中毒疫情和28起组胺中毒疫情，分别涉及60名和108名患者。NPDS报告称，2005年至2009年期间，每年平均有173次雪卡毒素暴露呼叫和200次组胺中毒暴露呼叫。在对漏报情况进行调整后，我们估计每年有15910例（90%可信区间[CrI]4140 - 37408）雪卡毒素中毒疾病，导致343例（90% CrI 69 - 851）住院，3例死亡（90% CrI 1 - 7）。我们估计每年有35142例（90% CrI：10496 - 78128）组胺中毒疾病，导致162例（90% CrI 0 - 558）住院，0例死亡。
雪卡毒素中毒和组胺中毒对美国人的影响比监测系统报告的更为严重。尽管更多数据可改进这些评估，但海鲜中毒导致的疾病估计数量凸显了这一公共卫生问题。包括教育在内的各项努力可减少雪卡毒素中毒和组胺中毒。
