LATEBREAKER
Environment/Climate Change
Foodborne disease outbreaks caused by ciguatoxin and scombroid toxin — Foodborne Disease Outbreak Surveillance System, United States, 2011–2022 Sonny Hoang* Son Hoang Cassie Hartley Virginia Roberts Anna Chard
Background: Ciguatoxin and scombroid toxin are among the top five etiologies of foodborne disease outbreaks linked to fish in the United States each year. Ciguatoxins produced by algae can accumulate in reef fish through the food chain; scombroid toxin poisoning occurs when fish are consumed after being held at improper temperatures. Climate change disruptions to marine ecosystems and critical cooling infrastructure may exacerbate the challenges of preventing these fish poisonings.
Methods: We analyzed ciguatoxin and scombroid toxin outbreaks reported to CDC’s Foodborne Disease Outbreak Surveillance System from 2011 through 2022, and characterized them by location of outbreak, importation status, location of food preparation, and implicated food vehicle.
Results: There were 165 confirmed ciguatoxin outbreaks (541 illnesses; 56 hospitalizations) and 172 confirmed scombroid toxin outbreaks (537 illnesses; 5 hospitalizations). Among ciguatoxin outbreaks, all were reported by a coastal state or territory, 87% did not implicate imported fish, and 82% were attributed to food prepared in private homes. The top three fish types linked to ciguatoxin outbreaks were barracuda (35%), grouper (13%), and amberjack (12%). Among scombroid toxin outbreaks, 98% were reported by a coastal state or territory, over 50% implicated imported fish, and 57% were attributed to food prepared in sit-down dining restaurants. Most scombroid toxin outbreaks were linked to tuna (80%).
Conclusions: Prevention measures for ciguatoxin and scombroid toxin poisonings should account for both environmental conditions and consumer behaviors. While reducing harvesting from high-risk areas and consumption of specific reef fish will prevent ciguatoxin poisoning, attention to temperature control of unprepared seafood is necessary from catch to consumption to prevent scombroid toxin poisoning.