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CIGUATERA FISH POISONING IN MALAYSIA:
A SHOCKING OUTBREAK IN 2010
Po Teen LIM FRST, UNIMAS, MALAYSIA
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OUTLINE • Introduction of CFP in Malaysia
• Highlight of the CFP outbreak in 2010
• Ciguatera-related and BHAB species found in Malaysia
• Questions remain to be addressed
• Way forward for ciguatera research in Malaysia
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Ciguatera fish poisoning in Malaysia
• Under-reported, due to low public awareness.
• Under-diagnosed, due to limitation in toxin analysis laboratory.
• Thus far, only one reported case of CFP in Malaysia.
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• 22 out of 36 from 5 families felt sick after consuming the red snapper on 8th August 2010 (attack rate of 61.1%).
• 11 (50%) were admitted to hospital.
• All of them bought from the same fish seller and claimed that texture of the fish became hardened after cooked.
• No other cases found in other health facilities.
(adapted from Nik Khair0l Reza et al. 2011)
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The CFP outbreak in 2010…
(adapted from Nik Khair0l Reza et al. 2011)
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Actions taken by the DHO after the incident…
(adapted from Nik Khair0l Reza et al. 2011)
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(adapted from Nik Khair0l Reza et al. 2011)
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(adapted from Nik Khair0l Reza et al. 2011)
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(adapted from Nik Khair0l Reza et al. 2011)
Amount consumed equivalent to match box size
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(adapted from Nik Khair0l Reza et al. 2011)
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(adapted from Nik Khair0l Reza et al. 2011)
• Gastrointestinal symptoms had resolved. • Itchiness and paraesthesia persist for about 1 month. • One patient was referred to tertiary hospital for hypotension and
bradycardia.
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(adapted from Nik Khair0l Reza et al. 2011)
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Investigating the source…
• Contaminated samples were bought from Kg Sg. Stan, Ayer Lanas, Jeli, which was bought from Far Frozen Fish Sdn Bhd, Tok Bali, Pasir Puteh (red snapper, Batch no MRH-5000 25kg), that was supplied from Chia Song Kow Cold Storage Trading CO. Sg Besar, Selangor, which claimed to be imported from Fungzou Hongdong Foods Co. Fujian, China (in July 2010).
(adapted from Nik Khair0l Reza et al. 2011)
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Questions remain to be addressed
• Was the outbreak REALLY due to CFP? – Lack of confirmation by analytical toxin analysis.
• What are the vectors of CFP? – Imported fishes involved in the outbreak, fishes
from Sabah was also been reported to cause CFP in Hong Kong.
• What are the CFP-causing organisms? Are they widely distributed in Malaysia? Gambierdiscus only? – No confirmation of toxins production in BHAB
species.
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CIGUATERA-RELATED AND BHAB SPECIES FOUND IN MALAYSIA
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Five genera:
1. Amphidinium,
2. Coolia,
3. Gambierdiscus,
4. Prorocentrum, and
5. Ostreopsis
Share similar habitats and
form assemblages.
Benthic Harmful Algal Blooms (BHABs)
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On-going BHAB studies
in Malaysia…
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On-going BHAB studies in Malaysia…
• Comparative study on BHAB species assemblage in selected coral reefs of Sarawak, Malaysia.
– Standardized sampling approach - Difficulty in data normalization/ comparison
• Species diversity of Gambierdiscus and Ostreopsis in Malaysia
– coupled with morphology and molecular data.
• Proposed future study: toxicology of BHAB species
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Sampling approach
• Application of artificial fiberglass screen with standard surface area (ca. 300 cm2) by standard protocols was demonstrated to allow assessment of BHAB community (Tester et al 2012), even in area such as coral reefs with the absence of macrophytes.
• The sampling approach is tested and applied in the present study.
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Sampling sites for the comparative study of BHAB species assemblages
Malaysia map showing sampling locations
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Artificial substrate sampling device
Float
Screen
weight
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Float
Screen
weight
Artificial substrate sampling device
Transect
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Relative abundances of BHAB species in the assemblages of Sampadi Island.
(Tan et al. 2013)
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BHAB species assemblages of Talang-talang Island. Tan et al. in prep
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Way forward for Ciguatera issue…
• Ciguatera toxins screening of potential fishes
– Lujanidae
– Prioritized location : Sabah
• Trans-boundary food safety issue – require development of simple and reliable technique for ciguatera diagnosis (ciguatera vs. non-ciguatera poisoning).
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Acknowledgements Prof. Dr Yasuwo Fukuyo, The University of Tokyo IOC-WESTPAC TMO for travel support Funding: • MOSTI Science Fund • UNIMAS Shell Chair Fund
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