SEAFOOD POISONINGS IN MADAGASCAR - ICHTHY OSARCOTOXICITY AND CHELONITOXICITY - ICHTHYOSCAROTOXICITY AND CHELONITOXICITY - RECENT EPIDEMIOLOGIC DATA

If seafood poisonings are well documented in the Pacific region, they are not often reported in the Indian Ocean, in Madagascar, fishermen a nd people living in coastal areas are traditionally aware of seafood p oisonings. Mass intoxications were described in the sixties, including lethal cases following sardine ingestion. From 1989 to 1993, 28 ichty osarcotoxism cases, mainly ciguatera occurring in children, were repor ted in Tulear hospital. From July 1993 to May 1994 nine seafood poison ing outbreaks occurred in coastal villages after turtle shark and sard ine meals. Clinical symptoms were related to marine toxins. For turtle intoxications, gastro-intestinal symptoms are the most frequently see n (acute stomatitis, dysphagia, vomiting and diarrhea), with case fata lity rates around 7 %. For shark intoxications, the most frequent symp toms were neurologic (paresthesia specially peribuccal and extremities ), and gastro-intestinal (diarrhea and vomiting), with specific case f atality rates varying from 0 Sb to 30 %. For sardine intoxication, sym ptoms were gastro-intestinal (vomiting) and neurologic (paresthesia), and from the two intoxicated people one died. Two previously unknown b iotoxins were isolated from the liver of a shark responsible for a mas s poisoning namely carchatoxins. For the turtles the search of cheloni toxin is under way For the sardines, clupeotoxin was isolated. Because of the frequency and the gravity of collective seafood poisonings occ urring in recent years, the Ministry of Health has implemented a Seafo od Poisoning National Control Programme. This programme is based on th ree major strategies : the selling of an epidemiological surveillance network, the prevention of the communities through educational program mes, and the developpement of research on marine eco-environment.