Fish linked to outbreaks in Philippines and Vanuatu

Fish has been connected to two separate outbreaks in the Philippines and Vanuatu.

Media reports on the number of sick people in the Philippines range from 20 to 51.

The City Government of Cadiz reported that some residents fell ill after consuming fish locally known as “aloy” or “tulingan”, which is a type of tuna. Officials in Cadiz asked the public to temporarily avoid consuming these types of fish.

Symptoms include rashes, itching, flushing, and breathing difficulties from improperly handled or stored fish. Once produced, histamine cannot be eliminated by normal cooking or freezing temperatures.

Onset of histamine food poisoning symptoms can range from minutes to several hours following ingestion of the toxin. Typically, the average incubation period before illness is one hour.

The most common symptoms of histamine, also known as scombroid fish poisoning, are tingling or burning sensation in the mouth, facial swelling, rash, hives and itchy skin, nausea, vomiting or diarrhea. They usually resolve within several hours without medical intervention.

Fish samples have been collected for testing. Initial reports suggest fish was transported from Iloilo and sold to local dried fish producers for processing but was later sold as fresh in a local market.

Officials advised people to only buy fish from reputable vendors, ensure it is fresh, properly stored, and cooked and to seek medical attention immediately if symptoms appear.

Ciguatera in Vanuatu
In Vanuatu, 75 ciguatera fish poisoning (CFP) cases have been reported nationally.

According to a situation report by the Vanuatu National Surveillance Unit, four people have been hospitalized but no deaths have been recorded.

From the start of this year, 45 men and 30 women have fallen sick. The 15- to 34-year-old age group is the most affected with 39 cases. Patients were reported across eight islands with almost two-thirds in Efate.

In total, 53 cases have been linked to unspecified other fish with 13 cases connected to reef fish, three to Karosol and two to red fish.  

Ciguatoxin is produced by a type of microalgae that accumulates in some fish that feed on these algae. Larger fish then consume Ciguatoxin-contaminated fish.

Ciguatoxins are not destroyed by cooking, freezing, or canning processes. Symptoms appear within hours of consuming contaminated food and usually last a few days. They include vomiting, diarrhea, muscle weakness, and dizziness. Some people suffer from itching, tingling, or blurred vision; others find cold things hot and hot items cold.