• Elizabeth G Radke, Lynn M Grattan, and John Glenn Morris.
• From the Department of Epidemiology and Emerging Pathogens Institute and the Department of Medicine, University of Florida, Gainesville, and the University of Maryland School of Medicine, Baltimore.
• South. Med. J. 2013 Dec 1; 106 (12): 655-7.

ObjectivesCiguatera is a foodborne illness that causes severe gastrointestinal and neurologic symptoms, but the risk factors for illness are not well established.MethodsIn St Thomas, US Virgin Islands, we performed a case-control study for ciguatera, enrolling 47 patients primarily through the emergency department and 141 age- and sex-matched controls identified through an island-wide survey. We used conditional logistic regression to assess health-related risk factors for ciguatera, including comorbidities and alcohol and tobacco use.ResultsCases were more likely than controls to report alcohol consumption at least weekly (odds ratio 5.7, 95% confidence interval 2.7-24.8). Cases also more frequently had a history of heart disease (odds ratio 6.3, 95% confidence interval 1.2-32.7). Previous ciguatera episodes, lower levels of education, and frequent fish consumption also were associated with illness.ConclusionsThis study provides preliminary evidence that preexisting health status influences an individual's risk of developing severe ciguatera. There may be a benefit to educating high-risk individuals about preventing ciguatera.

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