Poisonings on Kaua'i trigger alert on fishing

By Christie Wilson
Neighbor Island Editor

Fourteen people have fallen ill from ciguatera poisoning in the past two months after eating reef fish caught off the north shore of Kaua'i, the state Department of Health reported.

None of the victims, ranging in age from 5 to 80, required hospitalization, said Jo Manea, epidemiology specialist with the District Health Office on Kaua'i.

The ciguatera poisonings involved kole (surgeonfish) and ulua (jack) caught on the reef below Princeville and at 'Anini, she said.

"We seem to have this unique phenomenon on Kaua'i that almost every year people get sick around July, August and early September, particularly around Labor Day weekend," Manea said.

"It's summertime, people are out camping with their families, more people are fishing. It's a tradition," she said. "All those factors combine to increase the incidence of ciguatera poisoning."

The most recent Kaua'i poisoning occurred Wednesday, when two children aged 6 and 8, and their 37-year-old uncle, became ill after eating kole caught at Princeville, Manea said.

Although most residents are aware of the ciguatera threat and probably know someone who has had it, Manea said, "they never think they're going to get it." She said "it's kind of like Russian roulette" — sooner or later the odds will catch up with you.

"It's 'hot' out there, meaning it's dangerous to eat kole and ulua from the north shore," she said. "Although ulua and kole seem to be 'hot' fish right now, just about any reef fish can carry ciguatera."

Since the start of the year, 30 people in Hawai'i have fallen ill from ciguatera poisoning. Officials expect a lot more cases go undiagnosed or unreported because the victims are unaware of the condition, have mild cases, or are misdiagnosed as suffering from food poisoning.

The ciguatoxin is produced by microscopic organisms that grow on the surface of marine algae. The poison gets into the fish when they feed on the algae. The toxin also can accumulate in predator fish that eat the reef fish, making its way up the food chain to human consumption.

It cannot be detected by taste or smell, and cooking, drying, salting or freezing does not destroy the ciguatoxin.

Symptoms, which include numbness and tingling to mouth, hands and feet, joint and muscle pain, vomiting, diarrhea and chills, usually begin two to five hours after eating fish containing the toxin. The illness may last for a week or so in mild cases, but may persist for several months.

There is no treatment, although a kit for testing fish for ciguatera is sold at fishing supply shops and other stores.

To prevent poisoning, clean fish as soon as possible; don't eat head, guts or roe of any reef fish, especially sharks and eels; avoid fish caught in areas known to have a ciguatoxic algae problem.

The fatality rate from ciguatera poisoning is low, about one-tenth of a percent. The last known ciguatera deaths in Hawai'i occurred in 1964.

Barry Sweet, part owner of Hale'iwa Fishing Supply, has heard only second-hand reports of folks coming down with ciguatera poisoning. "I've never had any problem myself, but it's something that's always in the back of my mind when catching certain fish," he said.

Sweet's store sells ciguatera testing kits for $24.95 for five tests.

"It doesn't happen enough where people are scared enough of it," he said, "and people want to eat their fish. They know they could be a little more careful, but especially up here on this side, where a lot of people don't have high incomes, they're fishing to eat, not just to have fun. It's ignored a little bit more."

He said the price of the test kit keeps some people from using it.

On Kaua'i, people who fish know there are certain areas on the north shore where the risk of ciguatera is higher, said Jean Nakamura, co-owner of Lihu'e Fishing Supply. "They know it would be foolish to eat kole or roi (grouper) from the north shore," she said. Even with the awareness, Nakamura said she knows several people who have gotten sick from eating contaminated fish.

She said her store is selling more of the $26.50 kits.

Dr. Joanne Ebesu, research director for Oceanit, the Hawai'i company that makes the only commercially available ciguatera detection kit, justified the high price of the test kits by explaining that the process of creating the antibodies for ciguatera is very labor-intensive and costly.

"If you ever had ciguatera, you would definitely think that using our kit is worth it," said Ebesu, who years ago was poisoned after eating wahanui (snapper) she caught in Kane'ohe Bay.

Since it was first marketed in 1997, more than 6,000 kits have been sold worldwide, with the bulk of sales in Hawai'i, Ebesu said.

Just this week, the company started selling a trial-size kit that contains a single test.