 of increased outbreaks will continue in the region, and be a far more expensive concern in the future, if our understanding of, and response to, ciguatera is not extensively improved.
Despite over 50 years of ciguatera research in the Pacific, no comprehensive region-wide action has occurred to better manage ciguatera. Based on this study, an estimated 500,000 persons might have contracted ciguatera in the last 35 years, corresponding to a lifetime prevalence of 25%. It is remarkable that ciguatera has largely been ignored by the PICT national governments, with only two nations having an ongoing monitoring program and only one nation having a small unit devoted to researching ciguatera (Toxic Micro-algae Unit of the Institut Louis Malarde, French Polynesia). Given the rapidly changing physical environment (including global warming, extreme weather, and coral reef degradation) as well as the dependence of local populations upon fish for their physical and cultural survival, research into improved disease treatment and toxin detection, and a better understanding of the environmental factors contributing to ciguatera, are required to help reduce the likely growing adverse impacts of ciguatera.
Document and questionnaire sent to PICTs requesting questionnaire completion.
The authors would like to thank SPC Fisheries for their support, and the following people for responding to the questionnaire: Teina Rongo, Tearoa Ionangi, Dr Aung (Cook Is.); Andy Tafileichig (F. S. of M.); Solo Qaranivalu (Fiji); Dr Chinain Mireille (F. Poly); J. O'Mallan (Guam); R. Kanenaka, M. Wong, C. Giles, Assoc. Professor Paul Bienfang (Hawaii); Tonana George (Kiribati); F. Hernaez (Marshall Is); Dr Zin (Nauru); O. Segur (N. Caledonia); Dr Viwa Lailai, Vanessa Marsh (Niue); Ed Diaz, R. Brostrom, JohnTagabuel (Northern Mariana Is.); Losii Samsel (Palau); Joyce Samuel, Maria Sapatu (Samoa); Lee Pearce (Tokelau); Dr Siale 'Akau'ola, Poasi Ngaluafe (Tonga); Dr Nese Ituaso-Conway, Avana M. Paelate (Tuvalu); L. Tarivonda, Yvannah Taga (Vanuatu); A. Fotofili (Wallis & Futuna).
Conceived and designed the experiments: MPS TDB RJL. Performed the experiments: MPS. Analyzed the data: MPS TDB RJL. Wrote the paper: MPS TDB LEF RJ RJL.
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