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					                 Pan American Health Organization
                                  Regional Office of the
                           World Health Organization

                Fish-Kill Outbreak in the
                  Southern Caribbean:
          Epidemiology and Public-Health Impact




Genaro García
Regional Advisor on Food Safety
Veterinary Public Health Unit
Disease Prevention and Control
                                                     4th Annual Meeting of Inspection and
Amelia la Barbera                                 Quality-Control Services and Institutions
Fondo Nacional de Investigaciones Agropecuarias                           for Fish Products
(FONAIAP)                                         (Porlamar, Margarita Island, Venezuela,
Venezuela                                                          28 July- 1 August 2003)
                                Objectives


    1. Present an experience of
       fish mortality in the
       southeastern Caribbean (1999).

    2. Discuss its public-health implications
       (Health: Socioeconomic ---> Political)


4th Annual Meeting of Inspection and Quality-Control Services and   2
Institutions for Fish Products (Venezuela, summer 2003)
                   Where:             Caribbean Region
                   When:              1999




4th Annual Meeting of Inspection and Quality-Control Services and   3
Institutions for Fish Products (Venezuela, summer 2003)
                                 Hypothesis

             • Volcanic eruption in Trinidad.
             • Red tides (toxic and non-toxic).
             • Rainfall.
             • Chemical spillage.
             • Combination of:
                   High water temperatures.
                   Increase of nutrients.
                   Decrease of oxygen.

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Institutions for Fish Products (Venezuela, summer 2003)
              Fish Kill: Temporal Distribution
                              (Caribbean, 1999)

     Guyana:                     July 1999
     Venezuela:                  Beginning of August 1999
     Barbados:                   16 September 1999
     Grenada:                    End July – Beginning August 1999
     Saint Vincent: 2 September 1999
     Tobago:                     September (?) 1999
     Decline:                    By mid-September 1999,
                                  mortality had declined in affected
                                  English-speaking islands.
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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                Barbados (1)

   Began on 16 September 1999.
   Southeast coast affected.
   Fisherman reported greenish water in affected areas.
   Killing of reef fish : thousands per day.
   Mortality declining by last week.
   There are still no conclusive results on the cause(s)
    associated with the high fish mortality.

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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                Barbados (2)

    Water Samples
         None collected, thus no results for
          phytoplankton studies.
         Observation showed water high temperature of
          28–33° C.
         Fish samples taken of freshly killed reef fish
          from one (? ) affected area.


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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                Barbados (3)

        Fish Samples (cont.)
        No macroscopic lesions observed on skin.
        Pale gills.
        Liver, other internal organs: anemic appearance.
        Distended abdomen (air in peritoneal cavity).




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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                Barbados (4)

           Fish Samples (cont.)
           Streptococcus iniae isolated from liver,
            brain, gastrointestinal tract of dying fish.
              (Source: Ferguson, St. John, Roach, 1999)

           Samples taken of additional fish species
            from affected areas and “normal-healthy”
            fish.


4th Annual Meeting of Inspection and Quality-Control Services and   9
Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                Barbados (5)

            Fish Samples (cont.)
            Streptococcus iniae is being proposed as a
             determining factor for the fish-kill events in
                             Barbados.

               (Source: Ferguson, e-mail of 10 November 1999)




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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                Barbados (6)

        Fish Samples
        “Investigation of predisposing factors is
          required but most difficult …
           There are several areas for further
           monitoring/surveillance and research, the end
           result of which would be a … monitoring and
           early-control detection/warning system.”
                                               (Ferguson, personal communication, 11/10/99)



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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                 Grenada (1)

    Water Samples
         Improperly collected, thus no conclusive results for
          phytoplankton studies.
         Observation of high water temperature of 28–33° C.
         Oxygen demand (DO2) was low.
         Unusual organic matter.
         Salinity a bit lower.
         Carbamate-like compound present.

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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
                                 Grenada (2)

         Began at end July to beginning of August 1999.
         Mainly on the east coast.
         Fisherman reported greenish water in affected
          areas.
         Killing of reef fish : thousands per day.
         Mortality in Grenada declining by last week.
         Mortality still reported in Carracou by 28
          September 1999.
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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
             St. Vincent & the Grenadines (1)

            Began on 2 September 1999.
            Mainly on the east coast.
            Fisherman reported greenish water in
             affected areas.
            Killing of reef fish : thousands per day.
            Mortality declining by last week.
            Mortality still being reported in the
             Grenadines during the last two weeks.

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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
             St. Vincent & the Grenadines (2)

         Water Samples
         Improperly collected, thus no conclusive
          results for phytoplankton studies.
         Observation of high water temperature of
          28–33° C.
         DO2 was low .
         Unusual organic matter.
         Salinity a bit lower.
         High coliforms counts
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Institutions for Fish Products (Venezuela, summer 2003)
                          Country Situation 1999:
             St. Vincent & the Grenadines (3)


          Fish Samples
          No macroscopic lesions.

          Will be sent to Barbados regarding hypothesis
           of Streptococcus iniae.

          Frozen fish samples will be send to Venezuela.

          Japanese team.

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Institutions for Fish Products (Venezuela, summer 2003)
                            Country Situation 1999:
                    Trinidad and Tobago (1)

         The Institute of Marine Affairs (IMA) is
          investigating fish mortality in Tobago.
         Press release issued by the IMA.
         Preliminary report of findings:
          Report on water, phytoplanktons to be released
          and shared with countries and PAHO.
         IMA does not have capability to run bioassays
          for marine toxins.

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Institutions for Fish Products (Venezuela, summer 2003)
                           Satellite Images of
                    Chlorophyll a Concentration (1999)
                            Satellite: Sea WIFs (USA) (01)




                             Ocean:
 Chlorophyll a Concentration (mg/m3)

                              Land:
Normalized Difference Land Vegetation                        Minimum
                                        Maximum
                               Index
                            Satellite Images of
                     Chlorophyll a Concentration (1999)
                             Satellite: Sea WIFs (USA) (02)




                               Ocean:
   Chlorophyll a Concentration (mg/m3)

                                Land:
  Normalized Difference Land Vegetation                             Minimum
                                          Maximum
                                 Index

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Institutions for Fish Products (Venezuela, summer 2003)
                            Satellite Images of
                     Chlorophyll a Concentration (1999)
                             Satellite: Sea WIFs (USA) (03)




                               Ocean:
   Chlorophyll a Concentration (mg/m3)

                                Land:
  Normalized Difference Land Vegetation                             Minimum
                                          Maximum
                                 Index
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Institutions for Fish Products (Venezuela, summer 2003)
                Fish-Killing a Serious Public-Health
                    and Politico-Social Problem


       Indirect Impact on Public Health
            Tourism influx affected.

            Apprehension among the national
             population regarding consumption of fish
             until problem clearly defined.



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Institutions for Fish Products (Venezuela, summer 2003)
                        Fish Killing “a Serious”
                Public-Health and Politico-Social Problem



       Direct Impact on Public Health
             Human cases: Only one reported case associated
              to rock fish consumption in Bequia.
             Informal Interview of people from working people
              in Grenada, Saint Vincent:
              3 out of 10 persons interviewed reported diarrhea,
              vomiting, and cramping a few hours after
              consuming rockfish.
             Note: Is there any increase of diarrhea syndromes
              in the affected countries?
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Institutions for Fish Products (Venezuela, summer 2003)
                         Fish-Killing a “Serious”
                Public-Health and Politico-Social Problem


 Direct Economic Impact on Fisheries (St. Vincent)
      Fish-landing drop:               75% value of EC$ 500,000 per month.
      Fishermen:                       75% drop in activity.
      Vendors and
       fish-handlers:                   75% drop in activity.
      Exports to
       Martinique:                      Loss of US$ 120,000 per month.
      Export of affected
       species to USA:                  Loss of US$ 12,000 per month.
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Institutions for Fish Products (Venezuela, summer 2003)
                        Fish Killing “a Serious”
                Public-Health and Politico-Social Problem



       Direct Economic Impact on Fisheries
           (Saint Vincent)
            If current trend continues, losses will
               amount to
                 US$ 132,000 in exports.
                 US$ 375,000 in local markets.
                 US$ 507,000 per month total losses.

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Institutions for Fish Products (Venezuela, summer 2003)
                  Epidemiological Surveillance

  FK (P) = a + b1 (x1) + b2 (x2) + b3 (x3) + b4 (x1x2) + … + e
     FK (p) = Variable or probability of fish kill
     a = interceptor
     b1……bn = regression coefficients
     x1…….xn= independent variables (contributing factors)
     x1 = Temperature (Centigrade)
     X2 = Phytoplankton (number of cells per liter)
     X3 = toxic dyflagelates a and b (0 or 1)
     X4 = Streptococcus iniae (ufc/g)
     E = Error
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Institutions for Fish Products (Venezuela, summer 2003)
                 Start                  Monitoring                    Mouse Essay
                                                                       /Plankton



             SAS/MAC/GN
                                                                         Toxic
                                              Yes                    dinoflagelates

             Suspension                                                             No
                 of
             consumption
                             Surveillance Program for
                                                                    Certification
                               Marine Toxins (PSP)
                                     Venezuela
            Information
                                A. La Barbera, FONAIAP
                                                                         Health
                                                                         Permit

               Hospital
                alert
                                                                       Transport
                                                                        Permit


                Market
                                          >Sample
              supervision,
                                         frequency                                         Normal
              confiscation
                                                                                           sample
                                                               Commercialization         frequency


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Institutions for Fish Products (Venezuela, summer 2003)
                         Websites of Interest

    • Pan American Health Organization (PAHO/WHO)
      http://www.paho.org

    • Pan American Institute on Food Protection and
      Zoonoses (INPPAZ)
      http://www.panalimentos.org

    • World Health Organization (WHO)
      http://www.who.org

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Institutions for Fish Products (Venezuela, summer 2003)
                                     The End



                   Thank you very much!

                         garciage@paho.org




4th Annual Meeting of Inspection and Quality-Control Services and   28
Institutions for Fish Products (Venezuela, summer 2003)

				
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