Genaro García Regional Advisor on Food Safety Veterinary Public Health Unit Disease Prevention and Control Amelia la Barbera Fondo Nacional de Investigaciones Agropecuarias (FONAIAP) Venezuela 4 th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Porlamar, Margarita Island, Venezuela, 28 July- 1 August 2003) Pan American Health Organization Regional Office of the World Health Organization Fish-Kill Outbreak in the Southern Caribbean: Epidemiology and Public-Health Impact

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 2 1.Present an experience of fish mortality in the southeastern Caribbean (1999). 2.Discuss its public-health implications (Health: Socioeconomic ---> Political) Objectives

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 3 Where: Caribbean Region When: 1999

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 4 Volcanic eruption in Trinidad. Red tides (toxic and non-toxic). Rainfall. Chemical spillage. Combination of:  High water temperatures.  Increase of nutrients.  Decrease of oxygen. Hypothesis

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 5 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.

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 6 Country Situation 1999: Barbados (1) Began on 16 September 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.

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 7 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. Country Situation 1999: Barbados (2)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 8 Fish Samples (cont.)  No macroscopic lesions observed on skin.  Pale gills.  Liver, other internal organs: anemic appearance.  Distended abdomen (air in peritoneal cavity). Country Situation 1999: Barbados (3)

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

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 10 Fish Samples (cont.) Streptococcus iniae is being proposed as a determining factor for the fish-kill events in Barbados. (Source: Ferguson, of 10 November 1999) Country Situation 1999: Barbados (5)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 11 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) Country Situation 1999: Barbados (6)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 12 Water Samples Improperly collected, thus no conclusive results for phytoplankton studies. Observation of high water temperature of 28–33° C. Oxygen demand (DO 2 ) was low. Unusual organic matter. Salinity a bit lower. Carbamate-like compound present. Country Situation 1999: Grenada (1)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 13 Began at end July to beginning of August 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 Country Situation 1999: Grenada (2)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 14 Began on 2 September 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. Country Situation 1999: St. Vincent & the Grenadines (1)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 15 Water Samples Improperly collected, thus no conclusive results for phytoplankton studies. Observation of high water temperature of 28–33° C. DO 2 was low. Unusual organic matter. Salinity a bit lower. High coliforms counts Country Situation 1999: St. Vincent & the Grenadines (2)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 16 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. Country Situation 1999: St. Vincent & the Grenadines (3)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 17 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. Country Situation 1999: Trinidad and Tobago (1)

Satellite Images of Chlorophyll a Concentration (1999) Satellite: Sea WIFs (USA) (01) Ocean: Chlorophyll a Concentration (mg/m3) Land: Normalized Difference Land Vegetation Index Maximum Minimum

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 19 Satellite Images of Chlorophyll a Concentration (1999) Satellite: Sea WIFs (USA) (02) Ocean: Chlorophyll a Concentration (mg/m3) Land: Normalized Difference Land Vegetation Index Maximum Minimum

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 20 Satellite Images of Chlorophyll a Concentration (1999) Satellite: Sea WIFs (USA) (03) Ocean: Chlorophyll a Concentration (mg/m3) Land: Normalized Difference Land Vegetation Index Maximum Minimum

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 21 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.

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 22 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? Fish Killing “a Serious” Public-Health and Politico-Social Problem

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 23 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. Fish-Killing a “Serious” Public-Health and Politico-Social Problem

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 24 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. Fish Killing “a Serious” Public-Health and Politico-Social Problem

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 25 Epidemiological Surveillance FK (P) = a + b 1 (x1) + b 2 (x2) + b 3 (x3) + b 4 (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

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 26 Start Monitoring Health Permit Certification SAS/MAC/GN Toxic dinoflagelates Mouse Essay /Plankton Transport Permit Commercialization S uspension of consumption Information Hospital alert Market supervision, confiscation >Sample frequency Normal sample frequency Yes No Surveillance Program for Marine Toxins (PSP) Venezuela A. La Barbera, FONAIAP

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 27 Websites of Interest Pan American Health Organization (PAHO/WHO) Pan American Institute on Food Protection and Zoonoses (INPPAZ) World Health Organization (WHO)

4th Annual Meeting of Inspection and Quality-Control Services and Institutions for Fish Products (Venezuela, summer 2003) 28 Thank you very much! The End