title: Social ecological analysis of an outbreak of pufferfish egg poisoning in a coastal area of Bangladesh.
abstract: Recurrent outbreaks of marine pufferfish poisoning in Bangladesh highlight the need to understand the context in which the outbreaks occurred. In a recent outbreak investigation, a multidisciplinary team conducted a mixed-method study to identify the demography and clinical manifestation of the victims and to explore different uses of pufferfish, and local buying, selling, and processing practices. The outbreak primarily affected a low income household where an elderly woman collected and cooked pufferfish egg curry. Nine persons consumed the curry, and symptoms developed in 6 (67%) of these persons. Symptoms included vomiting, diarrhea, paresis, and tingling sensation; 2 (22%) persons died. The unstable income of the affected family, food crisis, and the public disposal of unsafe pufferfish byproducts all contributed to the outbreak. A multi-level intervention should be developed and disseminated with the participation of target communities to discourage unsafe discarding of pufferfish scraps and to improve the community knowledge about the risk of consuming pufferfish.
authors: International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh. saiful@icddrb.org
authors: M Saiful
authors: MS
authors: Islam
authors: Stephen P
authors: SP
authors: Luby
authors: Mahmudur
authors: M
authors: Rahman
authors: Shahana
authors: S
authors: Parveen
authors: Nusrat
authors: N
authors: Homaira
authors: Nur Har
authors: NH
authors: Begum
authors: A K M
authors: AK
authors: Dawlat Khan
authors: Rebeca
authors: R
authors: Sultana
authors: Shammi
authors: S
authors: Akhter
authors: Emily S
authors: ES
authors: Gurley
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001285:Atropine / Q000627:therapeutic use; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005400:Fishes, Poisonous; D005502:Food / Q000191:economics*; D005506:Food Contamination; D005517:Foodborne Diseases / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D009388:Neostigmine / Q000627:therapeutic use; D010063:Ovum; D023721:Tetraodontiformes
chemical_list: D009388:Neostigmine; D001285:Atropine