title: Association of cardiac disease and alcohol use with the development of severe ciguatera.
abstract: OBJECTIVE
  Ciguatera is a foodborne illness that causes severe gastrointestinal and neurologic symptoms, but the risk factors for illness are not well established.
  
  
  METHODS
  In St Thomas, US Virgin Islands, we performed a case-control study for ciguatera, enrolling 47 patients primarily through the emergency department and 141 age- and sex-matched controls identified through an island-wide survey. We used conditional logistic regression to assess health-related risk factors for ciguatera, including comorbidities and alcohol and tobacco use.
  
  
  RESULTS
  Cases were more likely than controls to report alcohol consumption at least weekly (odds ratio 5.7, 95% confidence interval 2.7-24.8). Cases also more frequently had a history of heart disease (odds ratio 6.3, 95% confidence interval 1.2-32.7). Previous ciguatera episodes, lower levels of education, and frequent fish consumption also were associated with illness.
  
  
  CONCLUSIONS
  This study provides preliminary evidence that preexisting health status influences an individual's risk of developing severe ciguatera. There may be a benefit to educating high-risk individuals about preventing ciguatera.
authors.affiliation: From the Department of Epidemiology and Emerging Pathogens Institute and the Department of Medicine, University of Florida, Gainesville, and the University of Maryland School of Medicine, Baltimore.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Radke
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Grattan
authors.forename: John Glenn
authors.initials: JG
authors.lastname: Morris
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D036841:Ciguatera Poisoning / Q000209:etiology*; D004522:Educational Status; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects