Un problème de santé publique réémergent à Madagascar: les intoxications collectives par consommation d'animaux marins. Aspects épidémiologiques, cliniques et toxicologiques des épisodes notifiés de janvier 1993 à janvier 1998

" Reemerging health problem in Madagascar : mass food poisoning following seafoods consumption. Epidemiological, clinical and toxicological aspects of outbreaks notified from January 1993 to January 1998". During these 5 last years, 19 outbreaks of mass seafoods poisoning were notified at the malagasy Health Ministry. This public health problem, which the administration had forgotten during still 30 years, had mobilised the Health Ministry since 1994 to plan monitoring and primary prevention measures. The marine animals which caused this problem are multiple : sharks, turtles, fishes and mollusca. Poisoning by sharks consumption were most frequent : they give predominant neurological signs. The clinical status varies from serious situation as in Manakara outbreak in 1993 with a lethality of about 30% to mild forms which recall rather the ciguatera as in outbreak of Toliara in 1997 with no death. In the majority of outbreaks, marine toxins were isolated. Popisoning by turtles con,sumption were not rare. Two turtles species were essentially found : Eretmochelys imbricata and Chelonia mydas. In half outbreaks, mucous and neurological signs considered as pathognomonical signs in chelonitoxism were found. Poisoning by fishes consumption were less frequent. They were caused by different species. Baudruche fish (Arothron sp) is fish known for its toxicity risk named clupeotoxism; the outbreak of Antalaha permitted to approach the toxin that could be palytoxin. The crimson snapper (Lutjanus erythropterus, Lutjanidae) gives a clinical status that could evoke the ciguatera. In these poisoning by fishes consumption, none of the clinical status was evocative of scombroïd poisoning. Poisoning by mollusca consumption were rare. Clinical status could evoke saxitoxin and lyngbia toxins poisoning outbreaks. Mots-clés : Food poisoning Marine toxins Sharks Turtle Fishes Mollusca Ichtyotoxism Chelonitoxism MADAGASCAR. Arch Inst Pasteur Madagascar 1998; 64 (1&2) : 71-76 1 Conseiller technique, Direction de la Lutte contre les Maladies Transmissibles (DLMT), Ministère de la Santé,BP 460, 101 Antananarivo Madagascar. 2 Service de Surveillance Epidémiologique, Ministère de la Santé/Direction de la Lutte contre les Maladies Transmissibles (DLMT), BP 460, 101 Antananarivo Madagascar. 3 Institut Pasteur de Madagascar, BP 1274, 101 Antananarivo Madagascar. 4 Faculty of Agriculture. Tohoku University. 1-1 Tsutsumidori Amamiyamachi. Aoba-ku. Sendai 981. Japan.