The number of annual CP cases worldwide has been estimated at between 50,000 and 200,000, but may represent only 20% of the actual figure.

Indeed, although considered the most widespread non infectious foodborne disease, the  data concerning the global population affected suffer from a real lack of completeness, partly due to the lack of information of health care workers and general population, no epidemiological surveillance programme available and difficulties related to the diagnosis (often incorrect or missing).

In addition, due to the lack of specific and effective treatment, many people prefer to treat themselves without the help of a physician, thus escaping the count since they are not subjected to declaration.

Few countries have implemented a CP surveillance program or require  its systematic report to Health authorities.
This lack of information therefore contributes to the large underestimation of the number of actual CP cases.

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The development of tourism and international trade, as well as the growing attraction for "exotic" products , make consumers of temperate regions new potential victims of Ciguatera.

Thus, increasing cases of so-called “imported” ciguatera are reported each year in the United States, Canada or Europe.

It may be a tourist becoming contaminated during a trip to an endemic country, or poisoning occurring in a temperate zone after consumption of contaminated fish imported from an endemic region.

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Map of imported Ciguatera cases

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If ciguatera was, until recently, considered as a problem specific to insular and coastal territories of warm seas, we assist for several years to a gradual expansion of ciguatera-affected zones, towards more temperate and previously free regions of Europe, Korea and South Australia...

Autochthonous cases of ciguatera (i.e. linked to the consumption of locally caught fish) have been recorded in new regions since the beginning of the 2000s, specifically in Madeira, the Canary Islands, Vietnam, Indonesia, Malaysia, Macau, Thailand and South Korea.

The emergence of these new ciguatera prone zones could originate from the impact of climate change (global warming) favoring the proliferation, on a global scale, of toxin-producing organisms and/or the migration of toxic tropical and subtropical fish to more temperate regions.

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