Ciguatera in the Gilbert Islands— COOPER 
413 
mation on currents, anchorages, and wrecks; 
officers and crews of all the ships in the colony, 
especially the Co-operative Society vessels; mem- 
bers of all the missions working in the Gilberts; 
Mr. G. Palmer of the British Museum (Natural 
History), London, and Dr. D. W. Strasburg of 
the U. S. Bureau of Commercial Fisheries, Ha- 
waii, for identifications of unrecorded species; 
and Dr. A. H. Banner and Dr. P. Helfrich of the 
Marine Laboratory of the University of Hawaii 
for advice in preparing this paper. 
The population statistics were taken from the 
"Report on Tarawa Atoll,” by E. Doran (I960); 
the land areas are taken from "Report on the 
Gilbert Islands: Some Aspects of Human Ecol- 
ogy,” by Rene L A. Catala (1957). The rainfall 
figures were kindly given me by the New Zea- 
land Meteorological Service, Laucala Bay, Suva. 
The maps, except that of Onotoa, are adapted 
from admiralty charts. The Fiji Government 
Printer gave great assistance in preparing the 
maps of Nikunau and Tabiteuea. The map of 
Onotoa was adapted from P. E. Cloud’s map, 
based on aerial surveys ( Atoll Research Bulletin 
12,1952). 
Above all, the greatest acknowledgment and 
thanks are due to the many Gilbertese old men 
and women, fishermen, and the "general pub- 
lic,” who patiently discussed for endless hours 
just "fish.” 
SYMPTOMS OF CIGUATERA POISONING 
IN THE GILBERTS 
Ciguatera poisoning is regarded as an occu- 
pational hazard by the Gilbertese, especially by 
those who have lived all their lives in a toxic 
area. As a result, they consider ciguatera poison- 
ing to.be a "Gilbertese sickness,” and they pre- 
fer to treat such sicknesses with their own 
remedies, as opposed to what they consider to 
be imported "European illnesses,” for which 
European medicines are logically more suitable. 
Gilbertese do not normally go to a medical offi- 
cer when poisoned by a fish, except on rare 
occasions when the victim is obviously on the 
point of death. Colony medical officers, there- 
fore, do not see or record many cases of fish 
poisoning. Although mild cases of poisoning are 
very frequent on some islands, medical depart- 
ment records are relatively few. 
The following sequence of symptoms of ci- 
guatera poisoning has been collected from talks 
with several assistant medical officers and col- 
ony dressers (male nurses trained at the Colony 
Central Hospital, Tarawa). At first, several 
hours after eating a toxic fish, there is nausea, 
followed by vomiting and severe stomach pains, 
which may be accompanied by diarrhea and 
fever. There is tingling of the arms and legs 
followed by numbness and a heaviness of the 
limbs, which may lead to complete loss of co- 
ordination or even to paralysis. The sense of 
balance is lost. In severe cases there may be 
great thirst. Intense itchiness is followed by 
peeling of the skin. Finally, in fatal cases the 
victim lapses into coma and dies. ■ 
The following case histories were taken from 
the assistant medical officer stationed on Betio, 
Tarawa. He, his wife, mother-in-law, and two 
teenage boys were poisoned in March, 1962. 
He caught a small Lutianus ho bar on the Betio 
lagoon reef. The fish was cooked and eaten on 
his return home, but no symptoms of poisoning 
appeared until 12 hr later. The five people in- 
volved ate varying amounts of the fish and had 
different symptoms. 
The assistant medical officer and his wife ate 
only a little of the fish. His symptoms, which 
appeared about 10 PM > were nausea but no vom- 
iting; his legs tingled and then felt numb; next 
morning the cement floor felt like ice to his 
bare feet and he was "very shivery” in the wind, 
but far too hot out of it. He managed to work 
for half the day, but then he felt too ill so went 
to bed. Next day he was better, the symptoms 
had all gone, but on the third day the tingling 
sensation in his legs returned and persisted for 
several days. His wife suffered nausea, vomiting 
all night, and a severe stomach-ache. She stayed 
in bed the next morning and complained of 
numbness in her arms and legs all day. She re- 
covered by the second day, except for a shivery 
feeling and an intensified tingling in her legs 
every time she put her hands in water. These 
feelings persisted for about a week. 
The old woman, the mother-in-law, ate more 
fish than the preceding two. She suffered from 
nausea, vomiting, and a severe stomach-ache all 
night. Next day and the day after, the vomiting 
and stomach-ache continued; she complained 
that she could not walk, her legs felt heavy, and 
