E. T. H. LIU, C. D’CUNHA, B. YAFFE, C. OSTACH, J. URQUHUART, K. GORMAN, W. LEE, J. YING, L. LANDRY, M. ARMSTRONG-EVANS, THE FISH TEAM, D. E. LOW, A. MCGEER. Mount Sinai/Princess Margaret Hospitals, University of Toronto and the Toronto Public Health Department, Canada.

Objective: S. iniae is an emerging pathogen of fish. There is recent evidence that this pathogen is capable of causing invasive disease in humans. During a one year period (1995-96) there were 9 patients with bacteraemia caused by S. iniae in the GTA. All had handled live or freshly killed fish. 6/9 fish were tilapia and 8/9 patients were of Chinese descent. Our objective was to study the fish buying and handling characteristics of Torontonians.

Methods: A questionnaire was designed to obtain information regarding the buying and preparation of raw fish, and the incidence of injury associated with handling fish. It was administered to customers outside a random sample of stores selling fresh fish in Scarborough, North York and the City of Toronto. Data were analyzed using EpiInfo 6.04.

Results: Between July and November 1997, 100 questionnaires were completed. 80/100 (80%) of people interviewed were of Chinese descent and 60/80 (75%) of these bought at least one raw fish per week compared to 5/20 (25%) non-Chinese (P<0.002). The last raw fish purchased was tilapia for 22/80 (28%) of Chinese and 0/22 (0%) for non-Chinese (P<0.005). However, the amount of time Chinese spent handling the fish (P<0.48) and storing the fish before preparation (P<0.60) were not significantly different when compared to the non-Chinese. 51/100 people reported at least one prior injury during fish preparation, and of these 39/51 (76%) claimed to have been injured from fins, 5/51 (10%) from bones and 7/51 (14%) from both. Only 29/51 customers had recalled which type of fish caused the injury and 13 of these 29 injuries were due to tilapia.

Conclusion: Our survey results indicate that the Chinese population purchased more whole raw fish than the non-Chinese population in the GTA. Tilapia was also consumed more often by the Chinese population, and there were more injuries associated with tilapia than other fish types. This may explain the predominance of Chinese and tilapia among the 9 patients with invasive S. iniae infection.

Presented at:

CANADIAN ASSOCIATION FOR CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES (CACMID), 66^th Conjoint Meeting on Infectious Diseases, Toronto, ON, Canada, Nov 8-12, 1998.