EuroCigua II identifies 10 ciguatera outbreaks in Europe and shows that the risk comes both from European waters and imported fish

The final EuroCigua II report catalogs 10 ciguatera outbreaks and 40 reported cases during 2020–2025, with eight outbreaks recorded in Spain and two in Germany and the Netherlands following consumption of fish imported from India. The project confirms the strongest evidence of local exposure in the Canary Islands and the persistent presence of ciguatoxin-associated microalgae in the Balearic Islands, but shows that the available data still do not permit uniform quantification of the risk across the EU.

Ten ciguatera poisoning outbreaks, involving 40 people, were reported in Europe between 2020 and 2025 in the data compiled by the EuroCigua II project. Eight outbreaks were reported in Spain, where the risk is already known, particularly in the Canary Islands, while two others, in Germany and the Netherlands, were associated with consumption of fish imported from India. The final report published on 14 October brings together, for the first time in the same assessment, epidemiological results, fish and microalgae analyses, the development of laboratory methods, and modeling of environmental factors to describe both exposure originating in European waters and the risk introduced through international fish trade.

In brief

EuroCigua II cataloged 10 ciguatera outbreaks and 40 cases reported during 2020–2025.

Eight outbreaks were reported in Spain, while two, in Germany and the Netherlands, involved fish imported from India.

The most consistent evidence of a complete local risk pathway comes from the Canary Islands, where toxin-producing microalgae, ciguatoxins in fish, and human cases were documented.

Persistent populations of Gambierdiscus were identified in the Balearic Islands, but the fish samples analyzed as part of the project did not demonstrate ciguatoxin-type toxicity under the test conditions.

The project improved surveillance and laboratory capacity, but the lack of sufficient reference standards and complete toxicological data still prevents a uniform risk assessment at EU level.Ciguatera is food poisoning caused by consuming fish that have accumulated ciguatoxins. These toxins are produced by certain microalgae, especially from the genera Gambierdiscus and Fukuyoa, which may be consumed by small organisms and then transferred through the marine food chain to larger fish. Toxins cannot be identified by consumers from the fish’s appearance or taste, and heat treatment is not a reliable method of eliminating the risk. Poisoning can cause gastrointestinal, cardiovascular, and neurological symptoms, some of which may persist after the acute episode.

The phenomenon is mainly associated with tropical and subtropical regions; however, its occurrence in Europe is no longer exclusively linked to people who consumed fish while traveling in such areas. Indigenous outbreaks have been documented in European Macaronesia, particularly in the Canary Islands and Madeira, and microalgae relevant to ciguatoxin production have also been identified in the Mediterranean Sea. The first EuroCigua phase documented 34 outbreaks and 209 cases in Europe for the period 2012–2019 and showed that the phenomenon had become sufficiently established in Macaronesia to require more systematic European surveillance.

EuroCigua II expanded precisely this surveillance. The project’s epidemiological component created a common protocol for reporting cases and outbreaks, so that information from different countries could be compared. However, the figure of 40 cases for 2020–2025 should be interpreted with caution. Ciguatera is considered underdiagnosed and underreported, and the project itself aims to improve the ability of physicians and authorities to identify poisonings. The available data therefore represent cases reported through participating systems, not an estimate of all people who might have been affected in Europe during that period.

The two outbreaks in Germany and the Netherlands show why the European assessment cannot be limited to marine areas where the microalgae live. In these cases, exposure was associated with fish imported from India. Globalized trade can bring species caught in waters where ciguatera is endemic to European markets, meaning that a consumer may be exposed in a European country even when the fish did not originate in European waters. For this reason, EuroCigua II included a separate component on ciguatoxins in imported fish and treated the product’s origin as one of the elements necessary for risk assessment.

Regarding indigenous risk, the Canary Islands offer the most complete combination of evidence. European research has identified microalgae there capable of producing toxins, fish in which ciguatoxins were detected, and poisoning cases following consumption of local catches. This sequence, from the toxin-producing organism to the fish and then to human illness, allows exposure to be characterized much more robustly than by merely identifying a microalga in a marine area.

The situation in the Balearic Islands shows why these stages must not be confused. EuroCigua II documented persistent populations of Gambierdiscus in the western Mediterranean, confirming the environmental presence of organisms associated with ciguatoxin production. However, the fish samples analyzed as part of the project did not show detectable ciguatoxin-type toxicity under the test conditions used. The presence of microalgae cannot automatically be translated into a claim that fish intended for consumption are contaminated or that the same level of risk exists as in the Canary Islands.

This distinction is also essential to how climate change is incorporated into the assessment. Water temperature and other environmental conditions influence the distribution and development of microalgae, and EuroCigua II developed models to study the relationship between biological, oceanographic, and climatic variables and the emergence of risk in the Canary Islands and the Mediterranean. The results can be used to identify areas requiring closer surveillance and to develop future scenarios, but they do not demonstrate that all European areas with warmer waters will automatically develop ciguatera outbreaks.

Another important component of the project was the ability of laboratories to identify ciguatoxins. Their detection is difficult because there are several toxin variants, concentrations may be very low, and reference materials are limited. EuroCigua II worked on culturing microalgae, characterizing toxins by mass spectrometry, developing reference materials, and increasing the capacity of participating laboratories. This progress enables more comparable results, but the final report shows that harmonization is not yet sufficient for all samples and all regions to be assessed through a fully uniform system.

The lack of numerically harmonized maximum levels for ciguatoxins does not mean that contaminated products may be marketed. EU rules on official controls provide that fishery products containing biotoxins such as ciguatera or other toxins hazardous to human health must not be placed on the market. The practical problem is that enforcing this ban depends on the authorities’ ability to identify contaminated products and on the existence of sufficiently robust methods and reference materials for control purposes.

EuroCigua II was coordinated by the Directorate-General for Public Health of Spain’s Ministry of Health and brought together health authorities, research institutes, and laboratories from several European countries, with the technical participation of EFSA and other organizations. The project began in 2022, and its final results were published in October 2026 in a package of reports on epidemiology, imported fish, microalgae, fish caught in risk areas, toxin characterization, and modeling.

The documents published in EFSA Supporting Publications are external scientific reports produced under the grant and do not represent a scientific opinion adopted by EFSA. They do not themselves introduce new mandatory limits, bans, or market rules. Their value lies in providing a stronger database and methods for future assessments and for controls by national authorities.

For European countries, the practical conclusion is that the risk must be monitored along two pathways simultaneously. In areas such as the Canary Islands and certain parts of the Mediterranean, monitoring of the marine ecosystem and locally caught fish is necessary. In the rest of the EU, import surveillance, rapid investigation of outbreaks, and identification of the fish’s origin remain equally important. The report does not indicate a new outbreak in Romania and does not demonstrate a specific risk for the Black Sea.

https://2eu.brussels/ro/news/eurocigua-ii-identifica-10-focare-de-ciguatera-in-europa-si-arata-ca-riscul-vine-atat-din-apele-europene-cat-si-din-pestele-importat