Kiribati has one of the highest rates of ciguatera poisoning in the Pacific (Lewis and Ruff 1993). The disease is contracted by consuming reef fish that have been contaminated by ciguatoxins.
A recent study found a statistically significant relation between sea surface temperatures and the reported incidence of ciguatera fish poisoning in Kiribati (Hales and others 1999). This relation was used to model the projected increases in ciguatera poisoning. The model shows that a rise in temperatures is expected to increase the incidence of ciguatera poisoning from 35–70 per thousand people in 1990 to about 160–430 per thousand by 2050.
These results should be interpreted cautiously, as the model is based on many uncertainties and limited data. The overall impact of climate change on ciguatera should perhaps be measured not in terms of incidence rates but in terms of how people respond to the increased risk (Ruff and Lewis 1997). This may include changes in diets, decreased protein intake, increased household expenditures to obtain substitute proteins, and loss of revenue from reef fisheries. In addition, reef disturbance has been linked to ciguatera outbreaks (Ruff, 1989; Lewis 1992), suggesting that improved management of coastal areas would be an important adaptation strategy.