Socioeconomic consequences of ciguatera poisoning in Rarotonga, southern Cook Islands

► We examined the socioeconomic consequences of ciguatera poisoning in Rarotonga. ► From 1989 to 2006, ciguatera poisoning halved the per-capita fresh-fish consumption. ► The economic consequences of ciguatera amounted to around NZD $750,000 per year. ► Costs associated with dietary shifts were approximated at NZD $1 million per year. ► Ciguatera may have changed the subsistence fishing lifestyle in Rarotonga.