Ciguatera Poisoning

Ciguatera poisoning occurs after eating reef dwelling fish that have fed on toxic plankton.

This can occur sporadically in the Pacific and Caribbean.

Affected fish cannot be distinguished by inspection, smell or taste, and cooking does not neutralize the toxin. Commercial tests to screen for ciguatera are being developed.

The best way to avoid during outbreaks is to avoid eating large predatory - type reef dwelling fish that are more likely to bio-accumulate the toxin.

The toxin is more concentrated in the head, liver, and gut of these fish.
Examples of some commonly affected species include: red snapper, grouper, barracuda, coral trout, cod and amberjack.

Symptoms usually occur after 1-6 hours (but have been up to 30 hours) after eating.

Mostly people are mildly affected with gastrointestinal symptoms (diarrhea, vomiting, and abdominal pain) but neurological also occur (muscle aches, weakness, blurry vision and burning).

Ciguatera poisoning also has particularly bizarre symptoms in that some will report a reversal of hot and cold sensations. Symptoms usually last less than 2 weeks.
Diagnosis is based on history.

Treatments involve antihistamines and sometimes administering mannitol (a medication that can be useful as a partial antidote).

Ciguatera Poisoning Information

Ciguatera Homepage-

Canadian Public Health Agency
Tahiti.net http://www.tahitinet.com/presense/ciguatera.html

Morbidity and Mortality Weekly Report Centers for Disease Control and Prevention http://vm.cfsan.fda.gov/~mow/cigua.html
Center for Disease Control CDC http://www.cdc.gov/ncidod/diseases/submenus/ sub_marine.htm
Divers Alert Network http://www.diversalertnetwork.org/medical/travel/seafood.asp