Ciguatera Fish Poisoning

Overview

Ciguatera fish poisoning is a foodborne illness caused by consuming fish contaminated with specific toxins.
It is the most frequent seafood poisoning globally, notably among travelers.
Common in tropical and subtropical regions: Pacific Ocean, Indian Ocean, and Caribbean Sea.
Incidence rates: 50,000 to 500,000 cases per year according to CDC.
Low risk of mortality.

Caused by eating fish contaminated with ciguatoxin.
Toxin produced by dinoflagellate Gambierdiscus toxicus, found in tropical shore areas and coral reefs.
Toxin concentration increases through the food chain:
- Herbivorous fish consume dinoflagellates.
- Carnivorous fish consume herbivorous fish.
- Humans consume carnivorous fish.
Toxin concentration highest in fish heads, roe, intestines, and liver.
Commonly affected fish species:
- Barracuda, sea bass, amberjack, moray eel, grouper, red snapper, parrotfish, hogfish, coral trout, kingfish, sturgeon fish.
Toxins cannot be detected by taste, odor, or texture and are not eliminated by cooking or other food preparation methods.

Appear 1-3 hours after consumption.
Gastrointestinal symptoms: Abdominal pain, nausea, vomiting, diarrhea.
Neurological symptoms (3-72 hours later):
- Itching, blurred vision, tingling, taste changes, numbness, muscle aches, headaches, hallucinations.
- Reversal of hot and cold sensations.
Other symptoms: Depression, blood pressure issues, chronic fatigue, irregular heartbeat.
May be sexually transmitted and through breast milk.
Symptoms duration: Weeks to years, up to 20 years, possible long-term disability.

Diagnosis based on symptoms and dietary history.
Likely if others who consumed the same fish also show symptoms.
Fish remains can be tested for confirmation.
Treatment is symptomatic and supportive.
- Intravenous fluids for dehydration due to nausea and vomiting.

Note: Cooking, smoking, freezing, or salting does not eliminate the toxins. Awareness and prevention are crucial.