Ciguatera fish poisoning
Ciguatera is a form of human poisoning caused by the consumption
of subtropical and tropical marine finfish which have accumulated
naturally occurring toxins through their diet.
Manifestations of ciguatera in humans usually involves a
combination of gastrointestinal, neurological, and cardiovascular
disorders. Symptoms defined within these general categories vary
with the geographic origin of toxic fish. Initial signs of
poisoning occur within six hours after consumption of toxic fish
and include perioral numbness and tingling (paresthesia), which may
spread to the extremities, nausea, vomiting, and diarrhea.
Neurological signs include intensified paresthesia, arthralgia,
myalgia, headache, temperature sensory reversal and acute
sensitivity to temperature extremes, vertigo, and muscular weakness
to the point of prostration. Cardiovascular signs include
arrhythmia, slowed heart rate or rapid heart rate, and reduced
Clinical testing procedures are not presently available for the
diagnosis of ciguatera in humans. Diagnosis is based entirely on
symptomology and recent dietary history.
Marine finfish most commonly implicated in ciguatera fish
poisoning include the groupers, barracudas, snappers, jacks,
mackerel, and triggerfish. Many other species of warm-water fishes
harbor ciguatera toxins. The occurrence of toxic fish is sporadic,
and not all fish of a given species or from a given locality will
The relative frequency of ciguatera fish poisoning in the United
States is not known. The disease has only recently become known to
the general medical community. There is a concern that incidence is
largely under-reported because of the generally non-fatal nature
and short duration of the disease.
Ciguatera poisoning is usually self-limiting, and signs of
poisoning often subside within several days from onset. However, in
severe cases the neurological symptoms are known to persist from
weeks to months. In a few isolated cases neurological symptoms have
persisted for several years. In other cases, recovered patients
have experienced recurrence of neurological symptoms months to
years after recovery. Such relapses are most often associated with
changes in dietary habits or with consumption of alcohol. There is
a low incidence of death resulting from respiratory and
All humans are believed to be susceptible to ciguatera toxins.
Populations in tropical/subtropical regions are most likely to be
affected because of the frequency of exposure to toxic fishes.
However, the geographic range of human poisonings has expanded.
This is due to increasing per capita consumption of fishery
products coupled with an increase in interregional transportation
of seafood products.
Food and Drug
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
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