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Ciguatera – Food Poisoning From Ciguatoxin

Ciguatera fish poisoning is the most frequently reported seafood toxic illness in the world. It is a type of seafood poisoning acquired by eating fish that have consumed dinoflagellates.

Dinoflagellates is a type of toxic single celled marine organism. It is a microscopic algae commonly found in subtropical and tropical climates. If a fish consumes other fish that have become toxic also causes ciguatoxin.

Food poisoning from ciguatoxin Is called ciguatera.

Ciguatera is caused by consumption of coral reef fish or carnivore’s fish that is contaminated by ciguatoxin. The algae are harmless to fishes. Ciguatoxin is odourless, tasteless and cannot be destroyed by cooking.so it is impossible to find if the fish is contaminated and requires extensive laboratory testing to confirm it .more than 400 different species of fishes has been implicated as a cause of ciguatera poisoning. It is possible that more than one form of toxin may be present in a fish.

Symptoms of ciguatera:

  • CFP is mainly associated with gastrointestinal, cardiovascular, neurological and neuropsychiatric symptoms.
  • The symptoms begins within 30 minutes of consumption of the contaminated fish . the initial symptoms are itching, tingling and numbness of lips, tongues, hands and feets.
  • The next symptoms from 6 to 17 hours may be abdominal cramps, diarrhoea, skin rashes, vomiting, dizziness etc.
  • Some individuals experience low blood pressure, breathing difficulties and even muscular paralysis.
  • Very severe cases may experience life threatening complications such as slow heartbeat, respiratory arrest or coma within hours of consumption.
  • A distinctive symptom reported by many patients is alteration or reversal of hot/cold temperature perception
  • The symptoms may vary from days to weeks or even months depending on each individual.

Symptoms of ciguatera

Evaluation:

Multiple tests are available to detect ciguatoxin including liquid chromatography mass spectrometry. But these tests are not available readily while the patients are in emergency. Treatment is given based on clinical findings, history of the patient and disease progression. 

Treatment for ciguatera

  • The main treatment is gastric lavage which means pumping out of all stomach contents.
  • Another method is vomiting induced by the administration of syrup of ipecac.
  • If shock or respiratory failure occurs immediate medical measures must be done.
  • Dextran, normal human serum albumin or blood transfusion is necessary to treat shock
  •  Meperidine may be prescribed for pain.

What to do if infected with ciguatera:

  •  Stay hydrated. Intravenous fluids are necessary for uncontrollable nausea and vomiting.
  •  Diphenhydramine may help relieve itching, it should be taken 6 hours once.
  •  Alcohol, fish, nuts and nut oil should be avoided because they may trigger recurrent symptoms.

Types of fishes that causes ciguatera:

The ciguatera toxin may be found in large reef fish

  • Moray
  • Barracuda
  • Grouper
  • Parrot fish
  • Red snapper
  • hogfish
  • Eel
  • Sturgeon fish
  • Amberjack
  • King fish
  • Seabass
  • Coral trout
  • Spanish mackerel

fish food poisoning

These fishes mostly live in coral reef waters . they are found in places such as Caribbean sea, Hawaii and central coastal America

Preventive measures:

Avoid eating reef fish and other types of fishes mentioned above that causes infection because there is no specific treatment once it occurs.

The centre of disease control has estimated that around 50000 cases are occurring every year and it is increasing. It is the most worst and frequent seafood poisoning. The risk is increasing due to coral reef detoriation and trade in seafoods.

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