What is ciguatera poisoning?
Ciguatera is a type of food poisoning. The ciguatera toxin may be found in large reef fish, most commonly barracuda, grouper, red snapper, eel, amberjack, sea bass, and Spanish mackerel. These fish live in coral reef waters between latitudes of 35 degrees south to 35 degrees north, corresponding to the area located between the Tropic of Cancer and the Tropic of Capricorn. These geographic lines ring the earth north and south of the equator and make up the tropics. These areas include the Caribbean Sea, Hawaii, and coastal Central America.
Ciguatera toxin tends to accumulate in predator fish, such as the Barracuda and other carnivorous reef fish because they eat other fish that consume toxin-producing algae (dinoflagellates) that live in coral reef waters.
Ciguatera toxin is harmless to fish but poisonous to humans. The toxin is odorless and tasteless, and it is heat-resistant, so cooking does not destroy the toxin. Eating ciguatera-contaminated tropical or subtropical fish poisons the person who eats it.
What causes ciguatera poisoning?
Ciguatera fish poisoning is caused by the consumption of reef fish that contain accumulated ciguatoxins. These toxins are produced by dinoflagellates, which are small marine organisms (microalgae) that belong to the species Gambierdiscus toxicus. Typically, they live in the coral reefs in tropical or subtropical areas.
Small herbivorous fish feed on these dinoflagellates. The ciguatoxins bio-accumulate in the marine food chain and contaminate larger predatory fish, usually weighing over 6 lbs. When humans consume the contaminated fish, it causes ciguatera fish poisoning.
Which fish are at risk of ciguatera food poisoning?
More than 400 different species of fish have been associated as the cause of ciguatera fish poisoning and such fish are said to be ciguatoxic fish.
Ciguatera toxin may be found in any large reef fish but is mostly found in the following:
- Barracuda
- Grouper
- Red snapper
- Moray eel amberjack
- Perch Spanish mackerel
- Parrotfish
- Hogfish
- Sturgeon fish
- Kingfish
- Coral trout
- Sea bass
QUESTION
See AnswerWhat are the symptoms of ciguatera poisoning?
Symptoms of ciguatera poisoning generally begin six to eight hours after eating the contaminated fish.
Symptoms may include:
The hot and cold sensation may be reversed.
Severe cases of ciguatera poisoning may result in the following:
Death due to heart or respiratory failure occurs in rare cases.
When should I see a doctor for ciguatera poisoning?
Severe cases of ciguatera poisoning require hospitalization for intravenous fluids. If you think you may have ciguatera poisoning, seek immediate medical attention.
A doctor should be consulted in every case about treatment for ciguatera poisoning, including available medications.
Health News
- TikTok Riddled With Misleading Info on Health: Study
- Patient Gets First-Ever Pig Kidney Transplant Plus Heart Pump
- Opioids During Pregnancy May Not Raise Psychiatric Risks for Offspring
- Watchdog Group Says U.S. Food Recalls Rose Again Last Year
- Could Heartburn Meds Raise Your Migraine Risk?
- More Health News ยป
What is the treatment for ciguatera poisoning?
If you or someone you know has ingested a fish that you suspect might be contaminated with ciguatera toxin, and you or they have signs or symptoms, such as nausea, vomiting, pain, trouble breathing, seizure, confusion, or abnormal skin color, call either an ambulance or the National Poison Control Center (1-800-222-1222) for guidance.
- The National Poison Control Center's phone number is 1-800-222-1222. This number is routed to the poison control center that serves your area.
- Place the telephone number (along with police, fire, and 911 or equivalent) near your home phones.
- Do not induce vomiting or give syrup of Ipecac.
- Ipecac was formerly used to induce vomiting in poisoned patients where there was a chance to get the toxin out of the body. Several advisory bodies such as the American Association of Poison Control Centers and the American Academy of Pediatrics have recommended that Ipecac NOT be used and that it should not even be kept in the household. For more information on this subject go to: http://www.poison.org/prepared/ipecac.asp
- Do not give activated charcoal at home. Allow medical personnel to decide if this treatment is appropriate.
The poison control center will instruct you on what to do.
- Maintain hydration. Intravenous fluids may be necessary for uncontrollable nausea and vomiting.
- There is no specific antidote for ciguatera poisoning.
- Diphenhydramine (Benadryl) may help relieve itching. Give 25-50 mg every 6 hours.
- Alcohol, fish, nuts, and nut oils should be avoided after exposure to ciguatera poisoning because they may trigger recurrent symptoms.
What are the complications of ciguatera fish poisoning?
Severe cases of ciguatera poisoning may result in breathing difficulties, muscular paralysis, coma, itching, skin rash, stiff neck, sweating, chills, tearing of the eyes, or drooling.
Death due to heart or respiratory failure may occur in rare cases within 24 hours.
Prevention of ciguatera fish poisoning
Ciguatera food poisoning may be prevented by:
- Avoid eating reef fish that weigh 6 lbs or more.
- Avoid eating the liver, intestine, head, and roe of smaller reef fish.
MedscapeReference.com. Ciguatera Toxicity.
Centers for Disease Control and Prevention. Fish Poisoning in Travelers: Ciguatera and Scombroid. https://wwwnc.cdc.gov/travel/page/fish-poisoning-ciguatera-scombroid
Friedman MA, Fleming LE, Fernandez M, et al. Ciguatera Fish Poisoning: Treatment, Prevention and Management. Mar Drugs. 2008;6(3):456-479. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579736/
Science Direct. Ciguatera. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/ciguatera
National Organization for Rare Disorders. Ciguatera Fish Poisoning. https://rarediseases.org/rare-diseases/ciguatera-fish-poisoning/
Top Ciguatera Poisoning Related Articles
Food Poisoning
Concerned about food poisoning outbreaks? From ground beef to lettuce, many foods can cause them. Learn about foodborne diseases like Salmonella, E. coli, norovirus, Campylobacter, Staph, and hepatitis A.9 Food Poisoning Myths That Are Wrong
Knowing too much wrong information about a condition is just as bad as knowing too little about a disease. That's why we took it upon ourselves to debunk these 9 food poisoning myths.Abdominal Pain
Abdominal pain can have many causes that range from mild to severe. Some of these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn's disease, ulcerative colitis, gallbladder disease, liver disease, and cancers. Signs and symptoms of the more serious causes include dehydration, bloody or black tarry stools, severe abdominal pain, pain with no urination or painful urination. Treatment for abdominal pain depends upon the cause.Diarrhea
Diarrhea is a change in the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.Dizziness
Dizziness is a symptom that often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and other medical conditions. Treatment of dizziness depends on the cause.Food Poisoning
Food poisoning is common but can also be life-threatening. Food poisoning symptoms include stomach cramps, diarrhea, and vomiting. Read about different types of food poisoning, treatment, and tips for prevention.Food Poisoning Quiz
What causes food poisoning? Can it be prevented? Take this quiz to learn about food safety and how to guard yourself against food poisoning.Food and Health: Foods Most Likely to Give You Food Poisoning
Every year, 1 in 6 people in the U.S. get a foodborne illness. Find out which foods sicken the most number of Americans, and how.Nausea and Vomiting
Nausea and vomiting are symptoms of many conditions including motion sickness, pregnancy, emotional stress, gallbladder disease, and other illnesses. Learn about causes, treatment, and when to be concerned.Skin Rash
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.Salmonella Food Poisoning Treatment, Symptoms
What is Salmonella? What are the best treatments for Salmonella, and what are its symptoms? From food poisoning to typhoid fever, learn about this common pathogen. Discover how to prepare food without Salmonella risk, and what to do if you get a Salmonella infection.Stomach Flu vs. Food Poisoning
The stomach flu (viral gastroenteritis) and food poisoning are not the same infections. However, they do have a few similar symptoms, for example:
- Nausea
- Vomiting
- Diarrhea
- Fever
- Abdominal (stomach) pain and cramping.
Symptoms and signs of food poisoning show up earlier (2 hours up to a couple of days) in comparison to the stomach flu in which symptoms may take 4 hours up to 48 hours (2 days) before symptoms begin. Medical treatment for the stomach flu and food poisoning generally is not necessary. A bland diet, drinking plenty of fluids, and rest may be the only treatment necessary.
What Can Trigger Vertigo?
Vertigo is the sensation of spinning or rocking, even when someone is at rest. Vertigo may be caused by a problem in the brain or spinal cord or a problem within in the inner ear. Head injuries, certain medications, and female gender are associated with a higher risk of vertigo. Medical history, a physical exam, and sometimes an MRI or CT scan are required to diagnose vertigo. The treatment of vertigo may include medication, special exercises to reposition loose crystals in the inner ear, or exercises designed to help the patient re-establish a sense of equilibrium. Controlling risk factors for stroke (blood pressure, weight, cholesterol, and blood glucose) may decrease the risk of developing vertigo.What Medicine Helps With Food Poisoning?
Learn what medical treatments can help ease your food poisoning symptoms and speed up your recovery. Many cases of food poisoning never get an official diagnosis from the doctor. If you need to visit your doctor for food poisoning, they will diagnose you based on your symptoms. Food poisoning is a common illness that usually resolves within one to two days. Learn the signs of food poisoning, what causes food poisoning, and what you can do to treat food poisoning.