Ciguatera Fish Poisoning: Treatment, Prevention and Management

Abstract

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to Mar. Drugs 2008, 6457 weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

Evaluation of Harmful Algal Bloom Outreach Activities

“…Recommendations for improving the Aquatic Toxins Hotline automated HAB system include the following: 1) Existing automated materials need to be revised to incorporate an ongoing evaluation component, with a focus on tourist not just resident callers, and in coordination with ongoing efforts in providing geographic location [23]; 2) Existing materials will need constant updating; and 3) Ongoing training should be provided for the Poison Information Specialists (as well as other healthcare providers) concerning the possible exposures and health effects from the aquatic toxins as new HAB research data and resources are made available [13,[23][24][25][26][27][28][29]. In addition, as different HAB educational outreach materials and services are created, these materials and services need to be evaluated before and after implementation in the target populations to improve their quality and utility.…”

Presumptive Case of Ciguatera Fish Poisoning in Mangalore, India

“…Distribution of ciguateric fish is restricted to tropical and subtropical waters, being particularly common in Pacific and Indian oceanic regions and in the tropical Caribbean Sea 3 . Depending on their geographical origin and chemical structure, CTXs are classified as Pacific (P-CTX), the Indian Ocean (I-CTX) and the Caribbean (C-CTX) of which P-CTXs are considered to be the most potent 4,5 . CFP outbreaks outside of endemic areas have been attributed to consumption of imported toxic fish 6 and expanding biogeographical range of Gamberdiscus spp.…”

Ciguatera, an Emerging Human Poisoning in Europe

“…Two families of P-CTX with seven different structures have been described throughout the years, as well as two structures of C-CTX and four of I-CTX [6]. In general, P-CTXs are considered the most potent, being 10-fold more potent than the Caribbean variants [7]. The toxicity of the four described I-CTXs variants is estimated at about 60% of the P-CTXs [8].…”