Ciguatera poisoning: a global issue with common management problems

Ciguatera poisoning

“…Estimates of its worldwide incidence have been placed as high as 50 000 cases annually, most being reported from the Pacific Ocean, Indian Ocean and the Caribbean. 5,11,13,14 It is fast becoming a global health issue as more fish are exported from endemic areas to temperate regions, where ciguatera poisoning is likely to be under-recognised. 15,16 Although clearly most ciguatera cases are seen in the tropics, there is an increasing potential for cases to be encountered in temperate regions.…”

“…17 It is probable that more cases will occur as international air travel grows and the public's appetite for exotic reef fish increases. 13 As ciguatoxic fish often look, smell and taste normal, there is a need to increase public awareness about the risks of consuming particular fish, and perhaps also to consider preventative measures during the importation process, as there are now several bioassays to detect ciguatoxin in fish. 5,18 Symptoms As there is no definitive test for the toxin in human body fluids, the diagnosis is based on the characteristic symptoms of ciguatera poisoning and the history of having eaten a suspected ciguatoxic fish, usually in an appropriate geographical context.…”

Ciguatera fish Poisoning: a Challenge to Emergency Physicians

“…The differential diagnoses include other types of food poisoning, botulism, organophosphate insecticide poisoning, snake envenomation, beta-blocker or calcium channel blocker toxicity, myocardial infarction and septicaemic shock. 1,2,[7][8][9] Treatment is mainly supportive and symptomatic. There is no antitoxin available.…”

“…6 Amitriptyline, lignocaine, mexiletine, gabapentine, nifedipine, calcium gluconate, corticosteroids and vitamin B 12 have also been claimed to be useful by some authors, but without controlled study. 1,5,6,13,15 …”

“…1 It is most common in tropical and subtropical regions, around the Indian Ocean, the Pacific Basin and the Caribbean. As a result of the increase in tourism and imported fish, it can occur in any country all over the world.…”