“…The clinical manifestations of the disease classically involve gastrointestinal disorders, cold allodynia, itching, paresthesia, asthenia, muscular pain, and dizziness, together with other neurological and cardio-vascular symptoms [ 7 ]. Although coral reef fish are usually regarded as the primary vectors of ciguatera, atypical ciguatera-like poisoning events following the consumption of giant clams ( Tridacna maxima ), marine gastropods ( Tectus niloticus ), and sea urchins ( Tripneustes gratilla ) are also occasionally reported from PICTs, most notably from French Polynesia, New Caledonia, Cook Islands, and the Republic of Vanuatu [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Besides the symptoms typical of CFP, atypical signs were also observed, such as the rapid onset of the disease (occurring within minutes), alteration of taste, burning sensation on the tongue and throat, as well as paralysis.…”