Ciguatera fish poisoning—ciguatera—although not very well known, is a dangerous type of food poisoning that affects at least 50,000 people every year. According to MSNBC, the true number of illness could be at least 100 times higher.
The exotic fish poisoning is difficult to detect and diagnose, is relatively unknown in the United States, and is incurable. Caused by coral algae toxins that build up in large tropical reef fish, it strikes with bizarre symptoms, reports MSNBC. And, while rare in the U.S., ciguatera fish poisoning is, says Richard Weisman—toxicologist and director of the Florida Poison Information Center—“the most common seafood-toxin illness reported in the world,” said MSNBC.
In the Carribean and other tropical locations—MSNBC mentioned Hawaii, Guam, the Virgin Islands, and Puerto Rico—ciguatera turns up in large, “predatory” fish, the type caught by sport fishermen on coral reefs; however, originates from a much more insidious source: Microscopic sea plants. The plants are eaten by small fish, which are eaten by larger fish, which are eaten by larger fish, and so on, said MSNBC, which pointed out that the poison becomes more intense as the food chain progresses.
The U.S. Centers for Disease Control and Prevention (CDC) say that ciguatera is caused by toxins produced by a marine microalgae called Gambierdiscus toxicus and are known to turn up in fish such as barracuda, black grouper, blackfin snapper, cubera snapper, dog snapper, greater amberjack, hogfish, horse-eye jack, king mackerel, and yellowfin grouper.
One victim described to MSNBC reactions that are often seen in food borne infections—diarrhea, vomiting, fatigue—but also some which are a bit more unusual for food poisonings such as a significantly low heart rate and odd neurological symptoms, such as painful tingling in her hands and feet and inverted hot and cold sensations. The CDC says that ciguatera can cause these symptoms and that when the hot-cold reversal occurs, hot sensations register as cold and vice versa; severely problematic for the patient interviewed by MSNBC who described the horror of walking over a tile floor that felt as if it was scalding her feet. Others have reported feeling as if their teeth are falling out, reported MSNBC.
Part of the problem with ciguatera is that the symptoms are similar to those found in a number of other diseases, such as multiple sclerosis, said MSNBC. According to Melissa Friedman, a neuropsychologist at Mount Sinai Medical Center in Miami who studied victims of the illness, “You can’t tell from the way it looks. You can’t tell from the way it tastes. There’s nothing you can do in terms of storage. There’s nothing you can do in terms of cooking,” quoted MSNBC.
Those who fall ill undergo myriad testing and lose time receiving one of the few treatments—intravenous mannitol—known to decrease or prevent symptoms, which can be exacerbated when overexerted, or eating fish or nuts, or drinking alcohol. The poison cannot be detected and freezing and cooking do not kill it, noted MSNBC.
In the past, outbreaks in the continental U.S. tended to crop up in tourists following tropical vacations, but, in recent years, ciguatera outbreaks are rising, said MSNBC. Two years ago, 10 patrons at two restaurants in St. Louis became ill; last year, some outbreaks were associated with grouper and amberjack fish consumption; and, last month, Canadian food safety inspectors issued a health alert after two people fell ill following consumption of ciguatera-tainted frozen Leatherjacket fish, said MSNBC. The U.S. Food and Drug Administration (FDA) recently expanded its ciguatera risk guidelines, focusing on fish caught in the northern Gulf of Mexico.
Meanwhile, legal actions against restaurant and seafood suppliers are on the rise as fish from so-called “ciguatera hot spots” are caught and served to unsuspecting consumers.
The CDC reports that ciguatera has no cure and that while symptoms can disappear in days or weeks, they can last for years.
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