Ciguatera Fish Poisoning

An illness caused by toxins produced by algae and dinoflagellates that are seen near reefs and ingested by tropical fish that are subsequently consumed by humans. 

It is characterized by stomach cramps, nausea, vomiting and diarrhea that occurs within an hour of ingestion. This can be followed by numbness and tingling of lips, weakness and pain of legs.

Where does it occur?

It is commonly seen in areas where reef fish are eaten – like Australia, the Caribbean, Hawaii, Pacific Islands and Florida.

How is it transmitted?

It is transmitted by ingestion of large fish that seem to inhabit reefs like barracuda, snapper, amberjack and grouper.

Is it contagious from person to person?


What is the risk for travelers?

The risk is generally low.

How soon after exposure will I develop symptoms?

Initial symptoms usually develop within 1-6 hours of ingestion.

What are the signs and symptoms?

Within hours of ingestion one develops abdominal symptoms of stomach cramps, nausea, vomiting and diarrhea. One also sees neurological symptoms of tingling and numbness around the lips, tingling, pain, or weakness of the legs either with or after gastrointestinal symptoms.

In severe cases there is a sensation of reversal of hot and cold temperatures, aching teeth, slow pulse, respiratory failure and even coma. Neurological symptoms can last months.

Are there any lab tests to diagnose the illness?

There are no specific lab tests.

Is there any treatment?

Intravenous mannitol has been helpful with symptoms.

What preventive measures can be taken?

Avoid eating reef fish.

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