Ciguatera Poisoning: An Unwelcome Vacation Experience

Winter, F. David

doi:10.1080/08998280.2009.11928495

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…However, recent indigenous CFP cases have been reported in Spain (Canary Islands) [ 7 ], temperate areas of Japan, South Korea [ 8 , 9 ], and CTX-containing marine organisms have been reported in the Madeira Archipelago and Israeli coast [ 10 , 11 ], reflecting a progressive expansion of the ciguatoxic risk at a global scale. Moreover, due to the increase in the international fish trade, tourism, and interest in exotic products, non-endemic regions, such as Europe or North America, are currently facing an increase in imported CFP cases [ 12 , 13 , 14 ], raising new concerns about fish import regulations, medical professional outreach, and management of a new category of patients.…”

Section: Introductionmentioning

confidence: 99%

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia)

Gatti

Lonati

Darius

et al. 2018

Toxins

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Ciguatera fish poisoning (CFP) is the most prevalent non-bacterial food-borne form of poisoning in French Polynesia, which results from the consumption of coral reef fish naturally contaminated with ciguatoxins produced by dinoflagellates in the genus Gambierdiscus. Since the early 2000s, this French territory has also witnessed the emergence of atypical forms of ciguatera, known as ciguatera shellfish poisoning (CSP), associated with the consumption of marine invertebrates. In June 2014, nine tourists simultaneously developed a major and persistent poisoning syndrome following the consumption of the gastropod Tectus niloticus collected in Anaho, a secluded bay of Nuku Hiva Island (Marquesas Archipelago, French Polynesia). The unusual nature and severity of this event prompted a multidisciplinary investigation in order to characterize the etiology and document the short/long-term health consequences of this mass-poisoning event. This paper presents the results of clinical investigations based on hospital medical records, medical follow-up conducted six and 20 months post-poisoning, including a case description. This study is the first to describe the medical signature of T. niloticus poisoning in French Polynesia and contributed to alerting local authorities about the potential health hazards associated with the consumption of this gastropod, which is highly prized by local communities in Pacific island countries and territories.

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Section: Introductionmentioning

confidence: 99%

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia)

Gatti

Lonati

Darius

et al. 2018

Toxins

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“…It is typical for neurological symptoms of CFP to linger on. A case presented by Winters [ 7 ] showed ciguatoxin presenting with persistent neurological deficits and improvement of symptoms with similar medications. Along with this presentation is generalized pruritus, a known neurologic symptom that presents and lasts like the others.…”

Section: Discussionmentioning

confidence: 99%

Ciguatera Toxin Syndrome from Amberjack Ingestion as a Cause of Chronic Dermatitis with Episodic Erythema

Lucas,

Kile,

Ganguli

et al. 2023

Cureus

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Bioaccumulation of naturally produced ciguatoxin (CTX), such as that in ciguatera poisoning, continues to be a subject of great interest. In this condition, CTX is ingested by subtropical and tropical reef fish. Humans consume the fish species, and CTX is absorbed through the gastrointestinal tract and binds voltage-gated sodium channels on nerve terminals to cause neurological, gastrointestinal, cardiac, and rare dermatological clinical manifestations. In this present case, we discuss a 65-year-old female who presented with acute loose bowel movements and generalized pruritus of her anterior chest wall, abdomen, and bilateral upper and lower extremities 48 hours after consumption of amberjack fish. The patient was treated with intravenous corticosteroids and epinephrine and discharged with an oral corticosteroid taper. After appropriate treatment protocol, the patient continued to have pruritus with a burning sensation in her extremities with a rare skin dermatitis. Subsequent treatment included topical corticosteroids and moisturizing lotion to create a skin barrier, fexofenadine for pruritus control, and gabapentin and amitriptyline for paresthesia. This case demonstrates the need for continued research and patient education into the broad clinical manifestations that present as life-altering ciguatera poisoning.

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“…Reef disturbances and global warming increase the risk of ciguatera by increasing benthic substrate for dinoflagellate growth [3]. Destruction of coral reefs aid increased growth of algae and their dinoflagellates [4]. This may also be influenced by the degree of sunlight exposure in the presence of silicates and oxides from adjacent land soils; and with algal detritus resulting in the development of peculiar algal turfs Turbinaria, Jania and Amphiroa species.…”

Section: Introductionmentioning

confidence: 99%

“…Ingesting fish meat containing CTX produces an illness very much similar to other food poisoning or gastrointestinal infections. The majority of patients begin to have signs and symptoms of ciguatera within 6 -10 hours (range 1 -48) [4]- [7]. Neurological symptoms often manifest early as headache, numbness, "classic" reversal of temperature perception, ataxia (rare) and muscle paralysis.…”

Section: Introductionmentioning

confidence: 99%

Marine Fish Toxins in Thailand: Report of 6 Suspected Ciguatera Cases

Saraya¹,

Sintunawa²,

Wacharapluesadee³

et al. 2014

CRCM

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Food poisoning or gastroenteritis is a common diagnosis for individuals who have nausea, vomiting and diarrhea after ingestion of fish. When also manifesting neurological symptoms, these are blamed on puffer fish poisoning, but ciguatera fish poisoning (CFP) can also manifest only with gastroenteritis, without neurological complications and remain undiagnosed. We report patients who fulfilled criteria of CFP suffering from severe GI disturbances, neurological manifestations, compromised cardiovascular status and autonomic dysfunction. All recovered within 1-3 days with supportive treatment. There were two small outbreaks: one in Bangkok in 2007 (2 patients) and another (2009) in Phuket (4 patients). All patients consumed the same unidentified fish portion and had severe GI symptoms. One had acute ventilatory failure requiring intubation whereas the remaining had neurological disturbances consisting of paresthesia, severe vertigo and ataxia. Absence of reflex tachycardia was noted in all patients who had severe volume depletion and shock. The most severe patient could be extubated within 24 hours and was discharged in 48 hours. All of the remaining recovered completely within 48 hours. Severe abdominal pain, nausea and vomiting and autonomic dysfunction in the form of bradycardia in the presence of hypotension were seen. Dramatic recovery within 48 hours occurred in all cases. None of the fish considered to have been responsible was available for testing. Physicians should be aware of CFP intoxication in the differential diagnosis of gastroenteritis-like syndromes after eating seafood.

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Ciguatera Poisoning: An Unwelcome Vacation Experience

Cited by 4 publications

References 6 publications

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia)

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia)

Ciguatera Toxin Syndrome from Amberjack Ingestion as a Cause of Chronic Dermatitis with Episodic Erythema

Marine Fish Toxins in Thailand: Report of 6 Suspected Ciguatera Cases

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