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Ciguatera Fish Poisoning, Causes, Signs and Symptoms, Diagnosis and Treatment.

. Chapters 0:00 Introduction 0:41 Causes of Ciguatera fish poisoning 2:09 Symptoms of Ciguatera fish poisoning 3:39 Diagnosis of Ciguatera fish poisoning 4:01 Treatment of Ciguatera fish poisoning Ciguatera fish poisoning (CFP), also known simply as ciguatera, is a foodborne illness caused by eating reef fish whose flesh is contaminated with certain toxins.[2] Such individual fish are said to be ciguatoxic. Symptoms may include diarrhea, vomiting, numbness, itchiness, sensitivity to hot and cold, dizziness, and weakness.[1][2] The onset of symptoms varies with the amount of toxin eaten from half an hour to up to two days.[3] The diarrhea may last for up to four days.[1] Some symptoms typically remain for a few weeks to months.[3] Heart difficulties such as slow heart rate and low blood pressure may also occur.[2] The specific toxins involved are ciguatoxin and maitotoxin.[2] They are originally made by a small marine organism, Gambierdiscus toxicus, that grows on and around coral reefs in tropical and subtropical waters.[2] These are eaten by herbivorous fish which in turn are eaten by larger carnivorous fish.[2] The toxins become more concentrated as they move up the food chain.[3] The fish most often implicated include barracuda, grouper, moray eel, amberjack, sea bass, and sturgeon.[2] Diagnosis is based on a person's symptoms together with having recently eaten fish.[1] If a number of those who eat the same fish develop symptoms the diagnosis becomes more likely.[1] If some of the fish they had previously eaten is available this can also be tested to confirm the diagnosis.[1] Preventive efforts include not eating reef fish, not eating high-risk fish such as barracuda, and not eating fish liver, roe, or fish heads.[2] Ciguatoxin has no taste or smell, and cannot be destroyed by conventional cooking.[2] There is no specific treatment for ciguatera fish poisoning once it occurs.[2] Mannitol may be considered, but the evidence supporting its use is not very strong.[1] Gabapentin or amitriptyline may be used to treat some of the symptoms.[2] The Centers for Disease Control estimates that around 50,000 cases occur globally each year.[2] Other estimates suggest up to 500,000 cases per year.[1] It is the most frequent seafood poisoning.[3] It occurs most commonly in the Pacific Ocean, Indian Ocean, and the Caribbean Sea between the latitudes of 35°N and 35°S.[2] The risk of the condition appears to be increasing due to coral reef deterioration and increasing trade in seafood.[2] The risk of death from poisoning is less than 1 in 1,000.[2] Descriptions of the condition date back to at least 1511.[3] The current name, introduced in 1787, is of Cuban Spanish origin and originally referred to the univalve mollusc Cittarium pica.[3]