From the Research
Definition and Causes of Ciguatera
- Ciguatera fish poisoning (CFP) is a foodborne illness caused by the consumption of fish containing ciguatoxin (CTX) 1.
- The toxin is produced by the microalgae Gambierdiscus spp., which are eaten by reef fish, and then accumulated in the fish's tissues, especially the viscera 1.
- Humans contract the illness when eating either fish that have eaten the algae or carnivorous fish that have eaten those fish 1.
Symptoms and Effects of Ciguatera
- CFP produces a complex array of gastrointestinal, neurological, and cardiovascular symptoms, which may last days, weeks, or months 2.
- The illness is typically mild to moderate in severity, with gastrointestinal and neurological manifestations, such as diarrhea, cramping, nausea, vomiting, paraesthesias, cold allodynia, fatigue, and pruritis 1.
- Rarely, the disease can be more severe, with significant neuropathic or cardiac effects, such as bradycardia and hypotension 1.
Epidemiology and Public Health Impact
- CFP is the most frequently reported seafood-toxin illness in the world, causing substantial human health, social, and economic impacts 2.
- The incidence rates of CFP range from several to thousands of cases per 100,000 per year, and it is endemic to Hawai'i and islands throughout the Caribbean and Pacific 1.
- Expanding trade in fisheries from ciguatera-endemic regions contributes to the wider distribution and increasing frequency of the disease among seafood consumers in non-endemic regions 3.
Diagnosis, Treatment, and Prevention
- The diagnosis of CFP is primarily clinical, with confirmatory tests from fish samples available in some cases 1.
- Treatment is supportive and symptomatic, with no disease-specific remedy, and the prognosis for most cases is good with a short duration of self-limited symptoms 1.
- Education on which species of reef fish and which body parts to avoid eating is essential in the prevention of CFP, as there are no effective treatments available 1.