Poison Prevention, Uncategorized

An Unhappy Fish Story: Poison Centers Warn of Rare Fish Poisoning

The symptoms can begin like those of a typical food poisoning: body aches, nausea, diarrhea and vomiting.  But then, the symptoms get weird: joint pain; numbness; tingling hands, feet or mouth; and most strange of all, the reversal of hot and cold sensations. If you’ve eaten fish in the last 24 hours, you may have come down with a marine toxin disease called ciguatera.

Image: Suat Eman / FreeDigitalPhotos.net

According to the American Association of Poison Control Centers, in 2010, U.S. poison centers fielded 178 exposure calls about ciguatera, the most frequently reported seafood-related illness in the world. While ciguatera used to be common only to tropical fishing communities, the globalization of our food supply and an increase in tourism have led to cases of ciguatera turning up in places as unexpected as Ohio and Alaska.

Ciguatera is caused by reef-dwelling algae called Gambierdiscus toxicus. When these algae get eaten by small fish, and they in turn are eaten by larger fish, the toxin can accumulate to dangerous levels and lead to serious symptoms for anyone who eats the seafood. If untreated, symptoms (such as joint pain, achy teeth and tingling) can last for weeks, or even months. It can be difficult for doctors not familiar with ciguatera to diagnose the disease, especially if the patient does not mention having eaten fish before the appearance of the illness.

Poison specialists at America’s 57 poison centers are trained to deal with unusual poisonings like ciguatera, as well as more common poisonings resulting from medication errors or a child’s curiosity.  Poison centers maintain an extensive network of experts who can quickly assist doctors in identifying and treating even unusual toxin-related diseases. About one-fifth of all calls to poison centers come from doctors, nurses and hospital staff who are seeking help caring for their patients.

The American Association of Poison Control Centers offers the following tips for safely enjoying fish at home or on vacation:

  • Buy your seafood from a reputable supplier with an established history of food safety.
  • Choose smaller fish. Larger fish have a greater chance of carrying ciguatera. There are currently no FDA-approved tests for identifying fish carrying ciguatera, and the fish does not look or taste unusual. Cooking or freezing the fish will not destroy the toxin.
  • If fishing in tropical areas, ask your guides about ciguatera, and avoid local species known to be affected.
  • If you develop symptoms like those described above, call your local poison center at 1-800-222-1222 immediately. Be sure to mention that you ate fish recently. If untreated, ciguatera can cause long-lasting neurological symptoms, but ciguatera can be treated effectively if it is diagnosed within the first 72 hours.

The American Association of Poison Control Centers supports the nation’s 57 poison centers in their efforts to prevent and treat poison exposures. Poison centers offer free, private, confidential medical advice 24 hours a day, seven days a week. We take calls in more than 150 languages and from the hearing impaired.

For questions about poison or if you think someone has been exposed to a poison, call 1-800-222-1222 to reach your local poison center.

– Contributed by Wendy Stephan, health education coordinator, Florida Poison Information Center – Miami 

5 thoughts on “An Unhappy Fish Story: Poison Centers Warn of Rare Fish Poisoning

  1. Only certain fish ar known to carry the toxin, they are all reef feeders. Most commonly encountered examples are grouper, snapper, mahi mahi. The public should NEVER eat barricuda, since they are often highly contaminated.

  2. I have seen cases of ciguatera-related symptoms in some people who dine on their last night of their tropical vacation and then become symptomatic upon return home hours later. This is why we all need to know about this topic.
    Treatment is supportive and symptomatic care; not mannitol. Strict avoidance of certain food triggers has been advocated.

  3. I have chronic Ciguatera and after 10 years it is still horrible. Over heating, itching, headaches that are worse than migraines and last for days, numbness and tingling etc, etc, etc. Since 2007 I also have a +ana for SLE and many other illnesses. I believe dental work, exercise, weight changes, weather changes, various foods, and various smells cause flare ups.

    When I got Ciguatera I could not find answers anywhere now I have them through experience.

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