Infectious Disease Compendium

Ciguatera

Microbiology

An algae.

Epidemiologic Risks

Eating fish that have been in algae blooms usually Gambierdiscus toxicus as well as Prorocentrum spp., Ostreopsis spp., Coolia monotis, Thecadinium spp. and Amphidinium carterae.

Found in the S. Pacific and Caribbean, about 35 degrees south to 35 degrees north. The bigger the fish, the bigger the risk. Greater than 400 species of fish can be a source, especially amberjack, barracuda, red snapper, grouper.

Syndromes

Acute gastroenteritis, then paresthesias, itchiness, sensitivity to hot and cold, dizziness, and weakness.

Treatment

Supportive. Be caring. Listen. Feel the pain.

Notes

Ciguatoxin is odorless, tasteless, and cannot be destroyed by standard cooking. So how do you know if the toxin is there? You don't.

From the (Wikipedia): "In Northern Australia, where ciguatera is a common problem, two different folk science methods are widely believed to detect whether fish harbor significant ciguatoxin. The first method is that flies are supposed not to land on contaminated fish. The second is that cats will either refuse to eat or vomit/display symptoms after eating contaminated fish. A third, less common testing method involves putting a silver coin under the scales of the suspect fish. If the coin turns black, according to the theory, it is contaminated. On Grand Cayman and other islands the locals will test barracuda by placing a piece of the fish on the ground and allowing ants to crawl on it. If the ants do not avoid the flesh and will eat it, then the fish is deemed safe". It doesn't work (PubMed).

Last Update: 06/10/18.