Ciguatera poisoning
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Ciguatera Poisoning: A Comprehensive Overview
Introduction to Ciguatera Poisoning
Ciguatera Poisoning (CP) is the most prevalent seafood-toxin illness globally, affecting between 10,000 and 50,000 people annually1 4. This illness results from consuming fish contaminated with ciguatoxins (CTXs), lipid-soluble toxins produced by dinoflagellates in the genera Gambierdiscus and Fukuyoa1 2. These toxins bioaccumulate in the food chain, primarily affecting carnivorous fish such as snappers, groupers, and barracudas1 3.
Global Occurrence and Trends
CP is most common in tropical and subtropical regions, particularly the Pacific and Caribbean areas, where local communities heavily rely on marine resources1 3. However, due to increased air travel and fish exportation, CP cases have been reported worldwide, including in non-tropical regions3 6. Recent data indicate an expansion of CP's geographical range to areas like Macaronesia and Southeast Asia1.
Clinical Manifestations
Neurological Symptoms
Neurological symptoms are predominant in CP, with more than 80% of cases presenting with neurotoxic effects such as paraesthesia, dysaesthesia, and heightened nociperception7 9. Other symptoms include metallic taste, pruritis, arthralgia, myalgia, and dental pain7. Severe cases may lead to cerebellar dysfunction, hypotension, bradycardia, and hypersalivation7.
Gastrointestinal and Cardiovascular Symptoms
Patients often experience gastrointestinal symptoms like diarrhea, abdominal pain, nausea, and vomiting within 24 hours of consuming contaminated fish9. Cardiovascular symptoms, although less common, can include hypotension and bradycardia7.
Diagnosis and Treatment
Diagnosing CP is challenging due to its varied symptoms and the lack of specific diagnostic tests. The diagnosis is primarily clinical, based on symptom recognition and patient history9 10. Treatment options are limited and often unclear. Some reports suggest that intravenous mannitol may alleviate symptoms, but its efficacy remains debated5 7.
Prevention and Management
Preventing CP involves avoiding the consumption of high-risk fish species in endemic areas. Public health initiatives emphasize the need for increased education, monitoring, and research to manage and mitigate CP risks effectively1 5. Recent advances in analytical chemistry, such as liquid chromatography coupled with mass spectrometry, offer new opportunities for detecting and quantifying ciguatoxins in fish, potentially improving food safety2.
Conclusion
Ciguatera Poisoning remains a significant global health issue, particularly in tropical and subtropical regions. Despite recent advances in understanding and detecting ciguatoxins, the disease's complex epidemiology and varied clinical manifestations pose ongoing challenges. Enhanced public health efforts, including education, monitoring, and research, are crucial to managing and reducing the impact of CP worldwide.
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Most relevant research papers on this topic
Ciguatera poisonings: A global review of occurrences and trends.
Ciguatera Poisoning is a globally prevalent illness, with the highest incidence rates in the Pacific and Caribbean regions, and requires increased education, monitoring, and research efforts to address its health impacts.
Literature Review
Highly CitedCiguatera Fish Poisoning in the Caribbean Sea and Atlantic Ocean: Reconciling the Multiplicity of Ciguatoxins and Analytical Chemistry Approach for Public Health Safety
Ciguatera fish poisoning is caused by a multiplicity of neurotoxins, with one major form (C-CTX-1) dominating, and new analytical methods are needed to ensure food safety.
Literature ReviewCiguatera Poisoning.
Ciguatera poisoning is a worldwide issue caused by ingestion of toxin-containing fish, with symptoms ranging from mild to severe and often affecting travelers and residents of tropical areas.
Case ReportCiguatera fish poisoning.
Ciguatera Fish Poisoning (CFP) is caused by the consumption of contaminated reef fish in sub-tropical and tropical waters, with at least 50,000 people affected annually, but only 2- 10% of cases are reported in the United States.
Highly CitedCiguatera Fish Poisoning: Treatment, Prevention and Management
Ciguatera Fish Poisoning (CFP) treatment options and prevention strategies vary, but IV mannitol may help alleviate symptoms and improve recovery.
Literature ReviewHighly CitedCiguatera: recent advances but the risk remains.
Ciguatera, a human poisoning caused by seafood, remains a global health issue, with no immunity and cumulative symptoms, and its epidemiology is complex and under-reported.
Highly CitedNeurology of ciguatera
Ciguatera is a severe fish poisoning with neurotoxic symptoms, and early diagnosis and treatment with intravenous mannitol is crucial for preventing secondary cases in cluster outbreaks.
Highly CitedCiguatera Fish Poisoning in the Pacific Islands (1998 to 2008)
Ciguatera fish poisoning in the Pacific Islands has increased by 60% from 1973-1983, with an estimated 500,000 Pacific islanders affected over the last 35 years.
Observational Study
Rigorous JournalHighly CitedClinical observations on 3,009 cases of ciguatera (fish poisoning) in the South Pacific.
Ciguatera (fish poisoning) typically presents with neurologic and gastrointestinal symptoms, often developing within 12 hours of ingestion, with multiple poisonings leading to more severe symptoms.
Observational StudyHighly CitedNeurological Disturbances of Ciguatera Poisoning: Clinical Features and Pathophysiological Basis
Ciguatera fish poisoning (CFP) causes complex clinical symptoms, with peripheral neurological signs persisting long after intoxication, and its neuropathophysiology is poorly understood.
Literature Review