Ciguatera is a form of food poisoning which is caused by ingestion of ciguatoxin, a toxin present in certain tropical fish. This form of food poisoning is not curable, but it is usually survivable, depending on how much the patient has ingested and how healthy he or she was to begin with. Incidence of ciguatera has radically declined thanks to closer inspection of tropical waters and prompt shut downs of fishing in areas suspected to be contaminated; people who eat a lot of seafood may want to keep an eye on seafood recalls to avoid ciguatera and other forms of seafood poisoning.
Ciguatoxin acts on the gastrointestinal tract, causing cramping, vomiting, diarrhea, and similar symptoms. It also causes neurological symptoms such as confusion, lack of balance, and nervous system malfunctions, like the perception of cold as heat. Symptoms often emerge very rapidly, thereby ensuring that the patient doesn't ingest any more fish, because he or she feels too ill to eat.
This toxin appears to originate in dinoflagellates, microscopic organisms found throughout the ocean. Research on ciguatera suggests that that ciguatoxin is most commonly found in the Pacific tropics and in the Caribbean, concentrated in fish which frequent coral reefs. Ciguatoxin is often subject to biomagnification, becoming more concentrated as it moves up the food chain, and since people often eat fish which are high on the food chain, they can be at risk of ciguatera poisoning.
Supportive care is usually the focus of treatment for ciguatera. Doctors address the individual symptoms of the patient to help him or her recover. Symptoms can flare up again up to 20 years later, often in response to eating potential allergens like nuts and shellfish, and ciguatera can also cause long-term neurological damage. People who have experienced ciguatera should be aware of this, and pass information about their illness on to care providers whenever possible.
The first reported cases of ciguatera appear to date to the 16th century, when mariners wrote about getting sick after eating tropical fish. By the 18th century, ciguatera had become fairly well-known, especially in the Caribbean, although the cause was not fully understood. The condition can be confusing, because fish may be safe to eat at some times, and not safe to eat at others, making it hard to link a specific species with ciguatera. Furthermore, ciguatoxin can be present in fish which frequent very distant areas, making it tricky to pin down the geological focus on the toxin and issue a warning or recall.
