Rare fish poisoning spreading beyond the tropics

Posted Jan. 23, 2012, at 8:57 a.m.

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.

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.

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.

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