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A fish story worth listening to.

Persons heading for warmer climes this winter--particularly Florida and Hawaii--should know that an illness from the distant tropics is now appearing on our shores. The ailment is ciguatera fish poisoning, which can produce an array of frightening symptoms--the only effective treatment for which must be given in its early stages.

Fish most likely to be contaminated with ciguatera toxin are: large specimens of grouper, red snapper, and, especially, barracuda in South Florida; amberjack in Hawaii; and red snapper throughout the Pacific.

Symptoms typically begin within a few hours of eating poisoned fish, but may begin a day later or more. Nausea, vomiting, watery diarrhea, and abdominal cramps occur first, followed by such neurological symptoms as numbness and tingling of the lips, tongue, and throat--then the fingers and toes. Weakness, dizziness, dry mouth, sharp shooting pains in the arms and legs, and the sensation that one's teeth are loose may also occur. Vision may become blurred or distorted, the skin may itch, and heart rhythm may slow. In pregnant women, the toxin can affect the fetus, producing bizarre fetal movements and facial palsies in the newborn.

Given within 48 hours of ingesting the poison, intravenous doses of mannitol, a complex sugar, can greatly reduce the severity and duration of symptoms. Most victims recover spontaneously within one or two months; however, in some, symptoms may persist for months or even years.

Ciguatera poisoning occurs only after eating saltwater fish. As a rule, the larger the fish, the more likely you are of being poisoned by it. No type of preparation, including cooking, will inactivate the toxin. Therefore, avoid barracuda, larger specimens of grouper and red snapper (more than five pounds) and hog fish (more than two pounds). Also, never eat any fish dish that contains unknown varieties. The best choices are yellowtail snapper, mahimahi, and whole headless fish that fits on a dinner plate.

Dr. Donna Blythe, a ciguatera expert in Coral Gables, Florida, maintains a hotline for physicians seeking information on diagnosis and treatment: 1-305-361-4619 or 661-0774.
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Title Annotation:ciguatera fish poisoning
Publication:Medical Update
Date:Dec 1, 1993
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