#36022 - 03/13/01 07:15 PM
Re: Fish poisoning.
Joined: Apr 2000
Ciguatera "Cig", is common thruout the tropical waters of the world and tends to concentrate in the upper levels of the food chain, hence fish like barracuda can have higher levels. It's generally wise to avoid eating large barracuda that have been collecting cig for a longer time. Doesn't seem to be a problem here in Belize however. Once a person has had a reaction to cig they have a life-long sensitivity to it.
Here's more info: http://www.emedicine.com/emerg/topic100.htm
[This message has been edited by Jesse (edited 03-13-2001).]
#36028 - 03/14/01 01:06 AM
Re: Fish poisoning.
Joined: Oct 1999
Here's what I have gathered....
Subject: Fish Poisoning Treatment
Came across the first ever effective treatment for Ciguatera
thought that it could be of great benefit to all fish eating
visitors and sailors. This report is by Carlos Perez, MD,
MD, Celia Perret, MD, Hospital Clinico Universidad Catolica
de Chile, in
Santiago. It appears in New England Journal Of Medicine,
March 1, 2001.
Ciguatera poisoning is caused by the Dinoflagelate
Gambierdiscus toxicus, the
toxin is absorbed by the smaller herbivorous fish on the
reefs, and magnified
biologically in the tissues of the larger carnivorous fish
King Fish, Jack, Snapper, Grouper, Rock Fish etc. The
Ciguatoxin is a
Neurotoxin and can range from just mild abdominal cramps and
dehydration, shock, severe pain, hot cold flashes, numbness,
failure and death. Until now all that was done was to treat
symptoms and hope
for the best.
The Drug used here is Gabapentin, in the US its NEURONTIN
400mg. This medication is used to treat partial Seizures and
various types of
painful nerve conditions like Diabetic Neuropathy etc. Any
way as the study
reports if has been very successful in totally reversing
symptoms over a
period of 2-3 weeks. They report the incidence to be about
50- 500 cases per
10,000 population in the Caribbean and South Pacific
On another note I would expect this to increase as the
demand for food by and
ever increasing population through out the Islands makes
impossible to throw
any thing back. As a kid growing up on Roatan I was warned
devastating danger of eating a beautiful Barracuda that I
might have caught,
my dear mother God bless her soul, had lost all of her teeth
to Amber Jack in
Utila Keys and would not let us eat any lage fish before
placing a piece in
Ant's nest. If the ant's ate the fish and lived it was good
so went the tale.
I have some serious doubts about the validity of this test
today, but I'm
still here. Another test was to feed it first to your Cat,
or Dog. Needless
to say no one worried about the SPCA. Lastly, a fisherman
from west told be
the best test was to feed it first to your Wife.
Well, along with the Antimalarials, Antidiarrheals,
Antibacterials, etc, etc,
I think some tablets of Neurontin might be a good investment
for the Next
As far as I know, the only treatment for Ciguatera ever
studied using a
double blind clinical trial has been IV Mannitol (1 g/kg)
Ciguatera (Bagnis et al "Efficacite du Mannitol dans le
Ciguatera. Bulletin de la Societe de Pathologie Exotique.
have shown that there is limited effectiveness of IV
Mannitol after 3 days
from first symptoms ----- although if used within the first
3 days, it is
highly effective in not only decreasing the acute symptoms
but also in
preventing the very debilitating Chronic Ciguatera (Blythe
D, et al Mannitol
Treatment for Acute and Chronic Ciguatera fish Poisoning.
Queensland Museum 1994;34:465-470.).
As you probably know, a multitude of medications have been
tried to treat
especially Chronic Ciguatera -- steroids, vitamins, and
NOT been shown to work ---- more recently, there have been
case reports of
individuals responding to tricyclic anti-depressants, Prozac
medications, non steroidal anti inflammatories, and calcium
----- however, I know of no published double blinded
clinical trials for
these interventions, only anecdotal case reports concerning
the use of these
We also recommend avoiding consumption of alcohol, caffeine,
chocolate, and all types of fish in persons with chronic
ciguatera based on
anecdotal reports of many patients that these substances can
paresthesias return or increase. In the Caribbean we
recommend avoiding the
consumption of large reef fish, particularly fillets (since
you don't always
know what you are eating), and if consuming reef fish, of a
size such that
the entire fish fits on your plate (based on historical data
that 50% of local barracuda over 20 lbs were ciguatoxic many
years ago). Of
note, baracuda cannot be sold legally in Miami-Dade County,
on these historical data.
We have a recent review that might be of interest:
Blythe DG, Hack E, Washington G, Fleming LE. The Medical
Seafood Poisoning. Hui, Kits, Stanfield. Seafood and
Marcel Dekker, 2000, pg. 311-319.
Lora E Fleming MD PhD
NIEHS Marine and Freshwater Biomedical Sciences Center
University of Miami School of Medicine
Dept of Epidemiology & Public Health
PO Box 016069 (R-669)
#36029 - 03/14/01 01:46 AM
Re: Fish poisoning.
Joined: Oct 2000
No argument here. The next cuda I eat will be my first! But, why would ANYONE eat a cuda in the first place? AC has an abundance of fish that make excellent table fare, so why even take a chance on baracuda? Frankly, the same can be said of Kingfish, that many people like, but often contain unacceptable levels of mercury, particularly concentrated in the dark lateral line. My rule of thumb is to NEVER order "Mystery Fish", particularly in a part of the world that has such easy access to so many fish species that pose no potential problems or risks. I didn't mean to suggest that the toxin wasn't a potential problem in Belize. Rather, I don't see it as being any more of a problem than anywhere else. This isn't a new issue, but it is one that might unnecessarily frighten tourists, particularly those that don't live near the ocean.
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Jun 10th, 2007