ciguatera

An acute toxic syndrome with predominantly gastrointestinal and neuromuscular features induced by ingestion of the flesh or viscera of various marine fish of the Caribbean and tropical Pacific reefs that contain ciguatoxin. [Sp. fr. cigua, sea snail] Sporadic cases of c. occur along the east coast of the United States from Vermont to southern Florida and in the U.S. Virgin Islands, Puerto Rico, and Hawaii. Occasional outbreaks result from group consumption of large catches of contaminated fish. The condition is probably underreported, many cases being dismissed as viral syndromes or seasickness. The lipid-soluble, heat-stable toxin is produced by the dinoflagellate Gambierdiscus toxicus, which is epiphytic on red and brown algae. Herbivorous fish foraging on reef algae consume the flagellates and are in turn consumed by carnivorous fish; the toxin becomes increasingly concentrated as it passes up the food chain. The heads and viscera of affected fish contain higher concentrations than other parts. Some 400 species of fish have been associated with human intoxication, including particularly predators such as amberjack, barracuda, grouper, moray eels, red snapper, sea bass, Spanish mackerel, and surgeon fish. Contaminated fish look, smell, and taste normal, and ciguatoxin is not destroyed by cooking, drying, salting, or freezing. Symptoms come on 3–12 hours after exposure (occasionally within minutes) and include vomiting and diarrhea, myalgia, dysesthesia and paresthesia of the extremities and perioral region, pruritus, headache, weakness, and diaphoresis. Bradycardia and hypotension may occur. A few deaths due to respiratory paralysis have been reported. Toxic effects usually resolve spontaneously in about 1 week but residual symptoms may persist for months. Repeated exposure can increase the sensitivity of an individual to the toxin. Diagnosis is confirmed by identification of toxin in uneaten portions of seafood or in the patient's serum. Treatment is purely supportive.

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ci·gua·tera .sē-gwə-'ter-ə, .sig- n poisoning caused by the ingestion of various normally edible tropical fish in whose flesh a toxic substance (as one produced by some dinoflagellates) has accumulated

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ci·gua·te·ra (se″gwə-taґrə) [Sp. (orig. Taino) cigua a poisonous snail + -era Sp. noun suffix] a form of ichthyosarcotoxism, marked by gastrointestinal and neurologic symptoms, caused by ingestion of tropical or subtropical marine fish such as the grouper and snapper that have ciguatoxin in their tissues. The term was formerly applied to all types of fish poisoning in the West Indies.