Ciguatera Fish Poisoning

Presented by: Robert Beckford ID#:620022488

 Ciguatera fish poisoning is a foodborne illness Humans acquire this illness by eating reef fish The reef contains naturally occurring toxin ciguatoxins It is endemic in many popular travel destinations, including the Caribbean and Pacific Islands, where travellers are at risk.

Ciguatera Fish Poisoning Is The Frequent most seafood toxin in the world
It causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms

Ciguatera toxins occur naturally in coral reef fish (e.g., grouper, snapper, barracuda, amberjack, and surgeonfish) that consume microalgae containing toxin precursors.

Epidemiology
ciguatera is common in only subtropical and tropical waters, particularly the Pacific and Caribbean, and usually is associated with fish caught in tropical reef waters Ciguatoxin is found in over 400 species of reef fish. Avoiding consumption of all reef fish (any fish living in warm tropical waters) is the only sure way to avoid exposure

Symptoms
Symptoms varied and included diarrhea, fatigue, headache, vomiting, bradycardia, hypotension, leg cramping, tooth pain, and paradoxical dysesthesias. Some symptoms persisted for up to 5 months

Diagnosis
No reliable biomarkers that can be used to confirm exposure. Based on time, course and the history of eating a reef fish. The current gold standard of CFP would include conformation of ciguatoxins in the consume fish

Detection in Fish
The FDA fish testing procedure is a two- tiered protocol 1) Invitro assay 2)Liquid chromatography-mass spectrometry(LC-MS). This method provides a high level of specificity for detecting CTX in fish

Treatment
Mannitol - Intravenous(IV) mannitol infusion is the nost common studied therapy for CFP. *IV mannitol is administerd at 0.5 to 1.0g/kg body weight over a 30-45 minutes period. *It is suggested that it be given within 4872hours. *Herbal medicines and remedied have being used to treat ciguatera. However there no scientific evidence demonstrating these remedies are safe.

Prevention
Avoid eating reef fish CFP occurrences are not attributable to in adequate food handling, storage, preparation, or procurement methods for the contaminated fish. CTX is heat-stable, and therefore, cooking, boiling, freezing, baking or frying doesnt eliminate or destroy the toxin from the fish tissue.

Surveillance and Reporting

CFP is reportable to the health organisation in various states in the USA Suspected cases are investigated by health officials and confirm cases are recorded in the states registry of reportable/notifiable disease. Surveillance will help to strategise plans to prevent occurrence and management of the condition

Outreach and education

Educate the public Stress on preventative measures Give statistical report on previous CFP Let them understand the toxin and it effects Arm them with information, so that the can spread the word.

The End