ciguatera fish poisoning

8/13/2019 Ciguatera Fish Poisoning

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Ciguatera Fish

Poisoning

Presented by: Robert

BeckfordID#:620022488


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Ciguatera fish poisoning is a

foodborne illness Humans acquire this illness by

eating reef fish

The reef contains naturallyoccurring toxin ciguatoxins

It is endemic in many popular

travel destinations, including theCaribbean and Pacific Islands,

where travellers are at risk.


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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 cardiovascularsymptoms

Ciguatera toxins occur naturally incoral reef fish (e.g., grouper,snapper, barracuda, amberjack, and

surgeonfish) that consumemicroalgae containing toxinprecursors.


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Epidemiology

ciguatera is common in onlysubtropicaland tropical waters,particularly the Pacific and

Caribbean, and usually is associatedwith fish caught in tropical reefwaters

Ciguatoxin is found in over 400

species of reef fish. Avoidingconsumption of all reef fish (any fishliving in warm tropical waters) is theonly sure way to avoid exposure
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Symptoms

Symptoms varied and included

diarrhea, fatigue, headache,

vomiting, bradycardia,hypotension, leg cramping,

tooth pain, and paradoxical

dysesthesias. Some symptomspersisted for up to 5 months


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Diagnosis

No reliable biomarkers that can be

used to confirm exposure.

Based on time, course and thehistory of eating a reef fish.

The current gold standard of CFP

would include conformation of

ciguatoxins in the consume fish


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Detection in Fish

The FDA fish testing procedureis a two- tiered protocol

1) Invitro assay 2)Liquid chromatography-mass

spectrometry(LC-MS).

This method provides a highlevel of specificity for detectingCTX in fish


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Treatment

Mannitol

- Intravenous(IV) mannitol infusion isthe nost common studied therapy for CFP.

*IV mannitol is administerd at 0.5 to 1.0g/kgbody weight over a 30-45 minutes period.

*It is suggested that it be given within 48-72hours.

*Herbal medicines and remedied have beingused to treat ciguatera. However there noscientific evidence demonstrating theseremedies are safe.


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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.


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Surveillance and

Reporting CFP is reportable to the health

organisation in various states in theUSA

Suspected cases are investigated byhealth officials and confirm casesare recorded in the states registryof reportable/notifiable disease.

Surveillance will help to strategiseplans to prevent occurrence andmanagement of the condition


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Outreach and education

Educate the public

Stress on preventative measures

Give statistical report on previousCFP

Let them understand the toxin and it

effects

Arm them with information, so that

the can spread the word.


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The End

ciguatera fish poisoning

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