Wen discussing chemicals hazards in food, we often mention ciquatoxin, a natural toxin found in tropical predator fish such as grouper and barracuda. CDC’s MMWR (Feb 1, 2013), Ciguatera Fish Poisoning - New York, 2010-2011, is a case study that looks at 28 cases of ciguatera fish poisoning (CFP) in 28 individuals that occurred in a one year period, from August, 2010 to July 2011. 13 people became ill after eating barracuda, and 15 after eating grouper.
The toxin originates as a precursor in dinoflagellates (microalgae) which live in coral reef areas. These algae are eaten by smaller fish and the precursor toxin is converted to the toxic form. Predator fish such as barracuda, grouper, snapper, amberjack and surgeonfish eat these small fish, and over time, this toxin accumulates in the larger fish’s body. People eat these larger fish and then suffer the symptoms of CFP. “CFP is characterized by various gastrointestinal, cardiovascular, and neurologic symptoms. A prolonged period of acute illness can result, and the neurologic symptoms can last months, with variable asymptomatic and symptomatic periods.” Typical symptoms include diarrhea, abdominal cramps, dizziness, headache, faintness, nausea, vomiting and tingling in the extremities (fingers and toes).
Two interesting points made in this report:
- “CFP is considered a highly underreported illness, with only an estimated 10% of cases reported to health authorities (7). Increasing awareness among health-care providers might improve reporting and investigation. However, CFP prevention is complicated by difficulty in identifying high-risk fishing grounds and inadequate industry knowledge and compliance with the FDA seafood Hazard Analysis and Critical Control Point (HACCP) regulations.† Premarket testing of fish for CTX is not feasible because of the lack of rapid field methods and the sporadic distribution of toxic fish, even in endemic areas. Coordinated tracebacks of implicated fish by federal and state agencies to specific fishing grounds remains the primary strategy for managing CFP.”
- “This investigation demonstrates the value of CFP-implicated fish traceback along with updated information on emerging CFP risks, including new harvest areas and species. Prevention through education alone might be limited by seafood mislabeling.”
Ciguatera Fish Poisoning — New York City, 2010–2011
February 1, 2013 / 62(04);61-65