In a CDC report, in 2014, a Florida woman contracted ciguatera fish poisoning after eating black grouper in a restaurant. Five additional cases were also reported, also associated with black grouper from the same international supplier.
About 7 hours after eating black grouper, the woman experienced acute onset of neurological symptoms including paradoxical temperature perception (burning sensation like dry ice), paresthesias (tingling or pricking or “pins and needles”, in the peripheral nerves), extremity numbness, a metallic taste, nausea, vomiting, abdominal pain, diarrhea, arthralgia, and myalgia.
Ciguatera fish poisoning (CFP), occurs when predatory reef-dwelling fish harboring ciguatoxins is ingested. Ciguatoxin is stable to both freezing or cooking. The naturally occurring toxin originates in several dinoflagellate (algae) species. That toxin accumulates in the meat of preparatory reef fish as they eat smaller fish that have eaten the toxic algae.
Morbidity and Mortality Weekly Report (MMWR)
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6440a3.htm?s_cid=mm6440a3_e
Use of Surveillance Systems in Detection of a Ciguatera Fish Poisoning Outbreak — Orange County, Florida, 2014
Weekly
October 16, 2015 / 64(40);1142-4
Benjamin G. Klekamp, MSPH1; Dean Bodager, MPA2; Sarah D. Matthews, MPH1