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Bizarre fish poisoning sparks alarm

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Bizarre fish poisoning sparks alarm

Postby crashmister » Fri Feb 27, 2009 7:39 pm

For those of you who eat what you catch and everyone who eats fish in general. You are going to want to read this......

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The fish was delicious, no doubt about it.

Perfectly seasoned and cooked just right, the broiled grouper on the Texas menu last summer tempted Donna Schroeder to eat every bite.

The only problem? It was poisoned, tainted with a hard-to-detect toxin that produces symptoms so bizarre, they put peanut-linked salmonella infections to sham

“It’s horrible, I’m telling you,” said Schroeder, 65, a retired Beaumont, Texas, realtor, who is only now recovering from the worst symptoms of ciguatera fish poisoning, an exotic foodborne illness that health officials say may be dramatically under-recognized in the United States.

The malady afflicts at least 50,000 people a year worldwide — and the real number may be 100 times that many. While ciguatera fish poisoning is largely unknown in most of the U.S., several recent cases have attracted growing concern, officials say. They hope a greater awareness will help alert consumers and doctors and improve treatment of the incurable illness caused by coral algae toxins that accumulate in large tropical reef fish.

Within hours of the July dinner, Schroeder was stricken not only with typical nasty food poisoning symptoms — diarrhea, vomiting and fatigue — but also with a dangerously slow heart rate and neurological problems that caused her hands and feet to tingle painfully and, oddest of all, reversed her sense of hot and cold. Some patients also say they feel like their teeth are falling out — and the symptoms can linger for years.

“Whatever I touched, if it was hot, it would feel cold. If it was cold, it felt hot,” Schroeder recalled. “I couldn’t walk on the tile floor. It felt like it was burning me.”


Brandon Gothier Photography
Donna Schroeder, 65, of Beaumont, Texas, had to diagnose ciguatera fish poisoning herself after doctors failed to recognize the illness.


That should have been a clue to emergency room crews and doctors, but it wasn’t, said Schroeder, who was sent home with a general diagnosis of food poisoning, but nothing to explain the odd reactions or why they lingered so long.

”Doctors don’t even know what it is,” she said. “How sad is that?”

Ciguatera fish poisoning often is missed, even though it is the most common seafood-toxin illness reported in the world, said Richard Weisman, a toxicologist and director of the Florida Poison Information Center.

“If you go to the Caribbean Islands, you can’t find anybody who hasn’t had it,” he said.

Residents there and in other tropical places — Hawaii, Guam, the Virgin Islands, Puerto Rico — know that large, predatory fish caught by sport fishermen on coral reefs are common sources of ciguatera fish poisoning.

The actual toxin is produced by microscopic sea plants, which are eaten by smaller fish that are, in turn, eaten by larger fish such as barracuda, grouper, sea bass and snapper. The toxins become increasingly concentrated as they move up the food chain.

Ciguatera risk?
The following species may pose a danger of ciguatera fish poisoning:

— Moray eel
— Barracuda
— Grouper
— Kingfish
— Jacks
— Snapper
— Surgeonfish
— Parrot fish
— Wrasses
— Hogfish
— Narrow barred Spanish mackerel
— Coral trout
— Flowery cod
— Red emperor

Recent outbreaks
In the continental U.S., reported cases have been rare, typically confined to tourists who become ill after returning home from tropical vacations or to fishermen sickened by their own deep-sea catches.

Recently, however, worries about the illness increased after it cropped up in unexpected places. In 2007, 10 people in St. Louis who ate imported fish at two restaurants were sickened with ciguatera.

Last year, several unspecified outbreaks of ciguatera linked to grouper and amberjack compelled the federal Food and Drug Administration to expand guidelines warning about the risk of ciguatera in fish caught in the northern Gulf of Mexico.

And just last month, food safety inspectors in Canada issued a health hazard alert for ciguatera-tainted frozen Leatherjacket fish after two people became ill in that country.

Symptoms mistaken for multiple sclerosis
Part of the problem is that ciguatera fish poisoning is hard to detect for seafood suppliers and consumers alike, said Melissa Friedman, a neuropsychologist at Mount Sinai Medical Center in Miami who studied victims of the illness.

“You can’t tell from the way it looks. You can’t tell from the way it tastes. There’s nothing you can do in terms of storage. There’s nothing you can do in terms of cooking,” she said.

Instead, people simply eat the toxic fish and become ill. Baffled doctors often confuse ciguatera symptoms with those of multiple sclerosis, or else they come away empty-handed, Weisman said.

“There are people having CT scans, MRIs, all these tests.” he said. “They do million-dollar workups, but no test will ever come back positive.”

Three-day window for best treatment
That can delay one of the only treatments for the illness: an intravenous dose of a drug called mannitol, which can reduce or prevent the neurological symptoms. The drug is most effective, however, within the first 72 hours of illness, Weisman said.

The worst of the illness usually lasts for a week or two, and it's rarely fatal. But in some victims, the effects linger much longer, or never really go away. Many patients find that certain foods such as other fish, nuts or alcohol trigger relapses, and that overexertion can send the symptoms flooding back.

One of the most pressing problems with ciguatera is that, although the illness has been chronicled since Christopher Columbus' crew ventured to the New World, there is no baseline data about incidence — or prevalence.

Between 1998 and 2002, the federal Centers for Disease Control and Prevention logged only 16 foodborne outbreaks of ciguatera affecting 73 people in the U.S., a 2006 summary showed.

But only 2 percent to 10 percent of ciguatera fish poisoning cases are reported to authorities and many health officials don’t realize it’s a reportable condition, said Dr. Lora Fleming, a ciguatera expert from the University of Miami. Using data from Dade County, Fla., where about 50 to 60 cases are reported a year, experts estimate that for every single case of ciguatera detected, between 10 and 100 cases go unreported.

Just last month, the CDC launched the Harmful Algal Bloom-related Illness Surveillance System, a monitoring system that will track ciguatera in people and animals, among other things. First results aren’t expected for a year, however, said Lorraine Backer, a scientist with the National Center for Environmental Health.

One outcome of the project may be to further discussions of whether global climate change is influencing ciguatera outbreaks, Backer said. Some scientists believe that ciguatera is moving north as ocean waters warm, and that increased numbers of hurricanes and tropical storms may cause disturbances in coral reefs that make them more hospitable to the toxic algae.

'More prevalent than we think'
In the meantime, it’s hard to convince victims like Donna Schroeder that ciguatera is not a serious, growing and misunderstood problem. She only discovered she had ciguatera poisoning by asking her daughter to research fish-borne food illnesses on the Internet and then matching her bizarre symptoms to those listed online.

“I feel it’s more prevalent than we think,” Schroeder said. “There’s a lot more of it and people are getting sicker.”

Schroeder has filed a lawsuit against the place where she ate the meal, the Stingaree Restaurant in Crystal Beach, Texas, and against Katie’s Seafood Market of Galveston, Texas, which supplied the seafood.

The legal action was inspired mostly by a desire to raise awareness about the illness, Schroeder said. “I really wanted to get the word out about this fish,” she said.

But other victims have been less altruistic. Todd Stewart, a lawyer in Jupiter, Fla., has handled a dozen ciguatera cases in the decade, including the largest-ever settlement for the illness in the state’s history. It was in the six figures, he said, declining to be more specific.

Stewart argues that seafood suppliers and restaurants have an obligation to research so-called “ciguatera hot spots,” places in the world where the ciguatoxin is common, and to avoid buying fish from there.

“They ought to be asking: Did you take this from a ciguatera area?” he said. “You could potentially be exposing customers to a poisonous fish.”

Brad Vratis, general manager of the Stingaree Restaurant, said he couldn’t even pronounce “ciguatera” before he learned of Schroeder’s illness. “We haven’t served a piece of grouper in this restaurant since then,” Vratis said.

It can be tough for consumers to protect themselves against a poison that can’t be detected and can’t be killed by freezing or cooking. At least one Hawaiian company, Oceanit Laboratories Inc., markets a $30 ciguatera fish test kit that claims to successfully identify the toxin within an hour, said Dr. Joanne Ebesu, a senior scientist with the company.

But the paper co-authored by Friedman and Fleming concludes that no commercially-available fish testing product has been proven to be accurate by independent tests.


Mostly, Fleming said, consumers are on their own.

Fish-lovers hoping to avoid ciguatera poisoning can take a couple of steps. First, ask where the fish is from. If a restaurant or supplier can’t say, be wary.

Second, eat small portions of different fish instead of larger servings of a single fish. That will perhaps lessen the dose of any toxin present.

Finally, consider avoiding certain fish altogether.

“Personally, I don’t eat large reef fish,” said Fleming. “And I don’t eat fillets of fish because I don’t know what the original fish was.”

© 2009 msnbc.com
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Re: Bizarre fish poisoning sparks alarm

Postby bolo » Fri Feb 27, 2009 7:45 pm

Big grouper and snapper has known to have this posion. Rare but it has happen. It is the risk you take when eating fish. Same goes with uncook chicken, pork, and oysters.

Thanks for the great article. This will inform other members who don't know.
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Re: Bizarre fish poisoning sparks alarm

Postby permitchaser » Fri Feb 27, 2009 9:22 pm

i will take my chance i love eating what i catch .i just look make sure fish is healthy .i always check the flesh .they kits for poison ciwatera means when they r sick :shock:
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Re: Bizarre fish poisoning sparks alarm

Postby permitchaser » Fri Feb 27, 2009 9:24 pm

if you are paranoid buy the kit at capt harris bait n tackle :wink:
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Re: Bizarre fish poisoning sparks alarm

Postby crashmister » Fri Feb 27, 2009 11:00 pm

Permitchaser The article said it can't be detected. Also it can't be frozen or cooked out of the fish. The reason I posted this was to inform not scare anyone. I don't eat fish so this doesn't effect me at all. I do know if someone in my family gets sick after eating fish at least being informed I can let the doctor know about the article and the possibility. Don't mistake concern for my fellow man as paranoia. And it's Ciguatera.
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Re: Bizarre fish poisoning sparks alarm

Postby cantseeme47 » Sat Feb 28, 2009 1:31 am

well some say to detect the pisoining when u catch a fish is it wont fight as hard as its suppose to also if the fish as black around the mouth and the scales come off really easy it is posioned. but this is wat i heard im no where near a 100% on this there is also another myth that if there are flies around and they land on ur fish but not on one them they say dont eat it. but a again they are things i heard dont go by me :mrgreen:
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Re: Bizarre fish poisoning sparks alarm

Postby bolo » Sat Feb 28, 2009 2:00 am

I have a tester that will allow me to know if the fish is posion. The kit is called Ricky Test.
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Re: Bizarre fish poisoning sparks alarm

Postby permitchaser » Sat Feb 28, 2009 11:00 am

thanks for the correction cantseme47 and its poisoning LOL dont worry i know what u mean.the ciguatera i read is most active around Bimini that area .thanks for the info if the fish fight hard is going to the oven or frying pan :lol:
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Re: Bizarre fish poisoning sparks alarm

Postby JDL » Sun Mar 29, 2009 10:32 pm

cantseeme47 wrote:well some say to detect the pisoining when u catch a fish is it wont fight as hard as its suppose to also if the fish as black around the mouth and the scales come off really easy it is posioned. but this is wat i heard im no where near a 100% on this there is also another myth that if there are flies around and they land on ur fish but not on one them they say dont eat it. but a again they are things i heard dont go by me :mrgreen:


These are all myths. There is no way to tell if a fish is positive for ciguatoxin (the toxin that causes ciguatera poisoning) other than testing the flesh of the fish.

Ciguatera poisoning is caused by a toxin produced by small single celled organisms (dinoflagellate algae) found on the reef. The toxin is bioaccumulated in reef fish through their diet. The algae is found in certain regions and along certain reef tracts. Large predators in areas where the algae is found may harbor the toxin. Barracuda, grouper, snapper, amberjack, hogfish, kingfish and many other predators on the reef may contain the toxin. Additionally, because it is bioaccumulated, larger individual fish are more likely to have higher concentrations of the toxin (one reason I won't eat a grouper over 15lbs).

Symptoms are usually short lived and include gastrointestinal symptoms as well as neurological symptoms. However, in some cases symptoms may last months or years.
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Re: Bizarre fish poisoning sparks alarm

Postby L8RBRA » Mon Mar 30, 2009 8:37 am

"They" say stick to fish under 5 lbs and you should be fine.
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Re: Bizarre fish poisoning sparks alarm

Postby BigBoiFishing » Mon Mar 30, 2009 6:36 pm

We can all go back & forth, but in our case, here in Florida its typically Cudas that can f@#k us over with this. Do Cudas look or act like they are vegetarians? NEGATIVE.

What happens is the following....the reef fish that do feed on said algae are in turn eaten by Cudas. This scenario truly pertains to us in Florida, 90% of the time. Have I eaten Snappers, Jacks or Groupers (Gag & Black) over 15 lbs no more than 40??? Yes, most times not caught by me :(

My rule, even if tempting...no Cudas/Picuas over 7#s.......so far, so good. :thumleft:

As 4 the article...most fish that are sold @ restaurants & supermarkets commercially are imported, like from Taiwan 4 example.

So fish & eat with caution but not in fear, but in reason. :reeling: :thumleft:
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Re: Bizarre fish poisoning sparks alarm

Postby Boruchlen » Thu Apr 02, 2009 4:49 pm

Hey all, this issue was gone over quite thoroughly before.

http://boatlessfishing.com/forum/viewtopic.php?f=2&t=11680&st=0&sk=t&sd=a&hilit=ciguatera

I found a great article on ciguatera poisoning, and they say that if you can fit a headless fish on a dinner plate, you're safe.
Here is the link. Worthwhile reading.
http://query.nytimes.com/gst/fullpage.h ... wanted=all

The first article mentioned by crashmister, is informative, but, if you analyze it a bit, you'll see that's it's blowing things out of proportion tremendously, mostly speculative, they can't get the figures correct, because there is simply not enough data.
It is more of a scare tactic (maybe written by PETA :D People Eating Tasty Animals :lol: )
At the same time, Ciguatera DOES exist, no question, just not in the quantities they try to make us believe.
Having said this, I wouldn't touch Baracuda at all, and would only feel comfortable eating fish under 16-18" without the head (except kings).
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