![]() In the US, ciguatera is almost exclusively present in Hawaii, southern Florida, and the northern Gulf of Mexico however, outbreaks have occurred from eating contaminated fish in restaurants in other parts of the country. Ciguatera is common in tropical or subtropical regions between 35°N and 35°S, especially throughout the Caribbean (especially in the east), Indian Ocean, around the South Pacific islands, and increasingly down the eastern coast of Australia. Risk and symptoms: Ciguatera fish poisoning is the most frequently reported fish-borne illness worldwide, resulting in approximately 50,000 cases annually. Typical food preparation procedures (e.g., cooking, freezing, salting, drying, smoking, or marinating) will not eliminate them. In particular, marine poisoning syndromes are caused by toxins that have accumulated in fish, shellfish, or turtles. Seafood-related illnesses can be caused by toxins, bacteria, viruses, and parasites. Seek medical care if ciguatera is suspected or if experiencing any respiratory or prolonged GI symptoms.Prevention includes avoiding the consumption of seafood caught in known high-risk areas and the skin or organs of fish. ![]() Symptoms usually resolve within 24 hours but can be fatal in persons who consume large amounts of Fugu prepared by unlicensed chefs. Tetradotoxin ( Fugu): Symptoms occur after eating pufferfish and include tingling and numbness of the tongue, lips, and face, followed by difficulty swallowing, walking, and breathing.Shellfish poisoning: Four types exist: paralytic, which includes symptoms such as tingling and numbness of face and limbs, progressing to drowsiness and respiratory paralysis neurotoxic, which includes symptoms such as nausea, vomiting, and diarrhea and nervous symptoms similar to ciguatera amnesic, which includes symptoms such as gastrointestinal (GI) illness, confusion, and short-term memory loss and diarrheic, which includes symptoms such as chills, nausea, vomiting, and diarrhea.Scrombroid: Symptoms are short-lived and include those of an allergic or histamine-like reaction, such as flushing, itching, rash, headache, rapid heartbeat, diarrhea, and vomiting.Symptoms such as heat and cold reversal (a burning sensation when touching something cold and a cold sensation when touching something hot) may occur and last for months. Severe cases may progress to seizures and coma. Ciguatera: Symptoms include diarrhea, cramping, and vomiting followed by numbness around the mouth and muscle aches.Symptoms can occur within minutes to hours after ingestion of the responsible seafood. Seafood poisoning is usually caused by consumption of shellfish and warm-water, reef-dwelling fish (e.g., amberjack, grouper, mackerel, red snapper, or tuna) that have accumulated toxins, which cannot be eliminated by freezing, smoking, or cooking.
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