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Emerging tropical diseases in Australia. Part 2. Ciguatera fish poisoning.
Ann Trop Med Parasitol. 2010 Oct; 104(7):557-71.AT

Abstract

Ciguatera poisoning is a food-borne neuro-intoxication caused by consumption of finfish that have accumulated ciguatoxins in their tissues. Ciguatera is a distressing and sometimes disabling condition that presents with a self-limiting though occasionally severe gastro-intestinal illness, progressing to a suite of aberrant sensory symptoms. Recovery can take from days to years; second and subsequent attacks may manifest in a more severe illness. Ciguatera remains largely a pan-tropical disease, although tourism and export fish markets facilitate increased presentation in temperate latitudes. While ciguatera poisoning in the South Pacific was recognised and eloquently described by seafarers in the 18th Century, it remains a public-health challenge in the 21st Century because there is neither a confirmatory diagnostic test nor a reliable, low-cost screening method to ascertain the safety of suspect fish prior to consumption. A specific antidote is not available, so treatment is largely supportive. The most promising pharmacotherapy of recent decades, intravenous mannitol, has experienced a relative decline in acceptance after a randomized, double-blind trial failed to confirm its efficacy. Some questions remain unanswered, however, and the use of mannitol for the treatment of acute ciguatera poisoning arguably deserves revisiting. The immunotoxicology of ciguatera is poorly understood, and some aspects of the epidemiology and symptomatology of ciguatera warrant further enquiry.

Authors+Show Affiliations

Chemical Analysis, Queensland Health Forensic and Scientific Services, P.O. Box 594, Archerfield, Queensland, 4108, Australia. ian.stewart@griffith.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21092393

Citation

Stewart, I, et al. "Emerging Tropical Diseases in Australia. Part 2. Ciguatera Fish Poisoning." Annals of Tropical Medicine and Parasitology, vol. 104, no. 7, 2010, pp. 557-71.
Stewart I, Lewis RJ, Eaglesham GK, et al. Emerging tropical diseases in Australia. Part 2. Ciguatera fish poisoning. Ann Trop Med Parasitol. 2010;104(7):557-71.
Stewart, I., Lewis, R. J., Eaglesham, G. K., Graham, G. C., Poole, S., & Craig, S. B. (2010). Emerging tropical diseases in Australia. Part 2. Ciguatera fish poisoning. Annals of Tropical Medicine and Parasitology, 104(7), 557-71. https://doi.org/10.1179/136485910X12851868779902
Stewart I, et al. Emerging Tropical Diseases in Australia. Part 2. Ciguatera Fish Poisoning. Ann Trop Med Parasitol. 2010;104(7):557-71. PubMed PMID: 21092393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emerging tropical diseases in Australia. Part 2. Ciguatera fish poisoning. AU - Stewart,I, AU - Lewis,R J, AU - Eaglesham,G K, AU - Graham,G C, AU - Poole,S, AU - Craig,S B, PY - 2010/11/25/entrez PY - 2010/11/26/pubmed PY - 2011/1/7/medline SP - 557 EP - 71 JF - Annals of tropical medicine and parasitology JO - Ann Trop Med Parasitol VL - 104 IS - 7 N2 - Ciguatera poisoning is a food-borne neuro-intoxication caused by consumption of finfish that have accumulated ciguatoxins in their tissues. Ciguatera is a distressing and sometimes disabling condition that presents with a self-limiting though occasionally severe gastro-intestinal illness, progressing to a suite of aberrant sensory symptoms. Recovery can take from days to years; second and subsequent attacks may manifest in a more severe illness. Ciguatera remains largely a pan-tropical disease, although tourism and export fish markets facilitate increased presentation in temperate latitudes. While ciguatera poisoning in the South Pacific was recognised and eloquently described by seafarers in the 18th Century, it remains a public-health challenge in the 21st Century because there is neither a confirmatory diagnostic test nor a reliable, low-cost screening method to ascertain the safety of suspect fish prior to consumption. A specific antidote is not available, so treatment is largely supportive. The most promising pharmacotherapy of recent decades, intravenous mannitol, has experienced a relative decline in acceptance after a randomized, double-blind trial failed to confirm its efficacy. Some questions remain unanswered, however, and the use of mannitol for the treatment of acute ciguatera poisoning arguably deserves revisiting. The immunotoxicology of ciguatera is poorly understood, and some aspects of the epidemiology and symptomatology of ciguatera warrant further enquiry. SN - 1364-8594 UR - https://www.unboundmedicine.com/medline/citation/21092393/full_citation L2 - http://www.diseaseinfosearch.org/result/1638 DB - PRIME DP - Unbound Medicine ER -