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Large outbreaks of ciguatera after consumption of brown marbled grouper.
Toxins (Basel). 2014 Jul 11; 6(7):2041-9.T

Abstract

Brown marbled grouper (Epinephelus fuscoguttatus) is an apex predator from coral reefs of the Indo-Pacific region. All five published case series of ciguatera after consumption of brown marbled grouper were reviewed to characterize the types, severity and chronicity of ciguatera symptoms associated with its consumption. Three of these case series were from large outbreaks affecting over 100-200 subjects who had eaten this reef fish served at banquets. Affected subjects generally developed a combination of gastrointestinal, neurological and, less commonly, cardiovascular symptoms. Gastrointestinal symptoms occurred early and generally subsided in 1-2 days. Some neurological symptoms (e.g., paresthesia of four limbs) could last for weeks or months. Sinus bradycardia and hypotension occurred early, but could be severe and prolonged, necessitating the timely use of intravenous fluids, atropine and dopamine. Other cardiovascular and neurological features included atrial ectopics, ventricular ectopics, dyspnea, chest tightness, PR interval >0.2 s, ST segment changes, polymyositis and coma. Concomitant alcohol consumption was associated with a much higher risk of developing bradycardia, hypotension and altered skin sensation. The public should realize that consumption of the high-risk fish (especially the ciguatoxin-rich parts and together with alcohol use) and repeated ciguatoxin exposures will result in more severe and chronic illness.

Authors+Show Affiliations

Division of Clinical Pharmacology, Department of Medicine and Therapeutics, Faculty of Medicine, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China. tykchan@cuhk.edu.hk.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25019942

Citation

Chan, Thomas Y K.. "Large Outbreaks of Ciguatera After Consumption of Brown Marbled Grouper." Toxins, vol. 6, no. 7, 2014, pp. 2041-9.
Chan TY. Large outbreaks of ciguatera after consumption of brown marbled grouper. Toxins (Basel). 2014;6(7):2041-9.
Chan, T. Y. (2014). Large outbreaks of ciguatera after consumption of brown marbled grouper. Toxins, 6(7), 2041-9. https://doi.org/10.3390/toxins6072041
Chan TY. Large Outbreaks of Ciguatera After Consumption of Brown Marbled Grouper. Toxins (Basel). 2014 Jul 11;6(7):2041-9. PubMed PMID: 25019942.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Large outbreaks of ciguatera after consumption of brown marbled grouper. A1 - Chan,Thomas Y K, Y1 - 2014/07/11/ PY - 2014/05/23/received PY - 2014/06/23/revised PY - 2014/06/25/accepted PY - 2014/7/15/entrez PY - 2014/7/16/pubmed PY - 2015/2/5/medline SP - 2041 EP - 9 JF - Toxins JO - Toxins (Basel) VL - 6 IS - 7 N2 - Brown marbled grouper (Epinephelus fuscoguttatus) is an apex predator from coral reefs of the Indo-Pacific region. All five published case series of ciguatera after consumption of brown marbled grouper were reviewed to characterize the types, severity and chronicity of ciguatera symptoms associated with its consumption. Three of these case series were from large outbreaks affecting over 100-200 subjects who had eaten this reef fish served at banquets. Affected subjects generally developed a combination of gastrointestinal, neurological and, less commonly, cardiovascular symptoms. Gastrointestinal symptoms occurred early and generally subsided in 1-2 days. Some neurological symptoms (e.g., paresthesia of four limbs) could last for weeks or months. Sinus bradycardia and hypotension occurred early, but could be severe and prolonged, necessitating the timely use of intravenous fluids, atropine and dopamine. Other cardiovascular and neurological features included atrial ectopics, ventricular ectopics, dyspnea, chest tightness, PR interval >0.2 s, ST segment changes, polymyositis and coma. Concomitant alcohol consumption was associated with a much higher risk of developing bradycardia, hypotension and altered skin sensation. The public should realize that consumption of the high-risk fish (especially the ciguatoxin-rich parts and together with alcohol use) and repeated ciguatoxin exposures will result in more severe and chronic illness. SN - 2072-6651 UR - https://www.unboundmedicine.com/medline/citation/25019942/Large_outbreaks_of_ciguatera_after_consumption_of_brown_marbled_grouper_ L2 - https://www.mdpi.com/resolver?pii=toxins6072041 DB - PRIME DP - Unbound Medicine ER -