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An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management.
Mar Drugs. 2017 Mar 14; 15(3)MD

Abstract

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties.

Authors+Show Affiliations

Mount Sinai Medical Center, Miami Beach, FL 33140, USA. melissafried@yahoo.com.Department of Psychology and Neuroscience, Nova Southeastern University, Fort Lauderdale, FL 33314, USA. mf934@nova.edu.National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. lfb9@cdc.gov.Marine Science Institute, University of Texas at Austin, Port Aransas, TX 78373, USA. robt.dickey@austin.utexas.edu.Jackson Memorial Medical Center, Department of Medicine, University of Miami, Miami, FL 33136, USA. jbernstein@med.miami.edu. Florida Poison Information Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA. jbernstein@med.miami.edu.Jackson Memorial Medical Center, Department of Medicine, University of Miami, Miami, FL 33136, USA. kschrank@med.miami.edu.NOAA-National Ocean Service, Center for Coastal Fisheries and Habitat Research, Beaufort, NC 28516, USA. steve.kibler@noaa.gov.Florida Poison Information Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA. wstephan@med.miami.edu.Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA. matt.gribble@emory.edu.Oceanography Department, University of Hawaii, Honolulu, HI 96822, USA. bienfang@soest.Hawaii.edu.School for the Environment, University of Massachusetts Boston, Boston, MA 02125, USA. bob.bowen@umb.edu.Food and Drug Administration, College Park, MD 20740, USA. stacey.degrasse@fda.hhs.gov.Food and Drug Administration, Dauphin Island, AL 36528, USA. harold.floresquintana@fda.hhs.gov.Food and Drug Administration, Dauphin Island, AL 36528, USA. christopher.loeffler@fda.hhs.gov.Florida Poison Information Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA. rweisman@med.miami.edu.Private Practice, Miami, FL 33133, USA. blythedrdiva@aol.com.Institut de Ciències del Mar (CSIC), 08003 Barcelona, Spain. berdalet@icm.csic.es.Department of Neurology, University of Miami, Miami, FL 33136, USA. dayyar@med.miami.edu.Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA. danielle.clarkson-townsend@emory.edu.Food and Drug Administration, College Park, MD 20740, USA. karen.swajian@fda.hhs.gov.Food and Drug Administration, Dauphin Island, AL 36528, USA. ronald.benner@fda.hhs.gov.Northern Institute, Charles Darwin University, Darwin 0909, Australia and Australian Institute of Marine Science, Darwin 0811, Australia. tom.brewer@cdu.edu.au.European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall Tr1 3HD, UK. l.e.fleming@exeter.ac.uk.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28335428

Citation

Friedman, Melissa A., et al. "An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management." Marine Drugs, vol. 15, no. 3, 2017.
Friedman MA, Fernandez M, Backer LC, et al. An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management. Mar Drugs. 2017;15(3).
Friedman, M. A., Fernandez, M., Backer, L. C., Dickey, R. W., Bernstein, J., Schrank, K., Kibler, S., Stephan, W., Gribble, M. O., Bienfang, P., Bowen, R. E., Degrasse, S., Flores Quintana, H. A., Loeffler, C. R., Weisman, R., Blythe, D., Berdalet, E., Ayyar, R., Clarkson-Townsend, D., ... Fleming, L. E. (2017). An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management. Marine Drugs, 15(3). https://doi.org/10.3390/md15030072
Friedman MA, et al. An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management. Mar Drugs. 2017 Mar 14;15(3) PubMed PMID: 28335428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management. AU - Friedman,Melissa A, AU - Fernandez,Mercedes, AU - Backer,Lorraine C, AU - Dickey,Robert W, AU - Bernstein,Jeffrey, AU - Schrank,Kathleen, AU - Kibler,Steven, AU - Stephan,Wendy, AU - Gribble,Matthew O, AU - Bienfang,Paul, AU - Bowen,Robert E, AU - Degrasse,Stacey, AU - Flores Quintana,Harold A, AU - Loeffler,Christopher R, AU - Weisman,Richard, AU - Blythe,Donna, AU - Berdalet,Elisa, AU - Ayyar,Ram, AU - Clarkson-Townsend,Danielle, AU - Swajian,Karen, AU - Benner,Ronald, AU - Brewer,Tom, AU - Fleming,Lora E, Y1 - 2017/03/14/ PY - 2016/12/07/received PY - 2017/02/13/revised PY - 2017/02/13/accepted PY - 2017/3/25/entrez PY - 2017/3/25/pubmed PY - 2017/6/27/medline KW - Gambierdiscus KW - algae KW - ciguatera fish poisoning KW - ciguatoxin KW - climate change KW - diagnosis KW - environmental change KW - food poisoning KW - harmful algal bloom KW - human health KW - natural toxins KW - neurology KW - neuropsychology KW - neurotoxin KW - seafood poisoning KW - treatment JF - Marine drugs JO - Mar Drugs VL - 15 IS - 3 N2 - Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties. SN - 1660-3397 UR - https://www.unboundmedicine.com/medline/citation/28335428/An_Updated_Review_of_Ciguatera_Fish_Poisoning:_Clinical_Epidemiological_Environmental_and_Public_Health_Management_ L2 - https://www.mdpi.com/resolver?pii=md15030072 DB - PRIME DP - Unbound Medicine ER -