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Old 22-02-2016, 19:05   #1
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Long term affects of Ciguatera

As a physician working periodically in the Caribbean I have treated several cases of Ciguatera. These cases have at times been mild with simple diarrhea and abdominal cramping to patients becoming hypotensive and ending up in the ICU. Unfortunately after my brief encounter these individuals were lost for follow up.
I would be interested to hear from actual individuals who have contacted Ciguatera regarding any long term effects that may still be present. Especially any of you who have been unfortunate to have more than one infection. Were your symptom worse the second time? How ofter does your symptoms return? Is there any food or beverage that exacerbates your symptoms?
I was born in the Caribbean and grew up eating Barracuda which incidentally one of the best tasting fish in the ocean. However now I never eat Barracuda but continue to eat other reef fish that may very well carry the toxin. I guess it may just be a matter of time before I suffer the fate of some of my patients.
Thanks for your time.
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Old 22-02-2016, 19:19   #2
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Re: Long term affects of Ciguatera

I contracted ciguatera in Venezuela 40 years ago. symptons: Hallucinations and fever. Hallucinations were great. I was 18 years old, starving on an island and I speared parrot fish and ate them. I've never had any recurrences of the sickness.And barracuda in the eastern carib is considered safe, and Delicious.
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Old 22-02-2016, 20:53   #3
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Re: Long term affects of Ciguatera

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Originally Posted by caradow View Post
As a physician working periodically in the Caribbean I have treated several cases of Ciguatera. These cases have at times been mild with simple diarrhea and abdominal cramping to patients becoming hypotensive and ending up in the ICU. Unfortunately after my brief encounter these individuals were lost for follow up.
I would be interested to hear from actual individuals who have contacted Ciguatera regarding any long term effects that may still be present. Especially any of you who have been unfortunate to have more than one infection.

I have had it 3 times.

Were your symptom worse the second time?

My symptoms were worst the first time, I felt sick for some days, in addition to headache, nausea, and tingling, 2nd and 3rd, about the same. Gastrointestinal distress, tingly mouth, itching.


How ofter does your symptoms return? Once the acute phase is over, did not experience them again. However, did notice that taking alcohol would make us itch. So we gave that up for 6 months, and that was long enough for the symptoms to not recur.

Is there any food or beverage that exacerbates your symptoms? I imagine more ciguatoxic fish would have, but we gave up the fresh fish for a very long time.

I was born in the Caribbean and grew up eating Barracuda which incidentally one of the best tasting fish in the ocean. However now I never eat Barracuda but continue to eat other reef fish that may very well carry the toxin. I guess it may just be a matter of time before I suffer the fate of some of my patients.

From what we have read, although your liver evacuates ciguatoxin slowly, you'll never lose it all, and it would be safer for you (like us) to avoid those luscious warm water fish. Sorry.
Thanks for your time.
Some years back the University of Hawaii did a lot of research on ciguetera, and for the severe hypotension cases, was recommending mannitol IV for it.

Ann
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Old 23-02-2016, 10:08   #4
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Re: Long term affects of Ciguatera

I am very selective in the fish we consume: dolphin, smaller snappers and grouper, grunts, mackerel, sea trout, hogfish, halibut, pompano, red fish, small tuna, etc. We have never had ciguatera from any fish I caught. However, in Miami, I bought and consumed a commercially prepared fish spread and within hours, I had a tingling sensation in my mouth, light-headedness, heart palpitations and a general feeling of anxiety. It lasted several hours before dissipating. I never had any residual effects(some on this Forum might dispute this revelation!). However, one of my friends who was an avid fisherman ate a large kingfish and was hospitalized for three months with vertigo, diarrhea and vomiting and claims to still feel the effects today, 20 years later, that also attacked his central nervous system. This is a very serious form of poisoning with potential life-long effects. We never eat Barracuda from anywhere. Period. Good luck and safe sailing.
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Old 23-02-2016, 18:09   #5
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Re: Long term affects of Ciguatera

Draw a straight line through Cuba and Martinique. South of this line you can eat small barracuda, groupers etc. North of that line, or older fish, the risk is too high.
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Old 23-02-2016, 20:20   #6
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Re: Long term affects of Ciguatera

G'Day Caradow,

Thanks for introducing a professional's interest in the problem.

I'll add to Ann's post... we ate the same fish at the same times!

First case, a portion of a large Spanish Mackerel, caught outside the reefs south of Il de Pins, New Caledonia: for me, it was general and somewhat severe general malaise, some itching, and eventually the canonical reversal of hot and cold. The latter was what finally clued us in as to what was wrong. The symptoms persisted for a week or so, gradually subsiding. It was some years ago, so my memories of exact sequence are suspect.

Second case, a few years later, was a large Giant Trevally, caught in the northern lagoon of New Cal, an area reputed to be cigua-free. We had one of the Cigua test kits then marketed, and used it with a 'safe' response. The kit was a few days past it's expiry date, and apparently was no longer valid. My symptoms were much the same as the first time, but with less of the hot/cold reversal and more itching. They subsided within a few days. BTW, had we not had the test kit, we would have never eaten any such fish.

Third case, about 5 years later, was from a very small, young Spotted Mackerel, caught in the Belep group, far north lagoon area in New Cal. Local knowledge said that these small fish (~80 cm long) were yearlings, coming into the lagoon for their first mating season, and that they were always OK. We asked the local women if they wanted a portion (heh, put your money where your mouth is!) and they were happy to have it. Lesson learned: the locals don't know it all, either! This time the symptoms were more in the GI tract for me, but with the typical itching and malaise. Again, within a week we both felt ok again.

In all three cases, we ate only one meal from the fish.

As far as I can tell, I have no chronic long term symptoms, but we are damn selective about what fin-fish we eat. We do not fish in new Cal waters at all, and even pull in our (generally ineffective) lines well before we make landfall after ocean passages. However, one of our closest friends was stricken in Vanuatu over twenty years ago. He damn near died... a singlehander, he sought aid at the Vila hospital, from visiting GPs and even from the local "witchdoctor" Nivan. He was comatose on his boat much of the time for a couple of weeks, with other yotties taking turns looking after him... "go see if Jules is dead yet" duty. He had persistent and severe ongoing symptoms for some years, with alcohol causing them to reappear, any sort of seafood doing likewise, extreme sensitivity of his skin to touch, especially if it was hot IIRC. Found it very uncomfortable to wear even a light cotton shirt. He is an infrequent participant in this forum, and I could try to put you into contact with him if it iwas of sufficient interest to you.

If your research is at all productive, I would sure be interested in your conclusions, either through this thread or by PM.

Cheers,

Jim
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Old 25-02-2016, 07:17   #7
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Re: Long term affects of Ciguatera

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Draw a straight line through Cuba and Martinique. South of this line you can eat small barracuda, groupers etc. North of that line, or older fish, the risk is too high.
Well Jedi I have treated several cases south of this line.
However did not ask how big the Barracuda were which I should have.
Have witnessed Cubans who tend the lighthouse at Guana del Esta (which is south of Cienfuegos on the southern coast) spear some fairly large Barracuda and eat them without apparent problems. Quite honestly I have heard rumors that the Cuban government puts workers out there for months at a time and sort of forgets about them. So guess eating Barracuda is better than starving to death.
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Old 25-02-2016, 19:11   #8
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Re: Long term affects of Ciguatera

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Well Jedi I have treated several cases south of this line.

However did not ask how big the Barracuda were which I should have.

Have witnessed Cubans who tend the lighthouse at Guana del Esta (which is south of Cienfuegos on the southern coast) spear some fairly large Barracuda and eat them without apparent problems. Quite honestly I have heard rumors that the Cuban government puts workers out there for months at a time and sort of forgets about them. So guess eating Barracuda is better than starving to death.

The line goes through Cuba, meaning the south coast is safe to eat and the north coast certainly is not.

We too met people south of this line getting sick... sometimes from the same fish others ate without problems. In all those cases the people had ciguatera poisening before...
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