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Ciguatera Fish Poisoning: Treatment, Prevention and Management

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Friedman, Melissa A.·2008·Marine Drugs

Abstract

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

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Research works printed but not linked: 72

  1. Crump, 1999, Ciguatera fish poisoning, Postgrad Med J, 75, 678, 10.1136/pgmj.75.889.678 · doi:10.1136/pgmj.75.889.678
  2. Swift, 1993, Ciguatera, J Toxicol - Clin Toxicol, 31, 1, 10.3109/15563659309000371 · doi:10.3109/15563659309000371
  3. Gillespie, 1986, Ciguatera in Australia. Occurrence, clinical features, pathophysiology and management, Med J Austr, 145, 584, 10.5694/j.1326-5377.1986.tb139504.x · doi:10.5694/j.1326-5377.1986.tb139504.x
  4. Fleming, 1997, ciguatera fish poisoning, Shoreman’s Travel Medicine Monthly, 1, 1
  5. deWolff, FA (1995). Marine toxins, Elsevier Press.
  6. Lawrence, 1980, Ciguatera fish poisoning in Miami, J Am Med Assoc, 244, 254, 10.1001/jama.1980.03310030030021 · doi:10.1001/jama.1980.03310030030021
  7. Begier, 2006, Outbreak bias in illness reporting and case confirmation in ciguatera fish poisoning Surveillance in South Florida, Pub Health Rep, 121, 658, 10.1177/003335490612100605 · doi:10.1177/003335490612100605
  8. Bagnis, 1968, Clinical aspects of ciguatera (fish poisoning) in French Polynesia, Hawaii Med J, 28, 25
  9. Bagnis, 1979, Clinical observations on 3,009 cases of ciguatera (fish poisoning) in the South Pacific, Am J Trop Med Hyg, 28, 1067, 10.4269/ajtmh.1979.28.1067 · doi:10.4269/ajtmh.1979.28.1067
  10. Withers, 1982, Ciguatera fish poisoning, Ann Rev Med, 33, 97, 10.1146/annurev.me.33.020182.000525 · doi:10.1146/annurev.me.33.020182.000525
  11. Yasumoto, T, Raj, U, and Bagnis, R (1984). Symposium on Seafood Toxins from Tropical Regions, Tohoku University Japan.
  12. Steidinger, K, and Baden, DG (1985). Toxic marine dinoflagellates, Academic Press. · doi:10.1016/b978-0-12-656520-1.50011-0
  13. Calvert, 1987, Treatment of ciguatera fish poisoning with amitriptyline and nifedipine, J Toxicol - Clin Toxicol, 25, 423, 10.3109/15563658708992645 · doi:10.3109/15563658708992645
  14. Friedman, 2007, Neuropsychological study of ciguatera fish poisoning: A longitudinal case-control study, Arch Clin Neuropsychol, 22, 545, 10.1016/j.acn.2007.03.003 · doi:10.1016/j.acn.2007.03.003
  15. Lewis, 2000, Ciguatera management, SPC Live Reef Fish Information Bulletin, 7, 11
  16. Falconer, I (1993). Algal toxins in seafood and drinking water, Academic Press.
  17. Chinain, 2007, Prevalence of chronic symptoms of ciguatera disease in French Polynesian adults, Am J Trop Med Hyg, 77, 842, 10.4269/ajtmh.2007.77.842 · doi:10.4269/ajtmh.2007.77.842
  18. Kodama, 1989, Variations in symptomatology of ciguatera poisoning, Toxicon, 27, 593, 10.1016/0041-0101(89)90121-9 · doi:10.1016/0041-0101(89)90121-9
  19. Chan, 2001, Chronicity of neurological features in ciguatera fish poisoning, Hum Exp Toxicol, 20, 426, 10.1191/096032701682692928 · doi:10.1191/096032701682692928
  20. Blythe, 1992, Clinical experience with i.v. Mannitol in the treatment of ciguatera, Bull Soc Pathol Exotique, 85, 425
  21. Benoit, 2000, Reversal of Pacific ciguatoxin-1B effects on myelinated axons by agents used in ciguatera treatment, Cybium, 24, 33
  22. Chan, 1993, Life-threatening bradycardia and hypotension in a patient with ciguatera fish poisoning, Trans Roy Soc Trop Med Hyg, 87, 71, 10.1016/0035-9203(93)90428-S · doi:10.1016/0035-9203(93)90428-s
  23. Glaziou, 1992, Study of factors that influence the clinical response to ciguatera fish poisoning, Bull Soc Pathol Exotique, 85, 419
  24. Ting, 2001, Ciguatera poisoning: a global issue with common management problems, Europ J Emerg Med, 8, 295, 10.1097/00063110-200112000-00009 · doi:10.1097/00063110-200112000-00009
  25. Bagnis, 1977, [Neurologic complications of ciguatera], Bull Soc Pathol Exotique, 70, 89
  26. Wang, 2005, Biomonitoring of ciguatoxin exposure in mice using blood collection cards, Toxicon, 46, 243, 10.1016/j.toxicon.2005.03.014 · doi:10.1016/j.toxicon.2005.03.014
  27. Wang, 2007, Optimization of ciguatoxin extraction method from blood for Pacific ciguatoxin (P-CTX-1), Toxicon, 49, 100, 10.1016/j.toxicon.2006.10.002 · doi:10.1016/j.toxicon.2006.10.002
  28. Ryan, 2007, Transcriptional profiling of whole blood and serum protein analysis of mice exposed to the neurotoxin Pacific Ciguatoxin-1, NeuroToxicol, 28, 1099, 10.1016/j.neuro.2007.05.013 · doi:10.1016/j.neuro.2007.05.013
  29. Manger, 1995, Detection of sodium channel toxins: directed cytotoxicity assays of purified ciguatoxins, brevetoxins, saxitoxins, and seafood extracts, J AOAC Int, 78, 521, 10.1093/jaoac/78.2.521 · doi:10.1093/jaoac/78.2.521
  30. Tiedeken, 2005, Use of two detection methods for discriminating ciguatoxins from brevetoxins: application to Great Barracuda from Florida, Toxicon, 46, 261, 10.1016/j.toxicon.2005.04.006 · doi:10.1016/j.toxicon.2005.04.006
  31. Pottier, 2003, Identification of slow and fast-acting toxins in highly ciguatoxic barracuda (Sphyraene barracuda) by HPLC/MS and radiolabelled ligand binding, Toxicon, 42, 663, 10.1016/j.toxicon.2003.09.004 · doi:10.1016/j.toxicon.2003.09.004
  32. Hamilton, 2002, Multiple ciguatoxins present in Indian Ocean reef fish, Toxicon, 40, 1347, 10.1016/S0041-0101(02)00146-0 · doi:10.1016/s0041-0101(02)00146-0
  33. Darius, 2007, Ciguatera risk assessment in two toxic sites of French Polynesia using the receptor-binding assay, Toxicon, 50, 612, 10.1016/j.toxicon.2007.05.007 · doi:10.1016/j.toxicon.2007.05.007
  34. Lewis, 1999, HPLC/tandem electrospray mass spectrometry for the determination of Sub-ppb levels of Pacific and Caribbean ciguatoxins in crude extracts of fish, Anal Chem, 71, 247, 10.1021/ac980598h · doi:10.1021/ac980598h
  35. Hamilton, 2002, Isolation and characterisation of Indian Ocean ciguatoxin, Toxicon, 40, 685, 10.1016/S0041-0101(01)00259-8 · doi:10.1016/s0041-0101(01)00259-8
  36. Hokama, 1998, Simplified solid-phase membrane immunobead assay (MIA) with monoclonal anti-ciguatoxin antibody (MAb-CTX) for detection of ciguatoxin and related polyether toxins, J Nat Tox, 7, 1
  37. Dickey, 1994, Evaluation of a solid-phase immunobead assay for detection of ciguatera-related biotoxins in Caribbean finfish, Memoirs of the Queensland Museum, 34, 481
  38. Hirama, 2001, Total synthesis of ciguatoxin CTX3C, Science, 294, 1904, 10.1126/science.1065757 · doi:10.1126/science.1065757
  39. Murata, 1989, Structures of ciguatoxin and its congener, J Am Chem Soc, 111, 8929, 10.1021/ja00206a032 · doi:10.1021/ja00206a032
  40. Crouch, 1995, Improvements in the Sensitivity of Inverse-Detected Heteronuclear Correlation Spectra Using Micro Inverse Probes and Micro Cells: HMQC and HMBC Spectra of Caribbean Ciguatoxin -- Preliminary Structural Inferences, Tetrahedron Lett, 36, 6827
  41. Vernoux, 1997, Isolation and characterisation of Caribbean ciguatoxins from the horse-eye jack (Caranx latus), Toxicon, 35, 889, 10.1016/S0041-0101(96)00191-2 · doi:10.1016/s0041-0101(96)00191-2
  42. Lewis, 1991, Purification and characterization of ciguatoxins from moray eel (Lycodontis javanicus, Muraenidae), Toxicon, 29, 1115, 10.1016/0041-0101(91)90209-A · doi:10.1016/0041-0101(91)90209-a
  43. Schnorf, 2002, Ciguatera fish poisoning: a double-blind randomized trial of mannitol therapy, Neurology, 58, 873, 10.1212/WNL.58.6.873 · doi:10.1212/wnl.58.6.873
  44. Bagnis, 1992, [Evaluation of the efficacy of mannitol in the treatment of ciguatera in French Polynesia], Med Tropicale, 52, 67
  45. Palafox, 1988, Successful treatment of ciguatera fish poisoning with intravenous mannitol, J Am Med Assoc, 259, 2740, 10.1001/jama.1988.03720180066035 · doi:10.1001/jama.1988.03720180066035
  46. Williamson, JA, Fenner, PJ, Burnett, JW, and Rifkin, JF (1996). Ciguatera (fish poisoning), University of New South Wales Press.
  47. Pearn, 1989, Ciguatera and mannitol: experience with a new treatment regimen, Medical Journal of Australia, 151, 77, 10.5694/j.1326-5377.1989.tb101165.x · doi:10.5694/j.1326-5377.1989.tb101165.x
  48. Botana, LM (2007). Marine neurotoxins as a starting point to drugs, Taylor and Francis (CRC Press).
  49. Berlin, 1992, Symptomatic improvement of chronic fatigue with fluoxetine in ciguatera fish poisoning, Med J Austr, 157, 567, 10.5694/j.1326-5377.1992.tb137364.x · doi:10.5694/j.1326-5377.1992.tb137364.x
  50. Lange, 1992, Travel and ciguatera fish poisoning, Arch Int Med, 152, 2049, 10.1001/archinte.1992.00400220075013 · doi:10.1001/archinte.1992.00400220075013
  51. Davis, 1986, Symptomatic improvement with amitriptyline in ciguatera fish poisoning, New Engl J Med, 315, 65, 10.1056/NEJM198607033150115 · doi:10.1056/nejm198607033150115
  52. Perez, 2001, Treatment of ciguatera poisoning with gabapentin, New Engl J Med, 344, 692, 10.1056/NEJM200103013440919 · doi:10.1056/nejm200103013440919
  53. Bourdy, 1992, Traditional remedies used in the western Pacific for the treatment of ciguatera poisoning, J Ethnopharmacol, 36, 163, 10.1016/0378-8741(92)90017-L · doi:10.1016/0378-8741(92)90017-l
  54. Blythe, 1990, Mother’s milk turns toxic following fish feast, J Am Med Assoc, 264, 2074, 10.1001/jama.1990.03450160042019 · doi:10.1001/jama.1990.03450160042019
  55. Lange, 1989, Can ciguatera be a sexually transmitted disease?, J Toxicol - Clin Toxicol, 27, 193, 10.3109/15563658909038583 · doi:10.3109/15563658909038583
  56. Lange, 1987, Ciguatera toxicity, Am Fam Phys, 35, 177
  57. Ebesu, J (1998). Isolation and Characterization of Novel Ciguateric Compounds from Acanthurus Triostegus (Manini), University of Hawaii. Ph.D. Thesis.
  58. Vernoux, 1993, Ciguatera in the French West Indies, Memoires of the Queensland Museum, 34, 631
  59. Davin, 1988, Ciguatera toxins adversely affect piscivorous fishes, Trans Am Fish Soc, 117, 374, 10.1577/1548-8659(1988)117<0374:CTAAPF>2.3.CO;2 · doi:10.1577/1548-8659(1988)117<0374:ctaapf>2.3.co;2
  60. Davin, 1986, Effects of ciguatera toxins on the bluehead, Trans Am Fish Soc, 115, 908, 10.1577/1548-8659(1986)115<908:EOCTOT>2.0.CO;2 · doi:10.1577/1548-8659(1986)115<908:eoctot>2.0.co;2
  61. Walsh, PJ, Smith, SL, Fleming, LE, Solo Gabriele, H, and Gerwick, WH Oceans and Human Health: Risks and Remedies from the Sea, Elsevier Science Publishers. in press.
  62. Fleming, 2007, Evaluation of Harmful Algal Bloom Outreach Activities, Mar Drugs, 5, 208, 10.3390/md504208 · doi:10.3390/md504208
  63. Abraham, 2005, Effects of inhaled brevetoxins in allergic airways: toxin-allergen interactions and pharmacologic intervention, Environ Health Perspect, 113, 632, 10.1289/ehp.7498 · doi:10.1289/ehp.7498
  64. Anderson, 1983, The epidemiology of ciguatera fish poisoning in Hawaii, 1975–1981, Hawaii Med J, 42, 326
  65. Morris, 1982, Clinical features of ciguatera fish poisoning: a study of the disease in the US Virgin Islands, Arch Int Med, 142, 1090, 10.1001/archinte.1982.00340190046008 · doi:10.1001/archinte.1982.00340190046008
  66. Czernichow, 1984, [Epidemiology of Ciguatera in the Iles Saintes (Guadeloupe)], Rev Epidemiol Sante Pub, 32, 315
  67. Lewis, 1986, Disease and development: ciguatera fish poisoning, Soc Sci Med, 23, 983, 10.1016/0277-9536(86)90255-8 · doi:10.1016/0277-9536(86)90255-8
  68. Luber, G, Azziz-Baumgartner, E, Latka, R, Monteihl, C, Conklin, L, and Backer, L Surveillance for ciguatera fish poisoning in Culebra, Puerto Rico. (in press).
  69. McMillan, 1980, Ciguatera fish poisoning in the United States Virgin Islands: preliminary studies, J Coll Virgin Is, 6, 84
  70. Holt, 1984, An analysis of poison control center reports of ciguatera toxicity in Puerto Rico for one year, J Toxicol - Clin Toxicol, 22, 177, 10.3109/15563658408992553 · doi:10.3109/15563658408992553
  71. Frennette, 1988, A large common-source outbreak of ciguatera fish poisoning, J Infect Dis, 158, 1128, 10.1093/infdis/158.5.1128 · doi:10.1093/infdis/158.5.1128
  72. Engleberg, 1983, Ciguatera fish poisoning: a major common-source outbreak in the U.S. Virgin Islands, Ann Int Med, 98, 336, 10.7326/0003-4819-98-3-336 · doi:10.7326/0003-4819-98-3-336

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Metadata

Authors
Friedman, M. A.
Venue
Marine Drugs
Publisher
MDPI AG
Published
2008-09
Volume
6
Issue
3
Pages
456-479
ISSN
1660-3397 (ISSN-L)
OpenAlex
W4256147205
Cited by
292
References
22
FWCI
8.18
Type
journal article
Language
en
Open access
gold

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