Fish Poisoning
The next time you sit down at a nice restaurant and order fish, think how much due diligence is required to make sure that you don't get sick after eating it. Remember the slogan of the famous seafood restaurant in Boston, "If it ain't fresh, it isn't legal" (Legal Seafood).
Ciguatera
Ciguatera poisoning can occur by consuming reef fish or fish that prey on them. Small reef fish consume the dinoflagellate Gambierdiscus toxicus which produces ciguatoxin throughout tropical regions of the world. The two most common toxins associated with Ciguatera are Ciguatoxin and Maitotoxin, and they are some of the most lethal natural substances known. There are about 50,000 cases per year. About 3-4% of households have an episode ANNUALLY in the US Virgin Islands.
The most common fish that are contaminated with ciguatera are:
Treatment is supportive and can include the following:
1 )nasogastric tube and charcoal flush
2) intravenous fluids
3) treatment if shock sets in (atropine, dopamine, etc)
4) amitryptylline (Elavil) can help with chronic ciguatera
Scombroid
Scombroid is a disease that occurs from eating old or decomposing fish. This can occur from poor refrigeration. Fish proteins can break down and release histamines and amines that can cause illness. The histamine is produced via bacterial decarboxylation of histidine. Scombroid is very rare and supposedly comprises less than 5% of food poisonings.
Fish most likely to cause scombroid include:
1) IV fluids and oxygen
2) antihistamines
3) bronchodilators
4) treatment for shock or any cardiac problems
Cooking does NOT inactivate the toxin.
SH
The next time you sit down at a nice restaurant and order fish, think how much due diligence is required to make sure that you don't get sick after eating it. Remember the slogan of the famous seafood restaurant in Boston, "If it ain't fresh, it isn't legal" (Legal Seafood).
Ciguatera
Ciguatera poisoning can occur by consuming reef fish or fish that prey on them. Small reef fish consume the dinoflagellate Gambierdiscus toxicus which produces ciguatoxin throughout tropical regions of the world. The two most common toxins associated with Ciguatera are Ciguatoxin and Maitotoxin, and they are some of the most lethal natural substances known. There are about 50,000 cases per year. About 3-4% of households have an episode ANNUALLY in the US Virgin Islands.
The most common fish that are contaminated with ciguatera are:
- barracuda
- grouper
- snapper, particularly red snapper
- moray eel
- any large predacious fish
- nausea, vomiting and abdominal pain
- diarrhea
- paresthesias: pain in the teeth, on urination, hot/cold temperature reversal, blurry vision
- cardiac arrhythmias (change in heart rhythm)
- rarely death can occur: lethality is usually seen with ingestion of the most toxic parts of fish (ie. the liver, viscera, roe and other organs).
Treatment is supportive and can include the following:
1 )nasogastric tube and charcoal flush
2) intravenous fluids
3) treatment if shock sets in (atropine, dopamine, etc)
4) amitryptylline (Elavil) can help with chronic ciguatera
Scombroid
Scombroid is a disease that occurs from eating old or decomposing fish. This can occur from poor refrigeration. Fish proteins can break down and release histamines and amines that can cause illness. The histamine is produced via bacterial decarboxylation of histidine. Scombroid is very rare and supposedly comprises less than 5% of food poisonings.
Fish most likely to cause scombroid include:
- scombroid dark meat fish: tuna, mackeral, bonito, skipjack, marlin
- non-scombroid species: mahimahi (dolphin), sardine, yellowtail, herring and bluefish
- onset of a large, itchy rash on the chest and back
- flushing
- palpitations
- headache
- diarrhea and abdominal pain
- anxiety
- rarely loss of vision
- shortness of breath
- low blood pressure and collapse
1) IV fluids and oxygen
2) antihistamines
3) bronchodilators
4) treatment for shock or any cardiac problems
Cooking does NOT inactivate the toxin.
SH
