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.
Highlights
Ciguatera Fish Poisoning (CFP) is the most commonly reported natural marine toxin related illness globally [1]
Patients seen within the first few hours after ingestion of toxic fish may benefit from treatment with oral activated charcoal to prevent further absorption of toxin from the gut, severe vomiting associated with CFP may preclude its administration [108,139]
Methods have been established for detecting CTXs in fish implicated in CFP outbreaks, the results of which are used to support the clinical diagnosis of CFP
Summary
Ciguatera Fish Poisoning (CFP) is the most commonly reported natural marine toxin related illness globally [1]. It is characterized by gastrointestinal, neurologic, and cardiac symptoms. In 2014, 41.3 metric tons of barracuda were sold in Florida [46,47], a significant seafood market, given that barracuda is broadly viewed as ha ving an extremely high potential to be ciguatoxic This highlights the importance of awareness on the part of the public and healthcare professionals, as well as the development of effective CFP risk management systems on a local to global scale
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