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SUMMER 2012
Ciguatera
The risk of many foodborne pathogens such as salmonella,
E. coli or scombroid can be minimized by following safe
handling guidelines, but there are exceptions to this rule.
Ciguatera is a notable example. Ciguatoxin is originally
produced by dinoflagellates, minute marine organisms eaten
by herbivorous fishes, which are in turn eaten by larger
predatory fish such as jacks, barracuda, snapper and grouper.
What makes this toxin different is that it is heat stable,
which means cooking does not break down the toxin.
Symptoms of ciguatera typically appear within six to 12
hours of ingestion and include nausea, vomiting, diarrhea and
numbness or tingling of the lips and skin around the mouth.
The numbness and tingling can spread to the extremities.
There may even be a reversal of hot and cold sensations. This
toxin is not generally life-threatening, but there have been
exceptions. Symptoms of ciguatera have been mistaken for
decompression sickness, but hyperbaric treatment has no effect.
Care is supportive, and symptoms usually resolve within a few
days or weeks. The best resource for knowing what fish is safe
to eat is local residents, so don’t be afraid to ask.
traveler’s Diarrhea
Despite our best efforts at prevention, traveler’s diarrhea may
strike. It can usually be managed without professional medical
care, but it is important to know when to seek care and to not
wait too long before doing so. The following points should be
used as guidelines for when to seek assistance:
• Diarrhea with accompanying abdominal pain that lasts
for more than 12 hours
• Diarrhea with a fever of 102˚F or higher
• Pain that is localized to a specific area of the abdomen
• Unusual tenderness or hardness of the abdomen
• Signs of shock (dizziness, rapid breathing, rapid pulse,
sweating, anxiety)
• Blood in the urine or stool
Even if none of these serious warning signs is present, anyone
who has diarrhea for 24 hours or longer should seek medical
treatment. Fluid loss may surpass the individual’s ability
to replace the loss solely by drinking. Over-the-counter
medications to minimize diarrhea are often used and may
“The best
resource
for knowing
what fish
is safe to
eat is local
residents,
so don’t
be afraid
to ask.”
Avoid eating large reef predators to reduce
your risk of ciguatera. Proper handling and
storage of fish as well as thorough cooking
will help reduce the risk of scombroid and
some other poisons.
S T E P H E N F R I N K