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Clinical Features of Ciguatera Fish Poisoning: A Study of the Disease in the US Virgin Islands

Clinical Features of Ciguatera Fish Poisoning: A Study of the Disease in the US Virgin Islands Abstract • Clinical data were obtained on 33 patients involved in 27 episodes of ciguatera fish poisoning occurring during a 14-week period on St Thomas in the US Virgin Islands. All patients had gastrointestinal tract symptoms, with 30 patients (91%) complaining of diarrhea and 23 patients (70%) complaining of vomiting; these symptoms occurred early in the disease and were of short duration. Twenty-three patients (70%) complained of malaise, and 19 patients (58%) had pain and weakness in the lower extremities. Dysesthesias were noted by 19 patients (58%); the median duration of dysesthesias was two weeks or more, with symptoms present in some cases for more than two months. Cardiovascular signs and symptoms, including both hypotension and bradycardia were noted in some acute cases. Therapy included antidiarrheal and antiemetic agents, intravenous fluids, atropine, and pralidoxime chloride. Efficacy of pralidoxime therapy could not be established on the basis of our data. (Arch Intern Med 1982;142:1090-1092) References 1. Hughes JM, Merson MH: Fish and shellfish poisoning. N Engl J Med 1976;295:1117-1120.Crossref 2. Halstead BW: Poisonous and Venomous Marine Animals of the World. Princeton, NJ, Darwin Press Inc, 1978. 3. Ciguatera poisoning, Caribbean Epidemiology Centre. CAREC Surveillance Rep 1979;5:4. 4. Bagnis R, Kuberski T, Laugier S: Clinical observations on 3,009 cases of ciguatera (fish poisoning) in the South Pacific. Am J Trop Med Hyg 1979;28:1067-1073. 5. Morris JG: Ciguatera fish poisoning. JAMA 1980;244:273-274.Crossref 6. Lawrence DN, Enriguez MB, Lumish RM, et al: Ciguatera fish poisoning in Miami. JAMA 1980;244:254-258.Crossref 7. Gelb AM, Mildvan D: Ciguatera fish poisoning. NY State J Med 1979;79:1080-1081. 8. Jones HR: Acute ataxia associated with ciguatera-type (grouper) tropical fish poisoning. Ann Neurol 1980;7:491.Crossref 9. Ciguatera fish poisoning, Maryland, Centers for Disease Control. MMWR 1980;29:610. 10. Yasumoto T, Nakajima I, Chungue E, et al: Toxins in the gut contents of parrotfish. Bull Jpn Soc Sci Fisheries 1977;43:69-74.Crossref 11. Bagnis R, Chanteau S, Chungue E, et al: Origins of ciguatera fish poisoning: A new dinoflagellate, Gambierdisus toxicus Adachi and Fukuyo, definitely involved as a causal agent. Toxicon 1980;18:199-208.Crossref 12. Hokama Y, Banner AH, Boylan DB: A radioimmunoassay for the detection of ciguatera. Toxicon 1977;15:317-325.Crossref 13. Berger JA, Berger LR: Studies to develop a colorimetric ELISA test to assay ciguatoxin in fish tissue. Review of International Oceanographic Medicine 1979;53-54:23-32. 14. McMillan JP, Granade HR, Hoffman P: Ciguatera fish poisoning in the United States Virgin Islands: Preliminary studies. J Col Virgin Islands 1980;6:84-107. 15. Harman HH: Modern Factor Analysis , ed 2. Chicago, University of Chicago Press, 1967. 16. Tatnall FM, Smith HG, Welsby PD, et al: Ciguatera poisoning. Br Med J 1980;281:948-949. 17. Hanno HA: Ciguatera fish poisoning in the Virgin Islands. JAMA 1981;245:464.Crossref 18. Rayner MD: Marine toxins from the Pacific: VII. Recent advances in the pharmacology of ciguatoxin , in Drugs From the Sea Conference Proceedings. Washington, DC, Marine Technology Society, 1970, pp 345-350. 19. Ohshika H: Marine biotoxins from the Pacific: IX. Some effects of ciguatoxin on isolated mammalian atria. Toxicon 1971;9:337-343.Crossref 20. Li KM: Ciguatera fish poison: A cholinesterase inhibitor. Science 1965;147:1580-1581.Crossref 21. Ohizumi Y, Shibata S, Tachibana K: Mode of the excitatory and inhibitory actions of ciguatoxin in the guinea pig—vas deferens. J Pharmacol Exp Ther 1981;217:475-480. 22. Rayner MD: Mode of action of ciguatoxin. Fed Proc Am Soc Exp Biol 1971;31:1139-1145. 23. Russel FE: Ciguatera poisoning: A report of 35 cases. Toxicon 1975;13:383-385.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Clinical Features of Ciguatera Fish Poisoning: A Study of the Disease in the US Virgin Islands

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340190046008
Publisher site
See Article on Publisher Site

Abstract

Abstract • Clinical data were obtained on 33 patients involved in 27 episodes of ciguatera fish poisoning occurring during a 14-week period on St Thomas in the US Virgin Islands. All patients had gastrointestinal tract symptoms, with 30 patients (91%) complaining of diarrhea and 23 patients (70%) complaining of vomiting; these symptoms occurred early in the disease and were of short duration. Twenty-three patients (70%) complained of malaise, and 19 patients (58%) had pain and weakness in the lower extremities. Dysesthesias were noted by 19 patients (58%); the median duration of dysesthesias was two weeks or more, with symptoms present in some cases for more than two months. Cardiovascular signs and symptoms, including both hypotension and bradycardia were noted in some acute cases. Therapy included antidiarrheal and antiemetic agents, intravenous fluids, atropine, and pralidoxime chloride. Efficacy of pralidoxime therapy could not be established on the basis of our data. (Arch Intern Med 1982;142:1090-1092) References 1. Hughes JM, Merson MH: Fish and shellfish poisoning. N Engl J Med 1976;295:1117-1120.Crossref 2. Halstead BW: Poisonous and Venomous Marine Animals of the World. Princeton, NJ, Darwin Press Inc, 1978. 3. Ciguatera poisoning, Caribbean Epidemiology Centre. CAREC Surveillance Rep 1979;5:4. 4. Bagnis R, Kuberski T, Laugier S: Clinical observations on 3,009 cases of ciguatera (fish poisoning) in the South Pacific. Am J Trop Med Hyg 1979;28:1067-1073. 5. Morris JG: Ciguatera fish poisoning. JAMA 1980;244:273-274.Crossref 6. Lawrence DN, Enriguez MB, Lumish RM, et al: Ciguatera fish poisoning in Miami. JAMA 1980;244:254-258.Crossref 7. Gelb AM, Mildvan D: Ciguatera fish poisoning. NY State J Med 1979;79:1080-1081. 8. Jones HR: Acute ataxia associated with ciguatera-type (grouper) tropical fish poisoning. Ann Neurol 1980;7:491.Crossref 9. Ciguatera fish poisoning, Maryland, Centers for Disease Control. MMWR 1980;29:610. 10. Yasumoto T, Nakajima I, Chungue E, et al: Toxins in the gut contents of parrotfish. Bull Jpn Soc Sci Fisheries 1977;43:69-74.Crossref 11. Bagnis R, Chanteau S, Chungue E, et al: Origins of ciguatera fish poisoning: A new dinoflagellate, Gambierdisus toxicus Adachi and Fukuyo, definitely involved as a causal agent. Toxicon 1980;18:199-208.Crossref 12. Hokama Y, Banner AH, Boylan DB: A radioimmunoassay for the detection of ciguatera. Toxicon 1977;15:317-325.Crossref 13. Berger JA, Berger LR: Studies to develop a colorimetric ELISA test to assay ciguatoxin in fish tissue. Review of International Oceanographic Medicine 1979;53-54:23-32. 14. McMillan JP, Granade HR, Hoffman P: Ciguatera fish poisoning in the United States Virgin Islands: Preliminary studies. J Col Virgin Islands 1980;6:84-107. 15. Harman HH: Modern Factor Analysis , ed 2. Chicago, University of Chicago Press, 1967. 16. Tatnall FM, Smith HG, Welsby PD, et al: Ciguatera poisoning. Br Med J 1980;281:948-949. 17. Hanno HA: Ciguatera fish poisoning in the Virgin Islands. JAMA 1981;245:464.Crossref 18. Rayner MD: Marine toxins from the Pacific: VII. Recent advances in the pharmacology of ciguatoxin , in Drugs From the Sea Conference Proceedings. Washington, DC, Marine Technology Society, 1970, pp 345-350. 19. Ohshika H: Marine biotoxins from the Pacific: IX. Some effects of ciguatoxin on isolated mammalian atria. Toxicon 1971;9:337-343.Crossref 20. Li KM: Ciguatera fish poison: A cholinesterase inhibitor. Science 1965;147:1580-1581.Crossref 21. Ohizumi Y, Shibata S, Tachibana K: Mode of the excitatory and inhibitory actions of ciguatoxin in the guinea pig—vas deferens. J Pharmacol Exp Ther 1981;217:475-480. 22. Rayner MD: Mode of action of ciguatoxin. Fed Proc Am Soc Exp Biol 1971;31:1139-1145. 23. Russel FE: Ciguatera poisoning: A report of 35 cases. Toxicon 1975;13:383-385.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1982

References