Tag Archives: ciguatera

Ciguatera intoxication happens; not cigar-related

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When I teach food service folks a certified food protection manager class I often stumble over the pronunciation of ciguatera poisoning (the New York Times says it’s sig-WAH-terra – I’ll go with that). The toxin is produced by a dinoflagellates (usually Gambierdiscus toxicus which lives on algae or dead coral) and is eaten up by sporting fish like barracuda, amber jack and some types of grouper and snapper.

The fish eat the small organisms and overtime bioaccumulate the toxin in their tissue.images

Then folks who like fish, eat it and get sick. Even if it’s cooked.

The toxin is pretty heat stable (FAO says that even 20 min of cooking at 158°F/70°C for 20 min was insufficient to fully denature the toxin protein). Ciguatera was responsible for an outbreak aboard a cargo ship earlier this year, leading to a code orange at a Saint John, New Brunswick (that’s in Canada) hospital. Thirteen crew members fell ill within hours of eating toxin-ridden fish.

Elizabeth Radke and colleagues at Florida’s Emerging Pathogens Institute published research earlier this week estimating that ciguatera is a much larger issue than the reported illness disease trackers believe. Public health data show that barracuda, grouper and amberjack caught from subtropical waters in the Bahamas and the Florida Keys are key risk factors.

From the paper:

Our finding that only 7% of diagnosed cases were reported to the FDOH may at first glance be surprising. However, for many notifiable diseases, physicians rely on laboratory reporting of cases, which is not available for ciguatera because of the lack of a diagnostic laboratory test. In addition, because ciguatera is not a communicable disease, physicians may be unaware that it is a notifiable condition in the State of Florida. One survey in Miami-Dade County found that only 47% of physicians knew that ciguatera was notifiable and this is likely to be lower in less endemic parts of the state.

We also found that Hispanics experience the highest rate of ciguatera illness in Florida, possibly due to more frequent consumption of barracuda than non-Hispanics. This may represent an opportunity for targeted, culturally relevant educational messaging after more narrowly identifying high-risk cultural groups.

Know your target audiences, their practices and communicate to them directly.

Battling bureaucracies: Eat lionfish? Sure, but beware of the nasty toxins

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A federal plan to battle invasive lionfish by dishing them up on America’s dinner plates may have backfired with the news that the flamboyantly-finned creatures can harbor a potentially dangerous neurotoxin.

JoNel Aleccia of mswnbc writes two years ago, officials with NOAA, the National Oceanic and Atmospheric Administration, launched a well-publicized campaign, complete with flashy pull-cards, a lionfish cookbook and a catchy slogan. As one newsletter put it, “If we can’t beat them, let’s eat them."

“Once stripped of its venomous spines, cleaned and filleted like any other fish, the lionfish becomes delectable seafood fare,” NOAA officials enthused.

But another government agency, the Food and Drug Administration, now frowns on the “Eat Lionfish” campaign after tests of nearly 200 lionfish show that more than a quarter exceed federal levels for a toxin that can cause ciguatera, a potentially dangerous fish food poisoning.

“We certainly don’t promote any campaign like that since we have found levels above our guidance,” said Alison Robertson, the FDA’s lead ciguatera researcher for the chemical hazards branch of the Gulf Coast Seafood laboratory. “It certainly wouldn’t be our recommendation at this time.”

Robertson said she and other FDA scientists decided to test the lionfish in the summer of 2010 after hearing about NOAA’s gustatory effort.

Of 194 fish tested, 42 percent showed detectable levels of ciguatoxin and 26 percent were above the FDA’s illness threshold of 0.1 parts per billion.

That’s enough to potentially sicken a diner with the illness that causes not only typical food poisoning symptoms – diarrhea, vomiting and fatigue – but also neurological problems such as painfully tingling hands and feet, a feeling of having loose teeth, and, oddest of all, a reversed sense of temperature.

“Whatever I touched, if it was hot, it would feel cold. If it was cold, it felt hot,” ciguatera victim Pat Schroeder of Beaumont, Texas, told msnbc.com three years ago. “I couldn’t walk on the tile floor. It felt like it was burning me.”

At least 50,000 cases of ciguatera poisoning are reported worldwide each year, but the real figure may be 100 times higher, experts say. There are dozens of confirmed reports of ciguatera poisoning in the U.S. each year with more than 300 logged by the Centers for Disease Control and Prevention between 2005 and 2009, according to the agency’s database. There were 84 cases in 2007, for instance, including 29 people sickened at a single dinner party.