injuries and poisoning
Fish and Shellfish Poisoning
Ciguatera poisoning
Ciguatera poisoning may result from eating any of the more than 400 species of fish from the tropical reefs of Florida, the West Indies, or the Pacific. The toxin is produced by certain dinoflagellates, which are microscopic sea organisms that the fish eat. The toxin accumulates in their flesh. Older fish and large ones (such as grouper, snapper, and kingfish) are more toxic than smaller, younger ones. The flavor of the fish is not affected. Food processing procedures, including cooking, cannot destroy the toxin. The initial symptoms—abdominal cramps, nausea, vomiting, and diarrhea—may begin 2 to 8 hours after the person eats the fish and last 6 to 17 hours. Later symptoms may include Itchiness Pins-and-needles sensations Headache Muscle aches A reversal of sensations of hot and cold Facial pain For months afterward, unusual sensations and nervousness may persist. Doctors may treat affected people with intravenousmannitol(a drug that reduces swelling and pressure), but it is unclear whether this provides any benefit. 