An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management

Author(s)

Melissa A, Friedman, Mount Sinai Medical Center
Mercedes Fernandez, Nova Southeastern University
Lorraine C Backer, Centers for Disease Control and Prevention
Robert W. Dickey, University of Texas at Austin
Jeffrey Bernstein, University of Miami
Kathleen Schrank, University of Miami
Steven Kibler, NOAA-National Ocean Service
Wendy Stephan, University of Miami
Matthew O. Gribble, University Rollins School of Public Health
Paul Bienfang, University of Hawaii
Robert E. Bowen, University of Massachusetts Boston
Stacey Degrasse, Food and Drug Administration
Harold A. Flores Quintana, Food and Drug Administration
Christopher R. Loeffler
Richard Weisman, University of Miami Miller School of Medicine
Donna Blythe
Elisa Berdalet, Institut de Ciències del Mar (CSIC)
Ram Ayyar, University of Miami
Danielle Clarkson-Townsend, Emory University Rollins School of Public Health
Karen Swajian, Food and Drug Administration
Ronald Benner, Food and Drug Administration
Tom Brewer, Charles Darwin University, Australia
Lora E. Fleming, University of Exeter Medical School

Document Type

Article

Publication Title

Marine Drugs

ISSN

1660-3397

Publication Date

3-14-2017

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.

DOI

https://doi.org/10.3390/md15030072

Volume

15

Issue

3

NSUWorks Citation

Friedman, M. A., Fernandez, M., Backer, L., Dickey, R. W., Bernstein, J., Schrank, K., Kibler, S., Stephan, W., Gribble, M. O., Bienfang, P., Bowen, R. E., Degrasse, S., Flores Quintana, H. A., Loeffler, C. R., Weisman, R., Blythe, D., Berdalet, E., Ayyar, R., Clarkson-Townsend, D., Swajian, K., Benner, R., Brewer, T., Fleming, L. E. (2017). An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management. Marine Drugs, 15(3).
Available at: https://nsuworks.nova.edu/cps_facarticles/1559