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* Ciguatera
* Scombroid
* Shellfish Poisoning
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*Food borne illness caused by
dinoflagellates
*Gambierdiscus toxicus
*The toxin produced is ciguatoxin
*Ciguatoxin is orderless, tasteless and
very heat stable
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Ciguatera Bioamplification
* Barracudas
* Moray eels
* Snapper
* Groupers
* Amberjacks
* Triggerfish
* Parrotfish
* Symptoms usually develop 1–3 hours after
eating contaminated fish
* They can include nausea, vomiting, diarrhea,
and stomach pain
* Some people may have neurologic symptoms,
such as a tingling sensation, tooth pain or
feeling as if the teeth are loose, itching, a
metallic taste in the mouth, and blurred vision
* Hot-cold reversal
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*Mannitol used in past – no good
evidence of benefit
*Symptomatic Rx, IV fluids
*Long term sequelae
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* Food Borne illness caused by high levels of
histamine
* Caused by fish that have naturally high levels of
the amino acid histidine – scombridae family
* Bacteria convert histidine to histamine when the
fish is not correctly stored
* Histamine is heat stable and not destroyed by
cooking
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*Tuna
* Mackerel
* Mahimahi
* Sardines, anchovies, herring
* Bluefish
* Amberjack
* Marlin
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* Symptoms usually develop within a few
minutes to an hour after eating fish
* Resemble an allergic reaction, such as flushing
of the face, headache, heart palpitations,
itching, blurred vision, cramps, and diarrhea
* Symptoms can be treated with antihistamines
Even without treatment, people usually get
better within 12 hours
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*Contaminated fish may taste
peppery, sharp, metallic, or bitter,
but it may also look and taste
normal. Fish should be iced,
refrigerated, or frozen immediately
after it is caught.
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* Brevetoxins
* Several forms of shellfish poisoning may occur
after ingesting filter-feeding bivalve mollusks
(such as mussels, oysters, clams, scallops, and
cockles) that contain potent brevetoxins.
* Culprit is dinoflagellate blooms called harmful
algal blooms (HABs). One example of a HAB is
the Florida red tide caused by Karenia brevis.
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*Neurotoxic
*Paralytic
*Amnestic
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*Similar to Ciguatera
*Nausea/vomiting/diarrhea
*Numbness or tingling in mouth
*Headache, dizziness
*Hot and cold temperature reversal
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*30 minutes after ingestion
*Numbness & tingling in mouth
*Arms and legs may become
temporarily paralyzed
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*Nausea, vomiting diarrhea
*Short-term memory loss
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*Most recover within 48 hrs
*No long-term sequelae reported
*IV fluids, sedatives, pain
management
 Ciguatera
 Scombroid
 Shellfish Poisoning
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