Warning from the Bay County Health Department:
The Food and Waterborne Disease Program received some information from FDA -Florida District of 5 ciguatera illnesses from consumption of grouper (state of residence unknown at this time - original information came from the FDA Baltimore District). The trace back implicated a firm in the Panama City, FL area. The firm has been contacted and has reported that over half of the lot of grouper implicated in the illnesses was distributed in the local Panama City area.
Ciguatera Fish Poisoning is a form of human poisoning caused by the consumption of subtropical and tropical marine finfish which have accumulated naturally occurring toxins through their diet. The toxins are known to originate from several <http://www.cfsan.fda.gov/cgi-bin/bbbglos?Dinoflagellida> dinoflagellate (algae) species that are common to ciguatera endemic regions in the lower latitudes.
Initial signs of poisoning occur within six hours after consumption of toxic fish and include perioral numbness and tingling (paresthesia), which may spread to the extremities, nausea, vomiting, and diarrhea. Neurological signs include intensified paresthesia, arthralgia, myalgia, headache, temperature sensory reversal and acute sensitivity to temperature extremes, vertigo, and muscular weakness to the point of prostration. Cardiovascular signs include arrhythmia, bradycardia or tachycardia, and reduced blood pressure. Ciguatera poisoning is usually self-limiting, and signs of poisoning often subside within several days from onset. However, in severe cases the neurological symptoms are known to persist from weeks to months. In a few isolated cases neurological symptoms have persisted for several years, and in other cases recovered patients have experienced recurrence of neurological symptoms months to years after recovery. Such relapses are most often associated with changes in dietary habits or with consumption of alcohol. There is a low incidence of death resulting from respiratory and cardiovascular failure.
Manifestations of ciguatera in humans usually involves a combination of gastrointestinal, neurological, and cardiovascular disorders. Symptoms defined within these general categories vary with the geographic origin of toxic fish.
Clinical testing procedures are not presently available for the diagnosis of ciguatera in humans. Diagnosis is based entirely on symptomology and recent dietary history. An enzyme immunoassay (EIA) designed to detect toxic fish in field situations is under evaluation by the Association of Official Analytical Chemists (AOAC) and may provide some measure of protection to the public in the future.
Marine finfish most commonly implicated in ciguatera fish poisoning include the groupers, <http://www.cfsan.fda.gov/~frf/rfe2gb.html> barracudas, snappers, jacks, mackerel, and triggerfish. Many other species of warm-water fishes harbor ciguatera toxins. The occurrence of toxic fish is sporadic, and not all fish of a given species or from a given locality will be toxic.
