The effects of the neurotoxins that can contaminate fish like red snapper and grouper can last for decades.
Ciguatera Poisoning & Chronic Fatigue Syndrome
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Ciguatera is one of the most common forms of food poisoning, which occurs after the consumption of fish contaminated with neurotoxins, produced by certain microalgae that build up the food chain. Just a few bites can be sufficient to induce the condition. Disturbingly, affected fish looks, smells, and tastes normal, and ciguatoxins are resistant to all forms of cooking, so there is no straightforward method to predict whether your tropical culinary dream will be followed by a ciguatera nightmare.
Literally, it can cause nightmares; about 1 in 6 may experience signs of hallucinatory poisoning: lack of coordination, hallucinations, depression and nightmares. Most suffer some kind of neurological symptoms, tingling, numbness and a burning cold sensation. For example, ciguatera sufferers have reported that a refreshing dive in the ocean actually caused burning pain, or that drinking cool beer felt like too hot coffee.
Sometimes a reversal of temperature sensation occurs, like cold objects feel hot and vice versa. The toxin itself may also be apparently sexually transmitted either direction after fish consumption, or as one of my favorite public health bloggers put it, when hot sex turns, cold and painful, blame it on dinner.
And the symptoms can persist for months or even years. Ongoing research has shown that people with chronic fatigue syndrome may actually be suffering the long-term effects of this fish food poisoning, or a condition called polymyositis, which causes diffuse muscle aches, pains, and inflammation. Some individuals intoxicated by fish consumption 25 years can previously experience a recurrence of the main neurological disturbances during periods of overwork, fatigue, or stress. You can still find the toxins stuck in their body decades later.
Recent outbreaks in New York City have drawn attention to the problem. A man eats grouper at a Manhattan restaurant, and goes from swimming two miles a day to having difficulty walking that lasts for months. But these aren’t just rare anecdotes. Ciguatera fish poisoning affects an estimated 15,000 Americans every year, causing hundreds of hospitalizations and even a few deaths. Again, the toxins are colorless, odorless, tasteless, and are not destroyed by cooking. Therefore CDC scientists suggest education efforts aimed at the prevention of seafood intoxication by avoidance of high-risk fish altogether. The AMA put out a similar advisory, suggesting that the only way to prevent it is to avoid eating fish like red snapper or grouper, but the problem is that a third of fish sold in the United States is mislabeled, so you don’t know what you’re getting. Some suggest feeding a large fish flesh meal to a cat, treating them like a court tester, and if they’re okay six hours later, you can dig in, but this is considered inhumane. But if it’s inhumane to feed it to your cat, how is it not inhumane to feed it to other members of the family?
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.
Please consider volunteering to help out on the site.
- J P Quod, J Turquet. Ciguatera in Réunion Island (SW Indian Ocean): epidemiology and clinical patterns. Toxicon. 1996 Jul;34(7):779-85.
- T Voets. TRP channel blamed for burning cold after a tropical fish meal EMBO J. Oct 3, 2012; 31(19): 3785–3787.
- R Pennotti, E Scallan, L Backer, J Thomas, F J Angulo. Ciguatera and scombroid fish poisoning in the United States. Foodborne Pathog Dis. 2013 Dec;10(12):1059-66.
- D M Goodman, J Rogers, E H Livingston. Ciguatera Fish Poisoning JAMA, June 26, 2013—Vol 309, No. 24.
- T A Ruff, R J Lewis. Clinical aspects of ciguatera: an overview. Pacific Health Dialog Vol 4 No 2.
- E D Barton, P Tanner, S G Turchen, C L Tunget, A Manoguerra, R F Clark, Ciguatera fish poisoning. A southern California epidemic. West J Med. 1995 Jul;163(1):31-5.
- L Lehane, R J Lewis. Ciguatera: recent advances but the risk remains. Int J Food Microbiol. 2000 Nov 1;61(2-3):91-125.
- E W Stommel, J Parsonnet, L R Jenkyn. Polymyositis After Ciguatera Toxin Exposure. Arch Neurol. 1991 Aug;48(8):874-7.
- N Graber, F Stavinsky, R Hoffman, J Button N Clark, DYC Dept of Health and Mental Hygiene, S Martin, CDC, and more. Ciguatera Fish Poisoning — New York City, 2010–2011. MMWR February 1, 2013 Vol. 62 No. 4.
- J L Jacquet. D Pauley. Trade secrets: Renaming and mislabeling of seafood Marine Policy Volume 32, Issue 3, May 2008, Pages 309–318.
Images thanks to NEON ja and Richard Bartz via Wikimedia Commons.
Ciguatera is one of the most common forms of food poisoning, which occurs after the consumption of fish contaminated with neurotoxins, produced by certain microalgae that build up the food chain. Just a few bites can be sufficient to induce the condition. Disturbingly, affected fish looks, smells, and tastes normal, and ciguatoxins are resistant to all forms of cooking, so there is no straightforward method to predict whether your tropical culinary dream will be followed by a ciguatera nightmare.
Literally, it can cause nightmares; about 1 in 6 may experience signs of hallucinatory poisoning: lack of coordination, hallucinations, depression and nightmares. Most suffer some kind of neurological symptoms, tingling, numbness and a burning cold sensation. For example, ciguatera sufferers have reported that a refreshing dive in the ocean actually caused burning pain, or that drinking cool beer felt like too hot coffee.
Sometimes a reversal of temperature sensation occurs, like cold objects feel hot and vice versa. The toxin itself may also be apparently sexually transmitted either direction after fish consumption, or as one of my favorite public health bloggers put it, when hot sex turns, cold and painful, blame it on dinner.
And the symptoms can persist for months or even years. Ongoing research has shown that people with chronic fatigue syndrome may actually be suffering the long-term effects of this fish food poisoning, or a condition called polymyositis, which causes diffuse muscle aches, pains, and inflammation. Some individuals intoxicated by fish consumption 25 years can previously experience a recurrence of the main neurological disturbances during periods of overwork, fatigue, or stress. You can still find the toxins stuck in their body decades later.
Recent outbreaks in New York City have drawn attention to the problem. A man eats grouper at a Manhattan restaurant, and goes from swimming two miles a day to having difficulty walking that lasts for months. But these aren’t just rare anecdotes. Ciguatera fish poisoning affects an estimated 15,000 Americans every year, causing hundreds of hospitalizations and even a few deaths. Again, the toxins are colorless, odorless, tasteless, and are not destroyed by cooking. Therefore CDC scientists suggest education efforts aimed at the prevention of seafood intoxication by avoidance of high-risk fish altogether. The AMA put out a similar advisory, suggesting that the only way to prevent it is to avoid eating fish like red snapper or grouper, but the problem is that a third of fish sold in the United States is mislabeled, so you don’t know what you’re getting. Some suggest feeding a large fish flesh meal to a cat, treating them like a court tester, and if they’re okay six hours later, you can dig in, but this is considered inhumane. But if it’s inhumane to feed it to your cat, how is it not inhumane to feed it to other members of the family?
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.
Please consider volunteering to help out on the site.
- J P Quod, J Turquet. Ciguatera in Réunion Island (SW Indian Ocean): epidemiology and clinical patterns. Toxicon. 1996 Jul;34(7):779-85.
- T Voets. TRP channel blamed for burning cold after a tropical fish meal EMBO J. Oct 3, 2012; 31(19): 3785–3787.
- R Pennotti, E Scallan, L Backer, J Thomas, F J Angulo. Ciguatera and scombroid fish poisoning in the United States. Foodborne Pathog Dis. 2013 Dec;10(12):1059-66.
- D M Goodman, J Rogers, E H Livingston. Ciguatera Fish Poisoning JAMA, June 26, 2013—Vol 309, No. 24.
- T A Ruff, R J Lewis. Clinical aspects of ciguatera: an overview. Pacific Health Dialog Vol 4 No 2.
- E D Barton, P Tanner, S G Turchen, C L Tunget, A Manoguerra, R F Clark, Ciguatera fish poisoning. A southern California epidemic. West J Med. 1995 Jul;163(1):31-5.
- L Lehane, R J Lewis. Ciguatera: recent advances but the risk remains. Int J Food Microbiol. 2000 Nov 1;61(2-3):91-125.
- E W Stommel, J Parsonnet, L R Jenkyn. Polymyositis After Ciguatera Toxin Exposure. Arch Neurol. 1991 Aug;48(8):874-7.
- N Graber, F Stavinsky, R Hoffman, J Button N Clark, DYC Dept of Health and Mental Hygiene, S Martin, CDC, and more. Ciguatera Fish Poisoning — New York City, 2010–2011. MMWR February 1, 2013 Vol. 62 No. 4.
- J L Jacquet. D Pauley. Trade secrets: Renaming and mislabeling of seafood Marine Policy Volume 32, Issue 3, May 2008, Pages 309–318.
Images thanks to NEON ja and Richard Bartz via Wikimedia Commons.
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Title
Ciguatera Poisoning & Chronic Fatigue Syndrome
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
Many more are killed by more conventional food poisoning bugs (Chicken Salmonella Thanks to Meat Industry Lawsuit), but isn’t that crazy? Reminds me of my Amnesic Seafood Poisoning video.
Other neurotoxin videos include Preventing Parkinson’s Disease With Diet and Essential Tremor and Diet.
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