Seafood Poisoning

Ciguatera Fish poisoning

And
Scombroid (Pseudoallergic) fish poisoning

 Most frequently reported seafood-toxin illness in the

world
Reported in florida, Hawaii, French Polynesia, the
marshal islands, Caribbean, and south pacific
islands, and virgin islands
Also occurs worldwide
Grouper is the most commonly identified source of
toxin
Snapper, kingfish, amberjack, dolphin, eel, and barracuda
farm-raised salmon

 Gambierdiscus toxicus the cause

Produces high conc. Of ciguatoxin and maitotoxin
Odorless, colorless, and tasteless not estroyed by
cooking or freezing

Biomagnification (reason)
Pathophysiology:
Lipid ciguatoxin-1 increases the sodium ion
permeability of excitable membranes and depolarizes
nerve cells, actions that are inhibited by calcium and
tetradotoxin

 2- 30 hour after ingestion:

Intitial symptoms diarrhea, vomiting, nausea, and
abdominal pain

Within a few days:

Intense itching, anxiety, malgias, painful intercourse, and
rash on palms and soles
Neurologic symptoms of circumoral or extremity
dysesthesias
May last for months
Also, eating fish organs, roe, or viscera greated symptoms
Diagnosis, based on clinical presentation and compatible
epidemiologic hx
No human biomarker

Treatment
Supportive
Gastric lavage to remove remaining toxin
IV fluids severe diarrhea
Parenteral administration of calcium to treat hypotension
Once adequate hydration is established

mannitol given within 48-72 hrs to reduce acute

symptoms and possible prevention of chronic neurologic
symptoms
*most cases are self-limited, and death occurs in less that
0.1% of cases

Scombroid Fish poisoning

Albacore , mackerel, tuna, bonita, kingfish
Nonscombroid fish mahi, mahi (dolphin fish)
swordfish, and bluefish

 Scombrotoxin, either histamine or the product

of the action of the toxin on fish flesh, is
responsible for the clinical syndrome
Clinical manifestation: acute occurs 10 min
to 2 hrs
Diarrhea, erythema, sweating, flushing,
diaphoresis, urticarial, nausea, and headache
Self-limited, terminating within 8-24 hrs

 Treatment:
Supportive
Gastric lavage
Fluid replacement
Antihistamines
Cimetidine