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Ciguatera - Disease Investigations Branch

Ciguatera

What is ciguatera fish poisoning?

Ciguatera fish poisoning is an illness caused by eating tropical reef fish that have accumulated a poison called ciguatoxin. Ciguatoxin is produced by microscopic organisms that grow on the surface of marine algae, seaweed, or coral. The poison gets into plant-eating fish when they feed on the algae or seaweed. The poison can then build up in larger predator fish near the top of the food chain, such as snapper, amberjacks, and groupers.

How do you get it?

You get ciguatera fish poisoning by eating fish contaminated with ciguatoxin.

What are the symptoms of ciguatera fish poisoning?

  • numbness, tingling, or a burning sensation around mouth, hands, or feet;
  • joint or muscle pains with weakness or cramps;
  • vomiting, diarrhea, chills, itching, headache, sweating, and dizziness;
  • reversal of temperature sensation in the mouth, where cold things feel hot and hot things feel cold; unusual taste sensations; nightmares; or hallucinations.

When do symptoms start?

Symptoms usually begin within a few minutes to 6 hours after eating fish containing ciguatoxin. Individuals can become more sensitive to the effects of ciguatoxin if they are exposed repeatedly. The symptoms can appear sooner and be more severe with repeated exposures.

For how long do the symptoms of ciguatera fish poisoning last?

The symptoms may last for a week or so in mild cases, but may continue for several months or longer in some people. Ciguatera is rarely fatal.

What is the treatment for ciguatera fish poisoning?

The treatment is mainly supportive care. Certain medicines have been reported to be helpful when started early in the illness. It is recommended that a person suffering from ciguatera fish poisoning avoid eating fish, fish sauces, shellfish, alcohol, and nuts for several months after the incident.

How can you keep from getting it?

  • Clean fish as soon as possible after they are caught or purchased.
  • Do not eat the head, guts, liver or roe (eggs) of any reef fish, especially those of sharks and eels.
  • Avoid eating fish caught at sites known to have a ciguatoxic algae problem.
  • Ciguatoxin is not destroyed by heat, cooking, drying, salting, or freezing the fish. Also, ciguatoxin has no smell and will not change the taste or appearance of the fish. So it is impossible to easily identify a fish that may contain the toxin.

Download pdf version of this fact sheet

For more information, see the CDC’s website.

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