June 28, 2002
The Kauai District Health Office is warning people to avoid eating
reef fish from waters of the North Shore area of Kaua’i after
reports of eight individuals becoming ill with ciguatera fish poisoning
since June 19th. Poisonings were caused by papio, and kole (surgeon
fish) from areas along the north shore from Princeville to
Miloli’i, Kaua’i and ulua caught near Koloa on the south
Historically, the incidence of ciguatera poisoning increases from
May through August on Kaua’i. This may be due to several factors,
including the calming of the seas, allowing accessibility to
The risk of ciguatera poisoning is not limited to Kauai. Department
of Health offices on Maui, Hawaii and Oahu have all received reports of
people ill with ciguatera during the first 6 months of 2002. Implicated
fish include grouper, palani, sea bass, wahanui, uku and ulua.
Ciguatera poison is found in reef fish and predator fish that feed
on reef fish. The fish are not affected by the poison, and it cannot be
detected by taste or smell. Freezing, cooking, drying or marinating
does not eliminate the poison. Feeding toxic fish or fish viscera
(guts) to animals, particularly cats, could poison them.
Symptoms of ciguatera occur because the toxin works on the nervous,
digestive and cardiovascular systems. Symptoms may occur from 1 hour to
1 day after eating the fish. The more toxic fish one eats, the more
severe the symptoms are. Fish may contain low levels of toxin that may
not cause symptoms after eating one serving of the fish, but may occur
after eating a second or third serving. Diarrhea is usually the first
symptom, followed by weakness, and aching muscles or joints. Itching,
headache, dizziness, numbness and tingling around the mouth or hands
and feet and the odd sensation that hot things feel cold or cold feels
hot may also occur. Eating fish or fish products, nuts or nut oils
(e.g. peanuts, sesame oil) and drinking alcoholic beverages may make
symptoms worse, or may cause return of symptoms for some individuals.
Individuals who have had ciguatera are at higher risk of getting it
To prevent ciguatera poisoning, one must avoid eating the fish that
carry the toxin. Be aware of the types of fish that cause ciguatera,
and know the locations where these fish have been caught. Pamphlets
describing these fish and locations for each island may be obtained
from the Department of Health. The head, guts and eggs contain higher
concentrations of the ciguatera toxin, so avoid eating these parts.
Ciguatera test kits are available for purchase at many fishing
supply stores. The company that produces the kit has a web site at www.cigua.com that lists stores that
sell the kit.
Contact the store by phone to determine if kits are available.
Report ciguatera poisoning to the Department of Health on your
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