A disease resulting from the consumption of contaminated fish, in which the toxin has accumulated via a food chain. The alga involved (the photosynthetic dinoflagellate Gambierdis custoxicus) is consumed by a small herbivorous fish. Larger fish feeding on the smaller fish concentrate the toxin further in the chain. This kind of intoxication is found in the South Pacific and the Caribbean. The various ciguatera toxins do not all contribute to poisoning to the same extent. The main cause is ciguatoxin. Symptoms of ciguatera poisoning are paresthesia in lips, fingers, and toes, vomiting, nausea, abdominal pain, diarrhea, bradycardia, muscular weakness, and joint pain. The mechanism underlying these symptoms may be based on the neuroactivity of ciguatoxin. It increases sodium permeability, leading to depolarization of nerves.
A form of fish poisoning due to eating certain types of bottomd-welling shore fish (e.g., grouper, red snapper, sea bass, and barracuda). The toxin, ciguatoxin, is present in fish that feed on dinoflagellates. It acts within 5 hr of ingestion, and symptoms may persist for 8 days or longer. Symptoms include tingling of the lips, tongue, and throat, abdominal cramps, nausea, vomiting, diarrhea, paresthesia, hypotension, and respiratory paralysis. Treatment is supportive, but treatment of respiratory paralysis may be required.