Background

• Ciguatera fish poisoning (or ciguatera) is caused by eating fish that contain toxins produced by the marine dinoflagellate microalga Gambierdiscus toxicus.
• Ciguatera causes gastrointestinal, neurological, and cardiovascular symptoms. Signs and symptoms vary widely, but ciguatera usually presents as gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and abdominal pain, accompanied by neurologic complaints, shortly after the ingestion of fish containing the toxins. Symptoms of ciguatera poisoning may persist for months or years.
• Epidemics are most common along tropical and subtropical coasts and usually involve the ingestion of large carnivorous fish. Ciguatera toxins account for over half of fish-related poisonings in the United States. The toxins are odorless and tasteless. Fish known to have carried ciguatera toxins include barracuda, black grouper, blackfin snapper, cubera snapper, dog snapper, greater amberjack, hogfish, horse-eye jack, king mackerel, and yellowfin grouper.
• Estimates place the annual number of ciguatera cases at 20,000 worldwide.

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