It would appear that ciguatera can be cumulative ie slow build up of the toxin. I suspect all of us living in the tropics proably have accumulated a degree of toxin within our bodies if we eat reef fish regularly.
When we eat a fish with a lot of toxin we can either tip ourselves over the line in regards to being ' symptomatic'.
We ' slowly' get rid of the toxin. I know guys who have had ciguatera before and they get mild symptoms on eating some reef fish clearly just tipping thmeselves over the line but not being really crook, many years down the track.
Some people get really sick with an acute dose ' poisoned' clearly a heap of toxin from an infected fish at once, usually a big fish.
Once again steer away from the big ones and dont eat too much of one fish especially if large. Share the love !!!!!
If too big put it back take a photo especially those spaniards and trout.