Ciguatera... Do We have it ???

[Bosunsmate]

Hi SK,

Hope you guys get over this quickly with no more nasty effects. Nothing worse than the runs from both ends, especially for the young ones.

Hope all get well sooner than later and everything proves to be nothing long lasting.

[dasher]

Hi guys,

just got the missus home, were all still recovering.

We are all suffering from burning our hands when washing them in cold water. Our lips and mouths are also very tingly and sensative.

I certainly would like it not to be The big"C". I suppose only time will tell.

we have been advised to stay away from all seafood, nuts, and alcohol for 3-6 months.

My wife had 4 saline bags through a drip and is still a bit on the dodgy side.

Thats about it for me, I am goin to find my pillow

Garry

Geez Garry that sucks mate. You and the family look after yourselves and remember the toxin if ciguatera is with you for life, so please take care and educate your kids as to the dangers mate. I hope it all turns out to be something else. You and yours take care mate.

[Grand_Marlin]

Apparently if you get it a second time, in close succession, it can knock you over for good.

Rule of thumb we used in cairns, was nothing over 5kg kept.

Also, as stated, there are known reefs (cant remember) up north that are riddled with cig ... especially in mackeral.

A friend of mine and her daughter in Noosa got it, from eating (supposedly) Barramundi from the take away shop. They had two feeds in 3 days and ended up in hospital, very, very ill.

Cheers

Pete

[DALEPRICE]

not good at all gary,
hope you all make a speedy recovery
no more spaniards i take it.
cheers dale

[Gbanger]

SK, this is terrible to hear.

Do you know what the doctors treated you with, this cigua check site reakons mannitol, followed by an anti-oxidant therapy... -> Vitamin B, C, and Beta-Carotene...

I always thought it was limited to tropical fish in the northern half of the GBR.

Good luck with it.

[choppa]

sorry to hear the outcome isnt what you all wanted SK,,,i tried to locate the print re the young fellas i posted about earlier in the thread to see if there was any help there for you all but its been filed somewhere oblivious to me at the moment,,, keep us informed on ya progress,, you probably dont feel like doing anything at the moment in time so heres wishing you all a fast recovery,,,,,,,,

choppa

[team_mongo]

Garry,

Sorry to say this - but sounds like classic ciguatera. My heart goes out to you..

You also have the classsic signs and symptoms -
1. intense vomiting, diarrhea and abdominal pain usually within 1-6 hours of ingestion, 90% within 12h. These gastrointestinal effects usually last for 24-36hrs.
2. 'reversal' of heat perception, actually more a intense painful tingling, burning or hot, dry-ice or electric shock sensations rather than cold feeling hot. This happens in about 89% of sufferers.
Also about 15% have 'autonomic dysfunction', which can mean the blood pressure can drop followed by sudden a rise, heart rate can slow and suddenly increase.
Most neurological symptoms settle within weeks, but can persist for months or years.

No fish for 3-6months, including shellfish. Some experts recommend avoiding chicken, pork, canned beef, eggs and nuts. The consumption of alcohol caused a reccurance of symptoms in 28% of queensland patients. This can last for years. Experimentally, it has been shown the 0.05% BAL increases the pain response to cigauratoxin.

As for treatments, mannitol is the favoured treatment in the acute phase, based on a couple of uncontrolled studies. Its effects have not been confirmed with animal studies - it has not been shown to reverse the nerve conduction effects of ciguatoxin, or protect against fatal poisoning.

As for testing, the college of pathologists dont have a blood test, and testing is done from the flesh of the fish. There are many tests, most are immunoassays. There are more than 20 precursor gambiertoxins and ciguatoxins. The toxins become more polar as they undergo oxidative metabolism and pass up the food chain. The main Pacific ciguatoxin (P-CTX-1) is different to the main Caribbean ciguatoxin 1 (C-CTX-1), which is less polar and 10-fold less toxic than P-CTX-1. So Cigua-check (which is a membrane immunobead assay to P-CTX-1) may not identify all Pacific ciguratoxin. So no single test is definitive. Another problem is the test looks for a high dose in a single fish, but lower levels (for which test negative) through multiple dosing can cause the same effects.

A bit of background stuff -
Ciguatera is caused by ciguatoxins accumulated in the muscles of certain subtropical and tropical marine finfish cause ciguatera. Ciguatoxins arise from biotransformation in the fish of less polar ciguatoxins (gambiertoxins) produced by Gambierdiscus toxicus, a marine dinoflagellate that lives on macroalgae, usually attached to dead coral. The toxins and their metabolites are concentrated in the food chain when carnivorous fish prey on smaller herbivorous fish. Humans are exposed at the end of the food chain.

More than 400 species of fish can be vectors of ciguatoxins. The moray eel (Lycodontis or Gymnothorax javanicus) is generally regarded as the most toxic ciguateric fish. In Oz the following are high risk -
narrow-barred Spanish mackerel (Scomberomorus commersoni) and other mackerel species
coral trout (Plectropomus spp.)
flowery cod (Epinephelus fuscoguttatus)
barracuda (Sphyraena jello)
red emperor (Lutjanus sebae)
queenfish (Scomberoides commersonianus),
grouper (Epinephelus lanciolatus)
red bass (Lutjanus bohar)
trevally (Caranx spp.)
Maori wrasse (Chelinus trilobatus)
kingfish (Seriola spp.)
parrot fish (Scarus spp.)
chinaman fish (Symphorus nematophorus)
paddletail (Lutjanus gibbus)
In Queensland, there is a ban on the capture of narrow-barred Spanish mackerel and barracuda in Platypus Bay, as these fish are frequently toxic.

BTW, ciguatera is completely tasteless and odourless. So its impossible to know by inspecting the fish.

Hope this helps,

George

[Spaniard_King]

George and all,

Thank you for your replies and concerns.

I was close to returning my wife to hospital last night as she once again started vomiting around 6:30pm. She convinced me to giver her 1/2 an hour to settle down in which time she fell assleep so I left her alone and she slept for a good 4 hours. We had a fairly good night with plenty of sleep.

We are all still experiencing senses reversal and lower leg muscular pain, nausea and diarreaha has stopped so we will begin the road back to eating today little by little I guess.


George I am particularly interested in this statement of your post
"This can last for years. Experimentally, it has been shown the 0.05% BAL increases the pain response to cigauratoxin. " can anyone explain this in lamens terms the 0.05% BAL bit

cheers

Garry

[blaze]

I really feel for you Garry, cant image what It would be like. Bad enough that it happens to one member of the family let alone more than one.
Hope it improves soon for all.
cheers
blaze

[agnes_jack]

Gary
Sorry to hear that mate, from what I have been told it is not a pleasant experience at all, especially for the kids.
Normally around hear it is a fairly rare experience to hear of ciguatera poisoning, yet around the hervey bay area it seems quite common?

Just before xmas last year there was a period of about 2 weeks where a few fish caused some probs. One morning Josh and I took one of the reps out for a troll. We only got the one fish in the boat as time was limited. It was only a small fish and ciguatera did not even cross my mind. The rep was going to stay with some friends that night, so we filleted the fish and packed half of it on ice in a styrofoam box for him, so he could take it down to his friends for dinner that night. The next morning he rang to say that 5 of them ended up sick as dogs!!!
At the same time time I know of several other fish that were eaten one was 22kg that caused no probs, and another two, both large fish that caused poisoning.
The fish in the photo is the one that the rep and friends ate. As you can see, quite a small fish!!!
Mackeral are now totally off the menu for my family!!!
Hope you all get a quick recovery, my sympathy goes out to you all.

Regards, Tony

[theoldlegend]

Hi Garry,

This is all a big worry, isn't it? Have been trying to get a handle on all the posts put up so far, and a couple stand out:

el_carpo said yesterday "clinical procedures are not presently available for diagnosis of ciguatera in humans".

team_mongo said today "College of Pathologists doesn't have a blood test. Testing is done from the flesh of the fish".

I guess all of this means that a doctor would be unable to tell you exactly what you are suffering from, but would have an idea, based on previous cases and your symptoms, and that there is currently nothing developed that would specifically counteract the effects of the illness. By that, I'm thinking along the lines of where you can get a flu needle or if you got bitten by a poisonous snake, you could get an anti-venene needle. That sort of stuff.

Unfortunately Garry, all my mental wanderings aren't helping you or the family overcome this, but I wish all of you a speedy recovery.

TOL

[A_DIFF_PERSPECTIVE]

Garry,
I think the 0.05% BAL means if ya have a few beers and are on the limit for driving etc, you will have increased side effects related to the ciguatera toxin and its poisoning effect will show its ugly mug again!!
That is my interpretation of it!!............. Am I right or wrong,,,,anyone??
Johnny M

[imported_admin]

Garry

Hope everything settles down with your wife and everyone comes out of this well.

It has been shown the 0.05% BAL increases the pain response to cigauratoxin.

Refers to Blood Alcohol Level.

Hence why they have suggested you stay off the drink.


Not sure whay you can't have peanuts though, maybe someone can explain this.

[bigmack]

and yet Seapup at Noosa and others Im sure all took spaniards over the weekend and no one else flet even slighty crook - a very ineteresting discussion and heads up. Im not sure if Im game to eat it anymore..............

Thanks for all the posts - glad to hear you are feeling better Gary & Family.

Cheers
Phill

[FishOn]

I, as are you guys, am concerned about this. Spanish are one of our primary table fish in the state and personally.

In doing more research in response to Garry's case, there are a lot of urban myths about ciguatera and how to detect it. The fact that I and others could have it but it remains dormant until it is tipped over the edge by a small piece of infected fish at the next meal is also a worry.

One of my defences has been to target smaller fish. But that approach could be misplaced as well. In Garry's case (15kg) and the suspected case spoken of by Tony (Agnes Jack), both were smaller fish.

It 'appears' that this may be a larger or increasing problem than I had previouly thought as we have a couple of very recent suspected/probable instances in small fish. These recent instances seem to be in areas not previously known for ciguatera.

Has the situation become worse or changed in any way?

I would like to know how many confirmed / probable / suspected . . . . . . cases occur and the details surrounding each case.

In reading the discussion here I am wondering what are the procedures for reporting and investigation, and who is responsible for these activities and any public disclosure? Only from being on AusFish have I read about these cases.

Kind regards
Trevor