User:Mr. Ibrahem/Ciguatera fish poisoning

Ciguatera fish poisoning (CFP), also known simply as ciguatera, is a foodborne illness caused by eating reef fish whose flesh is contaminated with certain toxins. Symptoms may include diarrhea, vomiting, numbness, itchiness, sensitivity to hot and cold, dizziness, and weakness. The onset varies with the amount of toxin eaten from half an hour to up to two days. The diarrhea may last for up to four days. Some symptoms may remain for a few weeks to months. Heart difficulties such as slow heart rate and low blood pressure may also occur.

The specific toxins involved are ciguatoxin and maitotoxin. They are originally made by a small marine organism, Gambierdiscus toxicus, that grow on and around coral reefs in tropical and subtropical waters. These are eaten by herbivorous fish which in turn are eaten by larger carnivorous fish. The toxins become more concentrated as they move up the food chain. The fish most often involved include barracuda, grouper, moray eel, amberjack, sea bass, and sturgeon. Diagnosis is based on symptoms together with having recently eaten fish. If a number of those who eat the same fish develop symptoms the diagnosis becomes more likely. If some of the fish they had previously eaten is available this can be tested to confirm the diagnosis.

Preventive efforts include not eating reef fish, not eating high-risk fish, and not eating fish liver, roe, or fish heads. Ciguatoxin has no taste or smell, and cannot be destroyed by conventional cooking. There is no specific treatment for poisoning once it occurs. Mannitol may be considered, but the evidence supporting its use is not strong. Gabapentin or amitriptyline may be used for some symptoms.

Ciguatera fish poisoning affects around 50,000 people globally each year, per the Centers for Disease Control. Other estimates suggest up to 500,000 cases per year. It is the most frequent seafood poisoning. It occurs most commonly in the Pacific Ocean, Indian Ocean, and the Caribbean Sea between the latitudes of 35°N and 35°S. The risk of the condition appears to be increasing due to coral reef deterioration and increasing trade in seafood. The risk of death from poisoning is less than 1 in 1,000. Descriptions of the condition date back to at least 1511. The current name came into use in 1787.