Ciguatera, fish sources

Engleberg NC, Morris JG, Lewis J, McMillan JP, Pollard RA, Blake PA. Ciguatera fish poisoning a major common-source outbreak in the U.S. Virgin Islands. Ann Int Med 98 336-337, 1983. 

Frenette C, MacLean JD, Gyorkos TW. A large common-source outbreak of ciguatera fish poisoning. JIrtfecDis 158 1128-1131, 1988. 

From ciguateric Moray eels. Acts like batra-chotoxin qv. Ciguatera is also the term applied to the syndrome (headache, paraesthesiae, lassitude, haematuria, pruritis, cardiac dysrhythmias, vomiting, diarrhoea) caused sporadically by the consumption of a range of reef-dwelling fish. In both types, the source of the poison may be the blue-green algae or other components of the diet but detailed descriptions of the chemical identity of the poison(s) are not available. 

Ciguatera is a consistently underappreciated and underreported problem. Many affected communities are at marginal socioeconomic or subsistence levels. Tourist hotels in tropical regions can afford to import their fish (and, in areas of high endemicity, such as the Virgin Islands, almost all do so), while local populations remain at risk. The public health impact of ciguatera is particularly high in remote atoll countries of the Pacific where daily intake of reef fish may exceed 100 g/person per day (Lewis, 1992) and where fish represent a major protein source that cannot be fully exploited,... 

McMillan, J.P, PA. Hoffman, and H.R. Granade (1986). Gambierdiscus toxicus from the Caribbean A source of toxins involved in ciguatera. Mar. Fish. Rev. 48, 48-52. 

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