Water

Ciguatera Poisoning – Diagnosis and Treatment

One of the most common disease in the world caused by marine toxin is

Ciguatera poisoning

, which occurs due consumption of reef fish contaminated with this toxin. Snapper, grouper and barracuda are such type of fish. It is difficult to know the real incidence of poisoning worldwide as most of the cases are not reported and under-diagnosis, mostly is endemic regions like the Caribbean). Nearly 50, 000 people living in or visiting the subtropical or tropical regions suffer from this poisoning around the world. According to

the CDC estimation

, only 2-10% of such cases are actually reported in the U.S. Read on to know more about the

diagnosis and treatment of ciguatera poisoning

.

Ciguatera poisoning leads to severe neurological symptoms like numbness, pain, temperature sensation changes, and profound weakness. The symptoms may last from weeks to months. The marine toxin,

ciguatoxin

which causes the poisoning is released by the dinoflagellate

Gambierdiscus toxicus

in the tropical areas.

Diagnosis of Ciguatera Poisoning

As there is no definite blood test to diagnose the presence of ciguatoxins, the diagnostic approach is based on the clinical features and history of the disease. Consumption of a contaminated fish leads to an acute neurological and gastrointestinal disease which forms the basis of diagnosis. A correct diagnosis is difficult without a clear clinical outline.

A simple eye test can however help in the diagnosis of ciguatera poisoning. This test is known as

Visual Contrast Sensitivity test

. The marine toxin which causes the poisoning effects the eye and it cannot discern shades of black, gray and white.

Treatment for Ciguatera Poisoning

The treatment is mostly symptomatic, which includes various agents like tricyclic antidepressants, anticholinesterases, antihistamines and vitamins. But they all give limited results. Decontamination with charcoal and emptying the gut is recommended in acute poisoning cases although diarrhea and vomiting prevents this mode of treatment.

Atropine is administered for treating bradycardia, and calcium or dopamine are administered for shock. Barbiturates and opiates should be strictly avoided as they may lead to hypertension. Also, opiates may further interact with the maitotoxin, which worsens the condition of ciguatera poisoning.

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