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Ciguatera fish poisoning (CFP) is a foodborne illness caused by fish containing ciguatoxin (CTX). The toxin is produced by the microalgae Gambierdiscus spp. which are then eaten by reef fish; humans contract the illness when eating either fish that have eaten the algae, or carnivorous fish that have eaten those fish. CTX is an odorless, tasteless, and colorless neurotoxin that blocks voltage-sensitive Na+ channels and accumulates in many tissues of the fish, especially the viscera. The illness is typically mild to moderate in severity with gastrointestinal (diarrhea, cramping, nausea, vomiting) and neurological (paraesthesias, cold allodynia, fatigue, pruritis) manifestations. Rarely, the disease can be more severe with significant neuropathic or cardiac effects such as bradycardia and hypotension. Endemic to Hawai'i and islands throughout the Caribbean and Pacific, CFP incidence rates range from several to thousands of cases per 100,000 per year. Since fishing is important for local food supply, exportation, and recreation throughout the Pacific, CFP is medically and economically significant in these areas. We present a case of CFP from Hawai'i to illustrate the disease, demonstrating that the diagnosis is primarily clinical, with confirmatory tests from fish samples available in some cases. Treatment is supportive and symptomatic with no disease specific remedy. The prognosis for most cases is good with a short duration of self-limited symptoms, but for some cases neurological sequelae can become chronic. With no effective treatment, education on which species of reef fish and which body parts to avoid eating is essential in the prevention of CFP. [ABSTRACT FROM AUTHOR]

Abstract: The central Pacific Ocean has arguably more ciguatera poisoning than any other place on earth. Here we tested two competing hypotheses that outline the primary causes of ciguatera outbreaks: (1) the ‘new surface hypothesis’ and (2) the ‘climate oscillation hypothesis’. Our findings indicated that in Rarotonga, from 1994 to 2010, the annual incidence of ciguatera poisoning ranged from 204 to 1,058 per 10,000 population per year. We found that the widest reefs of Rarotonga elicited the most cases of ciguatera poisoning, but found no relationship between ciguatera outbreaks and reef exposure. We also found strong correlations between cases of ciguatera poisoning and (i) the positive phase of the Pacific Decadal Oscillation, (ii) El Niño years, and (iii) periods with frequent disturbances. Yet, most disturbances occurred during the above-mentioned climate phases. This study links the two supposedly, mutually exclusive hypotheses. Moreover, as predicted by the ‘climate oscillation hypothesis’, the Pacific Ocean is now, in 2010, experiencing a negative phase of the Pacific Decadal Oscillation, and Rarotonga is reporting few cases of ciguatera poisoning. [Copyright &y& Elsevier]

The article discusses a research study on the distribution and abundance of ciguatera dinoflagellates at Johnston Atoll in the Pacific Ocean and how they are affected by water motion, depth and habitat. Standardized methodology was used in the investigation on toxigenic benthic dinoflagellates from the Gambierciscus, Prorocentrum and Ostreopsis genera at Johnston Atoll at different sampling stations including the channel habitats, the reef crest and back reef habitats. Results showed the negative correlation to water motion of three generas including Gambierdiscus, Prorocentrum and Amphidinium and the positive correlation of the Ostreopsis genera. Other observations include the negative correlation between Ostreopsis and Prorocentrum spp and their habitat separation.

Abstract: Dinoflagellates in the genus Gambierdiscus produce toxins that bioaccumulate in tropical and sub-tropical fishes causing ciguatera fish poisoning (CFP). Little is known about the diversity and distribution of Gambierdiscus species, the degree to which individual species vary in toxicity, and the role each plays in causing CFP. This paper presents the first global distribution of Gambierdiscus species. Phylogenetic analyses of the existing isolates indicate that five species are endemic to the Atlantic (including the Caribbean/West Indies and Gulf of Mexico), five are endemic to the tropical Pacific, and that two species, Gambierdiscus carpenteri and Gambierdiscus caribaeus are globally distributed. The differences in Gambierdiscus species composition in the Atlantic and Pacific correlated with structural differences in the ciguatoxins reported from Atlantic and Pacific fish. This correlation supports the hypothesis that Gambierdiscus species in each region produce different toxin suites. A literature survey indicated a >100-fold variation in toxicity among species compared with a 2 to 9-fold within species variation due to changing growth conditions. These observations suggest that CFP events are driven more by inherent differences in species toxicity than by environmental modulation. How variations in species toxicity may affect the development of an early warning system for CFP is discussed. [ABSTRACT FROM AUTHOR]

Abstract: Ciguatera is a significant food borne disease caused by potent polyether toxins known as ciguatoxins, which accumulate in the flesh of ciguateric fish at risk levels above 0.1ppb. The management of ciguatera has been hindered by the lack of analytical methods to detect and quantify clinically relevant levels of ciguatoxin in easily prepared crude extracts of fish. Here we report a ciguatoxin rapid extraction method (CREM) that allows the rapid preparation of fish flesh extracts for the detection and quantification of ciguatoxin by gradient reversed-phase liquid chromatography-tandem mass spectrometry (LC/MS/MS). CREM-LC/MS/MS delivers a linear response to P-CTX-1 spiked into fish prior to extraction. A similar response was obtained for P-CTX-1 spiked after extraction, indicating >95% extraction efficiency was achieved overall and 85% at the limit of quantification (0.1ppb). Using this approach, levels ≥0.1ppb P-CTX-1 could be detected and quantified from an extract of 2g fish flesh, making it suitable as a confirmatory assay for suspect ciguateric carnivorous fish in the Pacific Ocean. The approach is designed to simplify the extraction and analysis of multiple samples per day. [Copyright &y& Elsevier]