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Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties.

Monitoring for chloramphenicol (CAP) in aquaculture products is primarily performed by liquid chromatography--tandem mass spectrometry (LC-MS/MS), which requires expensive equipment and specialized training. Many laboratories prefer to screen samples with facile and high-throughput enzyme-linked immunosorbent assay (ELISA) kits for CAP residues before submitting samples for LC-MS/MS quantification and confirmation. We evaluated the performance of a Ridascreen (R-Biopharm) ELISA kit for CAP in spiked and incurred crab and shrimp muscle at levels bracketing the minimum required performance level for analysis (0.3 ng/g). The Ridascreen ELISA kit incorporates antibody directed against CAP. Incurred CAP levels in crab and shrimp muscle were verified using LC-MS/MS. We found good repeatability (relative standard deviation) of the ELISA in spiked and incurred crab and shrimp muscle samples, with values ranging from 6.8 to 21.7%. Recoveries of CAP from tissues spiked at 0.15 to 0.60 ng/g ranged from 102 to 107%. Minimal cross-reactivity with blank crab and shrimp muscle matrix components was observed. ELISA data were highly correlated with those of LC-MS/MS for CAP in incurred muscle tissue. We believe this study to be the first evaluation of the performance and comparability of a CAP ELISA kit and LC-MS/MS for determination of CAP residues, as well as their elimination, in crab muscle. Our findings support the use of this ELISA kit for screening purposes and, when used in conjunction with validated instrumental methods, for regulatory monitoring of CAP in these species. [ABSTRACT FROM AUTHOR]

Globally, ciguatera fish poisoning (CFP) avoidance efforts rely primarily on local knowledge of the fish being consumed, its collection location, and association with illnesses. In 2016, several fish that appeared to be hybrids between a local commercially prized species, Ocyurus chrysurus, and a regionally prohibited species Lutjanus apodus (due to CFP concerns), were caught nearshore in United States Virgin Islands waters, leading to confusion regarding the safety of consuming the fish. The hybrid status of the fish was verified as O. chrysurus (male) × L. apodus (female) by comparing two sets of gene sequences (mitochondrial CO1 and nuclear S7). Using an in vitro mouse neuroblastoma (N2a) assay, one of the hybrid fish exhibited a composite cytotoxicity of 0.038 ppb Caribbean ciguatoxin-1 (C-CTX-1) equivalents (Eq.); a concentration below the US Food and Drug Administration (FDA) guidance level for safety in fish products for CFP (0.1 ppb C-CTX-1 Eq.) but approximately 2× above the maximum described in the commercially prized parent species (0.019 ppb C-CTX-1 Eq./g). C-CTX-1 was confirmed in the hybrid sample by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The second hybrid fish tested negative for CTXs. This research confirms hybridization between two species with contrasting commercial statuses, discusses CTX accumulation implications for hybridization, and provides a methodology for future studies into novel CFP vectors, with the goal of providing critical information for fishermen and consumers regarding CFP risk management. [ABSTRACT FROM AUTHOR]