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Mar. Drugs 2017, 15(3), 72; doi:10.3390/md15030072

An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management

1
Mount Sinai Medical Center, Miami Beach, FL 33140, USA
2
Department of Psychology and Neuroscience, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
3
National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
4
Marine Science Institute, University of Texas at Austin, Port Aransas, TX 78373, USA
5
Jackson Memorial Medical Center, Department of Medicine, University of Miami, Miami, FL 33136, USA
6
Florida Poison Information Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
7
NOAA-National Ocean Service, Center for Coastal Fisheries and Habitat Research, Beaufort, NC 28516, USA
8
Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
9
Oceanography Department, University of Hawaii, Honolulu, HI 96822, USA
10
School for the Environment, University of Massachusetts Boston, Boston, MA 02125, USA
11
Food and Drug Administration, College Park, MD 20740, USA
12
Food and Drug Administration, Dauphin Island, AL 36528, USA
13
Private Practice, Miami, FL 33133, USA
14
Institut de Ciències del Mar (CSIC), 08003 Barcelona, Spain
15
Department of Neurology, University of Miami, Miami, FL 33136, USA
16
Northern Institute, Charles Darwin University, Darwin 0909, Australia and Australian Institute of Marine Science, Darwin 0811, Australia
17
European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall Tr1 3HD, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Lucio G. Costa
Received: 7 December 2016 / Revised: 13 February 2017 / Accepted: 13 February 2017 / Published: 14 March 2017
(This article belongs to the Special Issue Marine Neurotoxins)
View Full-Text   |   Download PDF [421 KB, uploaded 15 March 2017]

Abstract

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. View Full-Text
Keywords: ciguatera fish poisoning; ciguatoxin; harmful algal bloom; algae; seafood poisoning; Gambierdiscus; diagnosis; treatment; human health; natural toxins; climate change; environmental change; food poisoning; neuropsychology; neurology; neurotoxin ciguatera fish poisoning; ciguatoxin; harmful algal bloom; algae; seafood poisoning; Gambierdiscus; diagnosis; treatment; human health; natural toxins; climate change; environmental change; food poisoning; neuropsychology; neurology; neurotoxin
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Friedman, M.A.; Fernandez, M.; Backer, L.C.; Dickey, R.W.; Bernstein, J.; Schrank, K.; Kibler, S.; Stephan, W.; Gribble, M.O.; Bienfang, P.; Bowen, R.E.; Degrasse, S.; Flores Quintana, H.A.; Loeffler, C.R.; Weisman, R.; Blythe, D.; Berdalet, E.; Ayyar, R.; Clarkson-Townsend, D.; Swajian, K.; Benner, R.; Brewer, T.; Fleming, L.E. An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management. Mar. Drugs 2017, 15, 72.

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