Large Outbreaks of Ciguatera after Consumption of Brown Marbled Grouper
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AbstractBrown marbled grouper (Epinephelus fuscoguttatus) is an apex predator from coral reefs of the Indo-Pacific region. All five published case series of ciguatera after consumption of brown marbled grouper were reviewed to characterize the types, severity and chronicity of ciguatera symptoms associated with its consumption. Three of these case series were from large outbreaks affecting over 100-200 subjects who had eaten this reef fish served at banquets. Affected subjects generally developed a combination of gastrointestinal, neurological and, less commonly, cardiovascular symptoms. Gastrointestinal symptoms occurred early and generally subsided in 1-2 days. Some neurological symptoms (e. g., paresthesia of four limbs) could last for weeks or months. Sinus bradycardia and hypotension occurred early, but could be severe and prolonged, necessitating the timely use of intravenous fluids, atropine and dopamine. Other cardiovascular and neurological features included atrial ectopics, ventricular ectopics, dyspnea, chest tightness, PR interval >0.2 s, ST segment changes, polymyositis and coma. Concomitant alcohol consumption was associated with a much higher risk of developing bradycardia, hypotension and altered skin sensation. The public should realize that consumption of the high-risk fish (especially the ciguatoxin-rich parts and together with alcohol use) and repeated ciguatoxin exposures will result in more severe and chronic illness.
All Author(s) ListChan TYK
Journal nameToxins
Year2014
Month7
Day1
Volume Number6
Issue Number7
PublisherMDPI AG
Pages2041 - 2049
ISSN2072-6651
LanguagesEnglish-United Kingdom
Keywordsbrown marbled grouper; ciguatera; ciguatoxins; Epinephelus fuscoguttatus
Web of Science Subject CategoriesToxicology; TOXICOLOGY

Last updated on 2020-30-06 at 06:04