It was one year ago today that I came this close to dying. I did what many people do while on vacation - eat fresh seafood. I was in Saint Maarten in the Caribbean and had delicious Red Snapper for dinner one evening. At the time I was totally unaware of the fact that certain types of fish in the Caribbean can possibly carry a neuro-toxin. Within 6 hours of eating the fish contaminated with the Ciguatera toxin I was in horrible pain that only progressed over the next 8 hours. Coming close to dying that day was the culmination of the illness, however it did not end there. You see the effects of Ciguatera stay with you sometimes for years. There is no treatment for what Ciguatera does to you, only time. Some cases are worse than others. I was lucky enough to be on the extreme end of symptoms and a year later I still have flare ups of pain or numbness. I cannot eat seafood or even have it touch my food for fear of re-exacerbating the toxin that is still in my body.
I am writing this post today not only because it marks the one year anniversary of me getting sick but more importantly to help make people aware of the risk they put themselves at when they eat the fish that can be contaminated. This is the time of the year when people travel to the Caribbean or Hawaii and I want to alert them to the fact that if they eat that grouper sandwich or red snapper at dinner they may regret it.
I am here to tell you that this toxin is mean and potentially lethal. You do not want it. You do not want to experience the things I have over the past year. Things like muscle and bone pain that come on at random times for no reason and then just quit for no reason, a continually numb tip of my tongue, random pain in my finger tips that feels like my fingers are being melted like candles, the inability to hold cold things without my hands burning~I still have temperature reversal with cold where it feels very hot to my hands.
Here are some facts about Ciguatera "fish poisoning"
- Ciguatera is a food-born illness (food poisoning) caused by eating fish that is contaminated by Ciguatera toxin. Ciguatera toxin is a heat-stable lipid soluble compound, produced by dinoflagellates and concentrated in fish organs, that can cause nausea, pain, cardiac, and neurological symptoms in humans when ingested.
- The toxin may be found concentrated in large reef fish, most commonly barracuda, grouper, red snapper, eel, amberjack, sea bass, and Spanish mackerel.
- These fish live in coral reef waters and accumulate the toxin when they eat smaller reef fish which feed on the dinoflagellates.
- The area of concern include the Caribbean Sea, Hawaii, and coastal Central America.
- The toxin can't be detected. The fish look normal, smell normal and taste normal.
- The toxin can't be cooked away, or frozen away. It is always there.
- Symptoms generally begin 6 to 8 hours after eating the contaminated fish but can occur as early as 2 or as late as 24 hours after ingestion.
- Symptoms include nausea, vomiting, diarrhea, muscle pain, numbness, tingling, abdominal pain, dizziness, and vertigo. The classic finding of hot and cold sensation reversal is actually a burning sensation on contact with cold (allodynia).
- Teeth may feel loose and itching may be intense.
- Severe cases of ciguatera poisoning may result in shortness of breath, salivation, tearing, chills, rashes, itching, and paralysis. Bradycardia, coma and hypotension can occur. Death due to poisoning is rare (less then 0.5 %).
- There is an estimated 50,000 cases each year of Ciguatera poisoning. This number could be much higher since many cases, mine included, went unreported.
- The ocean temperatures are rising and there is more toxin on the coral and as a result it is expected that the number of cases of Ciguatera each year will also rise.
Besides staying away from these fish when you travel you should also not eat them when at home since you do not know the actual source of where the fish came from and you could potentially be eating fish from the waters that are known to carry the toxin. It is sad to say that the oceans are being polluted and we are now suffering the consequences as the fish we used to love are now making us sick.
I hope writing this saves someone from eating toxic fish and getting sick.
Dr. Tracey Cain