Ciguatera

The will ciguatera is a Ichtyosarcotoxisme, i.e. a Food poisoning due to the ingestion of fish flesh.

The most evocative demonstration is a wild Prurit (particularly with the palm of the hand and the plant of the feet) from where the name of scrapes given to the disease, but accompanied by signs by food poisoning (vomiting, diarrhea, pains abdominal…) and neurological (Paraesthesia S of the nose, the language, the hands and the feet…).

Among the more or less typical symptoms, the inversion of feeling for the temperature and the semi-sparkling water feeling by drinking plain water.

This intoxication is known since the 16th century (described by Christophe Colomb, Vasco de Gama, Locke…).

In fact, they are microalgae (developing on the dead coral) introduced by the fish which are in question, in particular dinoflagellé the Gambierdiscus toxicus (thus called because he was discovered for the first time in the islands Gambier). This micro-organism produces various Phycotoxine S of which the ciguatoxines and the maïtotoxine, which are primarily neurotoxines. The toxins start by accumulating in the herbivorous fish which consume the microalgae, then are concentrated in carnivorous fish. The ciguatoxines are fixed on the Canaux sodium, of the proteins, which then do not ensure correctly any more their role: transmission of the nerve impulse.

Others dinoflagellés are neighborly G. toxicus in the tropical mediums. Some pertaining to the Prorocentrum kind produce diarrheal toxins (okadaïque acid and a succession of derived molecules). Another kind, Ostreopsis, also contain toxins having a neurological activity. All these toxins can accumulate in fish at the same time as toxins of G. toxicus. This explains the diversity of the symptoms associated with will ciguatera.

Very many fish species of the hot seas can become toxic. These fish are all the more toxic as they are larger, the internal organs being particularly concentrated out of toxins:

sea perches
Mérou S
Carangue S
pikes of sea
fish-surgeons
Murène S
Parrot S
Barracuda S
Triggerfish S
Tétrodon S
etc

Treatment

There is no specific treatment. In the serious neurological forms, the intravenous perfusion of mannitol with 20% conduit with a fast improvement of the central nervous system disorders. Some propose Vitamine B12. In the serious cases, the reanimation is symptomatic (ventilation, rehydration, etc).

The cure occurs spontaneously in a few days or weeks, seldom years. But an infected person preserves a long time an over-sensitiveness at toxin, which explains the diversity of the symptomatology from one patient to another at the time of a meal where the same fish was consumed.

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