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Mar. Drugs 2008, 6(3), 456-479; doi:10.3390/md6030456
Review

Ciguatera Fish Poisoning: Treatment, Prevention and Management

1,2,* , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 6 and 11
1 Mount Sinai Medical Center, Miami Beach, Florida 33140, USA 2 NSF NIEHS Oceans and Human Health Center, Rosenstiel School of Marine and Atmospheric Sciences, Miami, FL 33136, USA 3 Carlos Albizu University, Miami, FL 33172, USA 4 University of Hawaii, Honolulu, HI 96822, USA 5 University of Miami Department of Medicine/Jackson Memorial Medical Center, Miami, FL 33136, USA 6 Food and Drug Administration, Division of Seafood Science and Technology, Center for Food Safety and Nutrition, Dauphin Island, AL 36528, USA 7 NOAA-National Ocean Service, Center for Coastal Environmental Health and Biomolecular Research, Charleston, SC 29412, USA 8 National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA 9 University of Miami Department of Neurology, Miami, FL 33136, USA 10 Florida Poison Information Center, Miami, FL 33136, USA 11 Aquatic Toxins Program, Division of Environmental Health, Florida Department of Health, Tallahassee, FL 32399, USA
* Author to whom correspondence should be addressed.
Received: 28 February 2008 / Revised: 24 July 2008 / Accepted: 19 August 2008 / Published: 21 August 2008
(This article belongs to the Special Issue Marine Toxins)
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Abstract

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.
Keywords: ciguatera fish poisoning; ciguatoxin; harmful algal bloom (HAB); treatment; human health; marine toxins ciguatera fish poisoning; ciguatoxin; harmful algal bloom (HAB); treatment; human health; marine toxins
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.

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Friedman, M.A.; Fleming, L.E.; Fernandez, M.; Bienfang, P.; Schrank, K.; Dickey, R.; Bottein, M.-Y.; Backer, L.; Ayyar, R.; Weisman, R.; Watkins, S.; Granade, R.; Reich, A. Ciguatera Fish Poisoning: Treatment, Prevention and Management. Mar. Drugs 2008, 6, 456-479.

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