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Ciguatera Fish Poisoning: Treatment, Prevention and Management
Mount Sinai Medical Center, Miami Beach, Florida 33140, USA
NSF NIEHS Oceans and Human Health Center, Rosenstiel School of Marine and Atmospheric Sciences, Miami, FL 33136, USA
Carlos Albizu University, Miami, FL 33172, USA
University of Hawaii, Honolulu, HI 96822, USA
University of Miami Department of Medicine/Jackson Memorial Medical Center, Miami, FL 33136, USA
Food and Drug Administration, Division of Seafood Science and Technology, Center for Food Safety and Nutrition, Dauphin Island, AL 36528, USA
NOAA-National Ocean Service, Center for Coastal Environmental Health and Biomolecular Research, Charleston, SC 29412, USA
National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
University of Miami Department of Neurology, Miami, FL 33136, USA
Florida Poison Information Center, Miami, FL 33136, USA
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; in revised form: 24 July 2008 / Accepted: 19 August 2008 / Published: 21 August 2008
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
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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.
Friedman MA, Fleming LE, 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. Marine Drugs. 2008; 6(3):456-479.
Friedman, Melissa A.; Fleming, Lora E.; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew. 2008. "Ciguatera Fish Poisoning: Treatment, Prevention and Management." Mar. Drugs 6, no. 3: 456-479.