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

Ciguatera Fish Poisoning: Treatment, Prevention and Management

Melissa A. Friedman 1,2,* email, Lora E. Fleming 2, Mercedes Fernandez 3, Paul Bienfang 4, Kathleen Schrank 5, Robert Dickey 6, Marie-Yasmine Bottein 7, Lorraine Backer 8, Ram Ayyar 9, Richard Weisman 10, Sharon Watkins 11, Ray Granade 6 and Andrew Reich 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; in revised form: 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

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Cite This Article

MDPI and ACS Style

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.

AMA Style

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. Marine Drugs. 2008; 6(3):456-479.

Chicago/Turabian Style

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.

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