Ciguatera fish poisoning in Brazilian traveler to Caribbean

ABSTRACT Ciguatera poisoning is the most common form of non-bacterial food-poisoning from fish worldwide. The incidence among Brazilians returning from high-risk regions is unclear because it is not a mandatory reportable disease. We describe a previously healthy 53-year-old Brazilian woman developed Ciguatera fish poisoning while traveling to Havana, Cuba. Physicians and health care professionals should advise travelers to avoid eating ciguatoxic fish species and potentially toxic fish species in the Caribbean islands. Despite the prognosis for most cases is good with a short duration of self-limited symptoms, early recognition of the identifying clinical features of ciguatera can result in improved patient care.

Ciguatera fish poisoning in the Philippines: A review of epidemiologically-confirmed outbreaks

Background@#Ciguatera fish poisoning (CFP) is a disease caused by the ingestion of poisonous coral reef fish. To the best of the author’s knowledge, no attempt has so far been made to consolidate available reports of outbreaks in order to characterize the toxidrome of CFP in the Philippines. @*Objective@#To review and consolidate data from epidemiologically-documented CFP outbreaks in order to characterize the toxidrome of CFP in the Philippines and identify the areas of high risk for outbreaks.@*Methods@#Epidemiologic reports of CFP outbreaks in the Philippines were reviewed. A compilation of symptoms of CFP patients was done to describe the toxidrome. High risk areas in the Philippines were identified.@*Results@#Ten reports were retrieved related to 17 CFP outbreaks from 1988 to 2010. No epidemiologic reports were found after 2010. Consolidation of reported symptoms showed a CFP toxidrome with prominent paresthesia, muscle weakness, and myalgia with some gastrointestinal symptoms. Based on the reports, the high risk islands identified were Palawan, Panay, Romblon, the islands in the Cuyo Pass, and Basilan. Cases of CFP continue to be encountered but are not reported to public health epidemiologists.@*Conclusion@#When put together, the reports describe a CFP toxidrome where the neurologic symptoms predominate over the gastrointestinal symptoms. Most of the cases occurred in the west central and southern portion of the archipelago suggesting a higher risk for CFP in that area. Cases of what appear to be CFP continue to be diagnosed although they are not reported to government epidemiology units. More systematic surveillance of CFP by government agencies is needed.

Severe bradycardia and prolonged hypotension in ciguatera

Ciguatera results when ciguatoxin-contaminated coral reef fish from tropical or subtropical waters are consumed. The clinical features that present in affected persons are mainly gastrointestinal, neurological, general, and much less commonly, cardiovascular. We report the case of a 50-year-old man who developed the characteristic combination of acute gastrointestinal and neurological symptoms after the consumption of an unidentified coral reef fish head. In addition to those symptoms, he developed dizziness, severe bradycardia (46 bpm) and prolonged hypotension, which required the administration of intravenous atropine and over three days of intravenous fluid replacement with dopamine infusion. Patients with ciguatera can develop severe bradycardia and prolonged hypotension. Physicians should recognise the possible cardiovascular complications of ciguatera and promptly initiate treatment with intravenous atropine, intravenous fluid replacement and inotropic therapy if such complications are observed.

Study of three ciguatera fish poisoning cases in Xiamen city, in 2005 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To find out the reason of three ciguatera fish poisoning cases in Xiamen in 2005 and identify the fish species.</p><p><b>METHODS</b>The grouper implicated in food poisoning and seven other coral reef fishes collected from market were tested by mice bioassay and ciguatoxin-test kit. The mtDNA was extracted from toxic grouper meat, and Cty b gene segment was amplified and the PCR products were sequenced. The sequences were compared with those in the GenBank.</p><p><b>RESULTS</b>The result turned out to be positive by the ciguatoxin-test kit, while the toxicity of the toxic grouper implicated in food poisoning was 0.11 mouse unit (MU)/g by mice bioassay. A 475 bp segments of Cty b gene was amplified by PCR and the sequence was 99% homologous with Epinephelus fuscoguttatus (GenBank: AY950695).No ciguatoxin in six grouper species collected from market was detected.</p><p><b>CONCLUSION</b>All three food poisoning cases were caused by consumption of ciguatoxin-carrying groupers.</p>

Ciguatera fish poisoning with elevated muscle enzymes and abnormal spinal MRI.

We report three cases of ciguatera fish poisoning. One patient died secondary to respiratory failure. Two patients showed elevated muscle enzymes and one patients had an abnormal cervical spinal MRI. MRI findings have not been previously described. MRI findings explain the mechanism of the L'hermitte phenomenon (a common complaint) among these patients. Respiratory failure is rare in ciguatera fish poisoning. Our findings suggest this could be related to respiratory muscles involvement.

Features of ciguatera fish poisoning cases in Hong Kong 2004-2007 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To review the clinical features and laboratory investigations of ciguatera patients in Hong Kong between 2004 and 2007 in order to show the timely sampling of implicated fish from ciguatera victims and application of validated mouse bioassay for confirming suspected clinical cases of ciguatera.</p><p><b>METHODS</b>Diagnosis of the ciguatera victims was based on history of coral fish consumption and clinical presentations stated in official guidelines for clinical diagnosis of ciguatera fish poisoning in Hong Kong. Food remnants of coral fish samples were collected swiftly from ciguatera victims between 2004 and 2007 for ciguatoxins (CTXs) analysis.</p><p><b>RESULTS</b>Major clinical symptoms in ciguatera patients included gastrointestinal and neurological effects including limb numbness and diarrhoea, which developed at 0.5 to 15 hours after consumption of fish. In most cases, neurological symptoms were more common than gastrointestinal symptoms. A broad range of attack rate (10%-100%) was observed in each ciguatera outbreak. Validated mouse bioassay on ether extracts of the food remnant samples confirmed that all were CTXs-positive (<0.5 - 4.3 MU/20 mg ether extract) and directly linked to the corresponding ciguatera cases.</p><p><b>CONCLUSION</b>Consistency between clinical and laboratory analysis for ciguatera poisoning illustrates the application of laboratory mouse bioassay in a timely fashion for confirming ciguatera poisoning cases and implementing effective public health measures. With further improvement in laboratory techniques, features of ciguatera fish poisoning cases can be better defined. Further studies are needed to determine the risk of each class of CTXs (Pacific-, Indian- and Caribbean-CTXs) in Hong Kong.</p>

Intoxicación por ciguatera. Estudio de 227 pacientes durante el periodo 1999 al 2005 / Ciguatera poisoning: Study of 277 patients in the 1999-2005 period

La ciguatera es la intoxicación alimentaría causada por el consumo de pescados ciguatóxicos, cuyos efectos sobre el ser humano pueden ser graves y conducir a la muerte. Se describieron las principales características epidemiológicas, clínicas y del tratamiento en los pacientes con ciguatera. La investigación incluyó 227 pacientes con ciguatera estudiados de forma prospectiva en el Hospital Clínico-Quirúrgico Universitario Comandante Manuel Fajardo de Ciudad de La Habana entre los años 1999 al 2005. Para la recolección de la muestra se elaboró una encuesta que recogió los datos demográficos, identidad personal, manifestaciones clínicas, tratamiento empleado en los pacientes, y la especie que causó la intoxicación. Se encontró que existe un incremento significativo en la incidencia de pacientes con ciguatera que acuden al hospital en los últimos 3 años. Los meses de abril a septiembre son los de mayor incidencia de la enfermedad. Hubo predominio de las mujeres sobre los hombres. Los pacientes comprendidos entre las edades de 21 y 50 años son los más afectados. El promedio de edad de los enfermos es de 39,2±10 años. Las especies barracuda y gallego fueron las que más frecuentemente provocaron la intoxicación en 74 y 38 pacientes, respectivamente y 73 intoxicados desconocían la especie ingerida. Los síntomas referidos con mayor frecuencia por los pacientes fueron la fatiga muscular, los trastornos gastrointestinales y las manifestaciones sensitivas. Los hallazgos más frecuentes al examen físico fueron los sensitivos, los signos de deshidratación y la debilidad muscular. El tiempo transcurrido entre la ingestión del pescado y el inicio del cuadro clínico fue menor o igual a las 12 horas en 70,8 por ciento de los casos. Los medicamentos que con más frecuencia se emplearon en los enfermos fueron los antieméticos, vitaminas, antihistamínicos y el manitol al 20 por ciento resultando este último la única terapia que revierte los síntomas en los pacientes con ciguatera.

Ciguatera is food poisoning caused by ingestion of ciguatoxic fish whose effects on the human beings could be severe and lead to death. The main epidemilogical, clinical and therapeutical characteristics in patients with ciguatera were described. The research covered 227 patients with ciguatera, who were prospectively studied at Comandante Manuel Fajardo clinical-surgical university hospital from 1999 to 2005. For sample collection, a survey was administered to gather demographic data, personal identity, clinical manifestations, treatment and the species causing the poisoning. It was found that the incidence of patients with ciguatera going to the hospital in the last three years had significantly increased. April to September was the most incidental period of the disease. Females predominated, the 21-50 years age group was the most affected and the average age of patients was 39,2±10 years. Barracuda and gallego were the main responsible for poisoning in 74 and 38 patients respectively. Seventy three poisoned persons did not know the fish species that they had eaten. The most frequent symptoms were muscular fatigue, gastrointestinal disorders and sensitive manifestations. On physical exam, the most common findings were sensitive manifestations, dehydration signs and muscle weakening. The lenght of time from fish ingestion to the onset of poisoning clinical picture was 12 hours or less in 70,8 percent of cases. The most used drugs were antiemetics, vitamins, antihystamines and 20 percent manitol, being the latter the only therapy capable of reversing symptoms in patients with ciguater.

Epiphytic dinoflagellates associated with ciguatera in the northwestern coast of Cuba

The spatial and temporal abundance of epiphytic dinoflagellates associated with ciguatera was studied over two annual cycles (March 1999 to March 2000 and March 2001 to March 2002) in the northwestern coast of Cuba. From 14 species of macroalgae (Phaeophyta, Chlorophyta, and Rhodophyta), 1340 samples were obtained identifying seven species as potentially noxious; five of them are new reports for Cuba's phytobenthos: Prorocentrum belizeanum Faust, P. concavum Fukuyo, P. mexicanum Tafall, Coolia monotis Meunier, and Ostreopsis lenticularis Fukuyo. ANOVA/MANOVA analysis showed significant spatial differences: lower cell abundance near the shoreline adjacent to a river inlet and higher cell abundance in the deepest area. Prorocentrum lima (Ehrenberg) Dodge 1975 was found mainly on Phaeophyta followed by Chlorophyta and Rhodophyta. Gambierdiscus toxicus was found mainly on Phaeophyta followed by Rhodophyta and Chlorophyta. All the species reported in the study area were mainly on Padina spp. (Phaeophyta). Acanthophora spicifera (Rhodophyta) did not host dinoflagellate species. Environmental conditions in summer (higher temperature, more nutrients, greater water transparency, and low wind intensity) are suitable for macroalgae development, which serves as a substrate for potentially harmful dinoflagellates, and possibly the main vector for spreading ciguatera along the coast of Cuba.

Se estudió la abundancia espacial y temporal de dinoflagelados epífitos asociados a la ciguatera durante dos ciclos anuales (marzo 1999 a marzo 2000, y marzo 2001 a marzo 2002) en la costa del noroeste de Cuba. Recolectamos 14 especies de macroalgas (Phaeophyta, Chlorophyta y Rhodophyta) y obtuvimos 1340 muestras. Identificamos siete especies de dinoflagelados potencialmente nocivas, cinco de ellas nuevos registros para el fitobentos cubano: Prorocentrum belizeanum Faust, P. concavum Fukuyo, P. mexicanum Tafall, Coolia monotis Meunier, y Ostreopsis lenticulares Fukuyo. El análisis de ANOVA/MANOVA mostró diferencias espaciales significativas: la abundancia celular más baja se encontró cerca de la desembocadura del río y la más alta en el área más profunda. Prorocentrum lima (Ehrenberg) Dodge, se encontró principalmente sobre las Phaeophyta seguido de las Chlorophyta y Rhodophyta. Gambierdiscus toxicus se encontró principalmente sobre las Phaeophyta seguido de las Rhodophyta y Chlorophyta. Todas las especies halladas en el área del estudio estaban sobre Padina spp. (Phaeophyta). No se encontró ninguna especie de dinoflagelado sobre Acanthophora spicifera (Rhodophyta). Las condiciones ambientales en verano (temperatura, nutrientes, transparencia de agua y la baja velocidad del viento) favorecen el desarrollo de las macroalgas, siendo un substrato adecuado para el desarrollo de dinoflagelados potencialmente nocivos, y posiblemente el vector principal para la extensión de la ciguatera en la costa noroeste cubana.

Especies de dinoflagelados del género Gambierdiscus (Dinophyceae) del Mar Caribe mexicano / Species of dinoflagellates of the genus Gambierdiscus (Dinophyceae) in the Mexican Caribbean Sea

Algunos dinoflagelados de hábitos bénticos están relacionados con la ciguatera, por consumo de pescado, en áreas tropicales. En el Caribe mexicano la ciguatera es un padecimiento relativamente común, sin embargo solo existe un trabajo sobre este tema y muy pocos antecedentes publicados sobre fitoplancton y microalgas bénticas. En este estudio se analizó material recolectado en varios puntos a lo largo de las costas del Estado de Quintana Roo, tanto con red de fitoplancton (54 mm), como de sedimento y epífitas de plantas macroscópicas, para estudiar los dinoflagelados tóxicos y asociados. Se registra la presencia de tres especies del género Gambierdiscus, asociadas con la producción de toxinas causantes de la ciguatera: G. belizeanus, G. toxicus y G. yasumotoi, todas distribuídas en áreas costeras poco profundas, incluyendo lagunas costeras. Las especies han sido estudiadas con microscopía de luz y electrónica de barrido. Para el reconocimiento de las especies se emplearon los caracteres morfológicos usuales, pero eventualmente se pueden usar caracteres fisiológicos, ecológicos y moleculares. La llamada "comunidad ciguatoxigénica" también está formada por especies de los géneros Prorocentrum, Ostreopsis y Coolia, cuyo estudio florístico y taxonómico se recomienda ampliamente, así como investigaciones complementarias de aspectos biológicos, ecológicos, fisiológicos y epidemiológicos de esta comunidad

Some dinoflagellates with benthic habits are related to ciguatera intoxication by fish consumption, especially in tropical areas. In the Mexican Caribbean, ciguatera is relatively common, but only one paper seems to have been published on the subject, and there are very few publicactions on phytoplankton and benthic microalgae. Material collected along the coast of the State of Quintana Roo with phytoplankton net (54 mm) and directly from sediment and epiphytes of macroscopic plants, was searched for toxic and other associated dinoflagellates. Samples were studied by light and scanning electron microscopy. Morphological characters were useful for species identification, but eventually physiological, ecological and molecular characters could also be used. Three species of Gambierdiscus, related to the production of ciguatera toxins, were identified: G. belizeanus, G. toxicus and G. yasumotoi. They are distributed in shallow coastal areas, including coastal lagoons

Paralytic Shellfish Poisoning (PSP) in Margarita Island, Venezuela

A severe outbreak of Paralytic Shellfish Poisoning (PSP) occurred in Manzanillo and Guayacán, northwestern coast of Margarita Island, Venezuela, between August and October 1991. A bloom of dinoflagellates including Prorocentrum gracile, Gymnodinium catenatum and Alexandrium tamarense seemed to be responsible for this outbreak. Levels of PSP toxins in mussels (Perna perna) exceeded the international safety limit of saxitoxin, 80 µg STX/100 g meat. PSP toxin values varied between 2 548 and 115 µg STX/100 g meat in Manzanillo, and between 1 422 and 86 µg STX/100 g meat in Guayacán. At both locations, the highest levels were detected in August, when 24 patients exhibited typical symptoms of PSP toxicity after consuming cooked mussels (16 required hospitalization). A high pressure liquid chromatographic (HPLC) procedure was recently used on the 1991 samples. The major toxin detected in samples of both locations was decarbamoyl saxitoxin (dcSTX), but low concentrations of saxitoxin were also found in Manzanillo samples. Gonyautoxins GTX1, GTX2 and GTX3 were detected only at Guayacán, while in both locations, decarbamoylgonyatouxin (dcGTX2,3) toxins were detected. These findings represent the first time that causative toxins of PSP in Venezuela have been chemically identified, and confirm the presence of dcSTX and dcGTX in mussels from the Caribbean Sea. The presence of dcSTX and dcGTX in shellfish is indicative that Gymnodinium catenatum was a causative organism for outbreak of PSP

Un severo brote de intoxicación paralizante por moluscos (PSP en inglés) ocurrió en Manzanillo y Guayacán en la costa noroeste de la Isla de Margarita, Venezuela entre agosto y octubre de 1991. Una proliferación de Prorocentrum gracile, Gymnodinium catenatum y Alexandrium tamarense causó el brote. Los niveles de PSP en mejillón (Perna perna) superaron los niveles máximos permisibles de saxitoxina, 80 µg STX/100g carne. Los niveles de toxinas variaron entre 2 548 y 115 µg STX/100 g carne en Manzanillo y entre 1 422 y 86 µg STX/100g carne en Guayacán. En ambas localidades, los máximos niveles se detectaron en agosto, cuando 24 personas presentaron síntomas típicos de PSP después de consumir mejillones cocidos (16 fueron hospitalizados). Se aplicó recientemente cromatografía líquida de alta presión (HPLC) a muestras del año 1991 y la toxina más detectada fue decarbamoyl saxitoxina (dcSTX), pero también se encontró saxitoxinas en muestras de Manzanillo. Las gonyautoxinas GTX1, GTX2 y GTX3 solo se encontraron en Guayacán; en ambas localidades se detectó decarbamoylgonyatouxin (dcGTX2,3). Estos hallazgos representan la primera vez que las toxinas causantes de un brote de PSP en Venezuela han sido químicamente identificadas, confirmando la presencia de dcSTX y dcGTX en mejillones del mar Caribe. La presencia de dcSTX y dcGTX en moluscos, indica que G. catenatum fue el organismo responsable de la intoxicación

Dinámica espacio-temporal de organismos precursores de marea roja en la costa Pacífica de América del Norte y Centroamérica / Spatial-temporal dynamics of red tide precursor organisms at the Pacific coast of North and Central America

La región costera del Pacífico de Centro y Norte America ha sido afectada de manera frecuente por fenómenos que se denominan proliferaciones algales nocivas o en inglés, "Harmful Algal Blooms" (HAB). A pesar de la gran cantidad de efectos en la salud pública, las actividades económicas y el medio ambiente, aún existe una abrumadora carencia de información en el tema. Esto no permite establecer si las causas principales de este evidente aumento en el número e intensidad de los eventos son naturales o antropogénicas. La incrementada utilización de las zonas costeras para actividades humanas encuentra paralelo en el denominado cambio climático, lo que dificulta discriminar entre la posible influencia de estos dos fenómenos. Series de datos de larga duración en regiones reducidas, así como las observaciones esporádicas realizadas cuando se presenta algún evento, nos permite comparar regímenes climáticos, condiciones geográficas, disponibilidad de nutrientes (incluyendo la eutroficación) y parámetros oceanográficos que promueven o permiten el desarrollo y mantenimiento de las proliferaciones, haciendo evidentes cambios drásticos en la biodiversidad y la biogeografía de los organismos productores de HAB

The Pacific coast of Central and North America has long been and still is impacted by the flourishing of microalgal populations known as Harmful Algal Blooms (HABs). The organisms that have caused recent HABs episodes in the region are among others, Gymnodinium catenatum, Pyrodinium bahamense var. compressum, and recently Cochlodinium cf. catenatum. In spite of the accumulated effects on the human health, the economic activities and the environment, scarce information is available on the subject. The augmented use of coastal zones for human activities is also paralleled by increased awareness of global climate changes. Thus, it is not an easy task to discriminate anthropogenic or natural phenomena, or both, as the major driving forces. The long-term data sets available for limited regions, as well as some sporadic observations during notorious blooms, allowed us to discriminate major changes in the biodiversity and biogeography of HAB organisms. Main changes refer to number of events, covered area, duration and frequency, number of blooming species and appearance of not previously reported harmful taxa. The variables more clearly related to these dynamic phenomena, seems to be sea surface temperature and wind force, but it is not yet possible to weight their contributions. The participation of rain is not fully evaluated to date. The collaborative communication among small-budget monitoring operations in the region allowed to "pass the voice" about peaking concentrations of HAB organisms, diminishing the risk of poisoning

Caribbean ciguatera: a changing paradigm

Analyses of ciguatoxicity in the great barracuda Sphyraena barracuda and quantity of toxic benthic dinoflagellates on coastal reefs (correlated with the number of cases of human ciguatera intoxications in Puerto Rico) were used to construct a model formulated on data obtained during the period of 1985-1988. The validity of the proposed model has been questioned by recent data obtained during the period of 1990-2000. Barracuda ciguatoxicity no longer showed a prominent seasonality while the fraction of randomly caught barracuda that were ciguatoxic significantly increased during this period. These two changes, accompanied by the discovery that ciguatoxic fish contained a variety of multiple toxins, appear to be correlated with the steadily increasing periods of elevated sea surface temperatures in this region

Pruebas de ciguatoxicidad en la gran barracuda, Sphyraena barracuda y la cantidad de dinoflagelados bentónicos tóxicos en los arrecifes de la costa están correlacionados con el número de casos de intoxicaciones por ciguatera en humanos, en Puerto Rico. Estos hechos fueron utilizados para construir un modelo que fue formulado con la información recopilada durante el período de 1985- 1988. La validez de este modelo propuesto ha sido cuestionada debido a la información recientemente obtenida durante el período 1990-2000. La ciguatoxicidad en la barracuda ya no demostraba una marcada asociación con las temporadas mientras que la cantidad de barracuda ciguatóxica capturada al azar tuvo un aumento significativo durante este período. Estos dos cambios estuvieron acompañados por el descubrimiento de que peces ciguatóxicos contienen una gran variedad de toxinas que parecen estar relacionadas con los períodos de elevadas temperaturas en la superficie del mar. Estas temperaturas continúan aumentando de manera que a su vez continúan en un aumento estable en esta región

Proliferaciones algales de la diatomea toxigénica Pseudo-Nitzschia (Bacillariophyceae) en el Golfo de Nicoya, Costa Rica / Algal blooms of the toxigenic diatom Pseudo-Nitzschia (Bacillariophyceae) in the Golfo de Nicoya, Costa Rica

En el mes de noviembre de 2001, se aisló de una marea roja cerca de la Isla San Lucas, las diatomeas Pseudo-Nitzschia pungens f. pungens seguida por Skeletonema costatum, Chaetoceros lorenzianus y en menor concentración Thalassiosira spp. las cuales fueron caracterizadas por microscopía electrónica de rastreo y transmisión, siendo esta la primera vez que se describe la presencia de estas especies produciendo proliferaciones en Costa Rica. Actualmente existe un aumento en el reporte de mareas rojas donde predominan las diatomeas, y los conteos celulares indican el aumento en el número de las especies conocidas como Pseudo-nitzschia pungens f. multiseries. A estas se les atribuye la producción del ácido domóico, un aminoácido de bajo peso molecular. Las intoxicaciones amnésicas por mariscos (IAM) que afectan a los humanos, se producen por la ingesta de mariscos contaminados con este ácido. En Costa Rica, hasta la fecha, solo se han reportado casos de intoxicación paralítica por mariscos contaminados por los dinoflagelados Pyrodinium bahamense var. compressum y Gymnodinium catenatum, sin embargo existe la posibilidad de producirse intoxicaciones humanas por la ingesta de mariscos y peces contaminados con toxinas amnésicas las cuales son hidrosolubles y termoestables. Debe entonces considerarse el peligro potencial de aparición de casos de intoxicaciones amnésicas y se sugiere la inclusión de estas especies en los programas de monitoreo permanente para tomar las medidas preventivas de salud pública

Water samples were collected during a red tide event in November 2001, near San Lucas Island (Gulf of Nicoya, Costa Rica). Superficial temperature was 27ºC and water was turbid, with no fetid smell. One sample was treated with negative staining and observed using a transmission electron microscope (TEM); another sample was observed using a scanning electron microscope (SEM). Samples had high concentrations of the diatom Pseudo-Nitzschia pungens f. pungens (characterized by two rows of poroids in the external channel), and lower concentrations of Skeletonema costatum (chains joined by external microtubules) and Chaetoceros lorenzianus (oval apertures and long chains, having setae with distinctive transverse rows and spines). This is the first time that the first species was described producing red tides in Costa Rica. However, reports about red tides with high concentration of species like P. pungens (variety multiseries) are increasing. These species have been related to the production of domoic acid, a low molecular weight amino acid which in humans can cause amnesic intoxications with seafood. Previously, Costa Rican reports of toxic accidents only referred to seafood contaminated with Pyrodinium bahamense var. compressum and Gymnodinium catenatum dinoflagellates. The increase in the number of Pseudo-Nitzschia causing harmful algae blooms is of interest for scientists around the world and must be documented. Similarly, some Chaetoceros species have been reported to be harmful to fish. We strongly recommend the establishment of a permanent surveillance program monitoring the presence of these species new at Costa Rican Pacific coast. Since the amnesic toxin is soluble in water and heat-resistant, we want to stress the possibility of having human cases of amnesic intoxication

Paralytic shellfish toxins in the chocolata clam, Megapitaria squalida (Bivalvia: Veneridae), in Bahia de La Paz, Gulf of California

Occurrence and toxic profiles of paralytic shellfish toxins (PST) in the chocolata clam Megapitaria squalida were investigated. From December 2001 to December 2002, 25 clams were obtained monthly from Bahía de La Paz, Gulf of California. Additionally, net (20 µm) and bottle phytoplankton samples were also collected to identify toxic species. Toxins were analyzed by HPLC with post-column oxidation and fluorescence detection. Toxicity in the clam was low and varied from 0.14 to 5.46 µg/STXeq/100 g. Toxicity was detected in December, March, April, June, and August. Toxin profile was composed mainly by STX, GTX2, GTX3, dcGTX2, dcGTX3, C2, dcSTX and B1. Gymnodinium catenatum was the only PST-producing dinoflagellate identified in the phytoplankton samples throughout the study period. G. catenatum was observed mainly in net samples from December 2001 to December 2002; however, in bottle samples, G. catenatum was only observed in five months. Highest abundance (2 600 cells l-1 ) was observed in March and the lowest (160 cells l-1 ) in June. G. catenatum mainly formed two-cell chains and rarely four or eight. The presence of PST in net phytoplankton samples support the fact that G. catenatum is the main source of PST in the clams. This study represents the first report of PST toxins in the chocolata clam from Bahía de La Paz

Se investigó la ocurrencia así como los perfiles de toxinas paralíticas (PST) en la almeja chocolata Megapitaria squalida (Sowerby, 1835), de la cual se recolectaron mensualmente 25 ejemplares de diciembre del 2001 a diciembre del 2000 en La Bahía de La Paz, Golfo de California. Simultáneamente, se obtuvieron muestras de fitoplancton de botella y de red (20 µM) para identificar especies tóxicas, así como para detectar la presencia de toxinas paralíticas. Las toxinas se analizaron por HPLC con una oxidación post-columna y detección fluorescente. La toxicidad en las almejas fue baja y varió de 0.14 a 5.46 µg/STXeq/100 g y se detectó en diciembre, marzo, abril, junio y agosto. El perfil de toxinas estuvo compuesto principalmente por STX, GTX2, GTX3, dcGTX2, dcGTX3, C2, dcSTX y B1, siendo similar al perfil observado en las muestras de red. Gymnodinium catenatum fue la única especie productora de toxinas paralíticas identificada en las muestras de fitoplancton a través de todo el período del estudio. G. catenatum se observó principalmente en muestras de red correspondientes a diciembre 2001-diciembre 2002; sin embargo, en muestras de botella, G. Catenatum solo fue observado en cinco meses. La abundancia más alta (2 600 céls l-1 ) se encontró en marzo y la más baja (160 céls l-1 ) en junio. G. catenatum se presentó formando cadenas de dos células y raramente de cuatro u ocho. La presencia de toxinas en las muestras de red donde esta especie es frecuente, apoya la idea de que G. catenatum sea la fuente principal de PST en las almejas. Este estudio representa el primer reporte de toxinas paralíticas en la almeja chocolata de Bahía de La Paz

Ciguatera fish poisoning in industrial ship crewmembers: a retrospective study in a seaport general practice in Trinidad and Tobago

The objective of this study was to outline the epidemiology of Ciguatera fish poisoning as seen in a general practice serving two industrial seaports in Trinidad and Tobago, in order to highlight the potential public health implications. A retrospective study was undertaken of all the cases of Ciguatera fish poisoning identified between November 1, 1992 and October 31, 1998 in a seaport general practice to identify signs, symptoms and treatment. An investigation of one outbreak was undertaken. Four outbreaks affecting 42 male ship crewmembers were identified. The suspect fish were caught in northern Caribbean waters en route to Trinidad and Tobago. The most common early symptoms were diarrhoea, vomiting, abdominal cramps, pruritus and tiredness. In the third outbreak, dysaesthesia was common. Progression to muscular weakness, ataxic gait, unsteadiness and other neurotoxic signs were seen in moderate to severe disease. Hypotension was an important prognostic sign in the initial case. Treatment was symptomatic and supportive and included vitamins B12 and BCO, folic acid, prostigmine, steroids and antihistamines as indicated. In the investigation of the second outbreak, the relative risk of 'eating fish meat' was 5 (95 CI 1.45, 17.27, p < 0.0001). Abdominal symptoms, pruritus, and muscle weakness with a history of consuming a fish-meal were diagnostic indicators of 'ciguatera fish poisoning.' All cases were industrial ship crewmembers. It is suggested that increased clinician awareness with early and appropriate treatment, and focussed public health intervention may help limit the potential public health impact of ciguatera poisoning in industrial ship crewmembers and other fish-consuming communities in the future

Marea roja: su situación en Chile / Red tide: its characteristics in Chile

Se conoce con el nombre de marea roja a un fenómeno de cambio de color de las aguas del mar ocasionado por el aumento de algunos organismos del plancton que se multiplican explosivamente y se concentran en la superficie de las aguas. Las especies tóxicas producen en su metabolismo compuestos químicos de muy alta toxicidad denominados toxinas marinas, que pueden ser acumuladas por moluscos filtradores en concentraciones dañinas para ser humano.De acuerdo a sus efectos estos compuestos se han clasificado como toxinas marinas paralizantes, neurotóxicas amnésicas, diarreicas y ciguatéricas. Las toxinas diarreicas y paralizantes son las encontradas con mayor frecuencia en nuestras costas.Debido a las repercusiones que la marea roja tiene para la salud del hombre y para la economía de países con grandes áreas de costa como Chile, ésta reviste especialimportancia y es objeto de constante vigilancia y estudio por parte de las autoridades marítimas y de salud. Por ello es indispensable que el médico general reconozca e inicie oportunamente el tratamiento de los cuadros de intoxicación aguda.

Shark Poisoning in Madagascar : a Case Report

About 600 persons were injured in the shark poisoning which occurred in Vohipeno. east coastal region of Madagascar. Four deaths were recorded. Clinical symptoms of 310 cases admitted in the hospital suggested a ciguatera poisoning