Ciguatera poisoning.

Ciguatera is a form of poisoning that occurs after eating tropical and subtropical ciguatoxic fish. The ciguatoxins are a family of heat stable, lipid soluble cyclic polyether compounds that bind to and open voltage-sensitive Na(+) channels at resting membrane potential, resulting in neural hyperexcitability, as well as swelling of the nodes of Ranvier. The authors describe a 45-year-old man who developed acute gastrointestinal symptoms in Antigua soon after eating red snapper and grouper, potentially "ciguatoxic fish". This was followed by neurological symptoms 24-48 hours later, including temperature reversal (paradoxical dysaesthesia), intense pruritus and increased nociception as a result of a small fibre peripheral neuropathy. The patient's symptoms and small fibre neuropathy improved over a period of 10 months.

Captain Cook on poison fish.

On his second voyage of discovery, Captain James Cook charted much of the South Pacific. The journey was long, from 1772 to 1775. During the exploration, the geographic, ethnographic, and scientific variety provided no shortage of work for the accompanying naturalists, astronomers, navigators, and painters. Culinary discoveries included new species of fish, many of which were sketched, dressed, and ultimately eaten. The examined journals and correspondence document clinical poisonings after ingestion of two different species of fish. The clinical findings are described and likely represent ciguatera and tetrodotoxin poisonings. Mechanisms of these toxin's actions are discussed in light of more recent studies.