Clinical experience with i.v. Mannitol in the treatment of ciguatera.

To assess the effectiveness of i.v. Mannitol treatment for Ciguatera Poisoning, 35 patients were treated from the Miami-Caribbean area with symptoms of acute and chronic Ciguatera Poisoning. Information was collected on demographics, fish type and location, timing and type of symptoms, and response to treatment. Iv Mannitol (1 g/kg infused 3-4 hours) given within 48 hours dramatically decreased the acute morbidity of Ciguatera Poisoning without serious side effects. Treatment also appears to be safe and effective in chronic cases up to eight weeks from ingestion of toxic fish.

A pilot study of a new ELISA test for ciguatoxin in humans.

The major impediment to the thorough study of Ciguatera in human populations has been the lack of definitive diagnostic ability. However, recently an ELISA test was developed which can diagnose Ciguatera qualitatively and quantitatively in human fluids, as well as in contaminated fish tissue. This study proposes to evaluate this new ELISA test in human subjects with the clinical diagnoses of acute and chronic Ciguatera Poisoning. The contaminated fish from exposed subjects, and the blood and urine of exposed and controls, will be examined using the new ELISA. The ELISA performance will be compared to traditional bioassays for the fish testing. In addition, a distinct diagnostic profile will be developed using serial questionnaires, physical examinations, and nerve conduction tests. Ultimately this ELISA test can be used not only in establishing the correct diagnosis of Ciguatera Poisoning, but also in the treatment and clinical prognosis, and in epidemiologic studies of Ciguatera Poisoning in human populations. We hope that this protocol will serve as a model for the study of the effects of other marine toxins on human populations.