The Centers for Disease Control (CDC) and the Food and Drug Administration (FDA) have issued warnings about ciguatera, a foodborne illness that comes from eating barricuda and certain other fish caught in tropical waters that have fed upon a microscopic algae called dinoflagellates. These ciguatoxins become more concentrated as smaller fish get consumed by larger fish such as barricuda, grouper, sea bass, mullet and snapper. Essentially, tropical predatory fish have higher concentrations of ciguatera.

Symptoms include nausea, vomiting and diarrhea, muscle weakness and altered sensation: numbness, tingling and perhaps most telling, cold foods feel hot and hot foods feel cold. There is no cure for the illness and symptoms can last anywhere from several days to weeks and in isolated cases, neurological symptoms can last for years.

Unlike many other toxins, ciguatera can not be killed by cooking or freezing. It is tasteless and there is no way to tell if a fish is contaminated by the toxin except by lab studies. Fish  harvested from tropical waters including the northern Gulf of Mexico and the coastal waters of Florida, can be contaminated.

The NY Times published an article written by Lisa Sanders, M.D. (author of “Every Patient Tells a Stroy: Medical Mysteries and the Art of Diagnosis”) about a young man who suffered from ciguatera poisoning that initially confounded doctors. Written as a medical mystery, readers are sure to enjoy it.

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