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Old 09-14-2007, 10:52 PM   #1
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When catching dinner, how concerned are cruisers about catching fish which carry the ciguatera toxin? I only know what amounts to 'folklore'. In Australian waters many anglers avoid eating large fish which are known to dwell amid coral reefs. The parrot fish (beautiful fillets!!) is known to be particulrly prone to ciguatera.

I understand fish caught in deep water, or away from coral, do not carry ciguatera. Is this correct?

Cheers

David.
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Old 09-15-2007, 12:16 AM   #2
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Hi David

First I am not a doctor so my remarks are just from research and first hand experience. In the 90's I traveled through the South Pacific for a number of years including NZ and Oz. My sister warned me before leaving about the perils of ciguatera. I contacted University of Hawaii researcher who was getting a test kit ready for insurance approval before putting it on the market.

http://cigua.oceanit.com/

Later we cruised with a couple on a West sail 43 and he was the guy reviewing her data for the insurance company approval. The researcher at UofH had a very serious case of ciguatera and even many years later still suffered side effects. The UofH researcher spent about an hour with my on the phone explaining the problems and seriousness of the poising.

I refer you to http://www.cdc.gov/nceh/ciguatera/

In my experience we never ate reef fish the total time we were in the tropics. We would consume ocean fish (Tuna, Wahoo, Mahi Mahi, etc). Our thinking is we were miles from serious medical help and it was just not worth taking the risk. We had friends in Vanuatu that came down with a very serious case and had to be rushed to Vila for treatment. We met many islanders that have had bad cases of ciguatera. Many of the islanders would tell us “Oh we can tell if the fish has toxins” If flies won’t land on it, by putting a coin on the meat and seeing if it turns color, feed a piece to a cat and see if that cat has effects. The most common method was to take a piece of raw fish and rub it on your lips. If your lips turned numb then do not eat it.

We were in an atoll where villagers on one side of the lagoon said don’t eat the parrotfish from the other side because you could get sick. When we went to the village on the other side of the lagoon they said, “oh the parrot fish are ok on this side but don’t go over to the other village!” The lagoon was only about 3 miles across! Go Figure!!

The final item that convinced us to not eat the reef fish is that the toxin collects in your system and will not dissipate. It’s always there and even though you might not have reached the level for an attack its like a time bomb waiting to happen. You may eat a reef fish and get really sick yet your wife may not have enough built up in her system to have any problems

Maybe someone more versed in this subject will jump in with comments.

Hope this helps

Chuck

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Old 09-15-2007, 02:48 AM   #3
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Thanks Chuck, and welcome to the forum. Very valuable information indeed. The CDC site should be recommended reading for anyone cruising in tropical waters. Did you try the test kit? At US$10 per test (AU$12), it could become an expensive exercise, but if that's the price of safety..........

Cheers

David.

PS Despite the 'cultural necessity' of eating ふぐ (fugu) which I am often reminded of by Kyo, I have so far managed to avoid eating the delightful puffer fish.....and I don't care how skilled the Jappo chefs are!
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Old 09-15-2007, 03:05 PM   #4
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chuck, would that have been Gary on OBSESSION? That bout frightened him. He had caught a huge grouper and in spite of misgivings ate some.

Peter suffered from Ciguatera (from a fish soup in a restaurant in Puerto Rico), which was very frightening. He couldn't stand to eat fish for at least six months after his illness. Ironically, a friend of ours, born in St. Martin and very savvy about ciguatera, came down with it several years after giving us advice about how to avoid it.

Advice: (a) only eat small reef fish - and by small she meant really small, two fish would be a meal for one person (she loved reef fish). ( Buy your fish from local fisherman you know and trust. Never, never eat barracuda.

The irony is that she followed her own advice, yet still came down with it. And that is because the toxin is extremely persistent in the body, building up until just a small amount extra creates the illness. I think that the reason that it took so long for her to suffer a bout was that for many years she and her husband spent the summer months in Paris where she couldn't get tropical reef fish. The doctors in St. Martin told her that she could not eat any fish for three years, the time they estimated that the toxin levels would decrease in her body. I'm not sure if the doctors were advising her on anything more than local knowledge, though, so don't take this last information as particularly reliable.

I just won't eat reef fish, and I warn everyone away from barracuda of any size.

One reference source, in relating various local methods for determining if the toxin was present in fish that they planned to eat, commented that the locals with the most information had usually suffered from Ciguatera at least once. In other words, their methods were doubtful. I think that it's the cumulative effect of the toxins that cause a lot of misinformation - simply because the person eating that last, push-over-the-edge fish, has no way of knowing whether it is this fish, alone, that caused the poisoning, or if it was something that was bound to happen at some point because of the amount of toxin already in his system. There's just not a strong correlation between cause and effect for those living in the tropics and eating tropical reef fish.

The worst instance of Ciguatera poisoning I'm familiar with also happened in St. Martin. One of the locals caught three barracudas in Simpson Bay Lagoon, and decided to have a cookout with all his family. Of fourteen members of the family, two died, three were extemely ill, including our acqaintance. The nerve damage was so bad that he flew to the US in hopes that they could help him, which they could not. Five had no symptoms at all, possibly because the 'cuda that they ate did not have a lethal level of toxin in its tissues. That doesn't mean that that barracuda was safe, just that it wasn't damaging to those five people. Barracuda eat other reef fish, so the concentration of the toxins will be greater than in the reef fish that it preys upon.

When Peter was sick with Ciguatera, I stayed up all night watching and listening to him breathe, ready to ask for a CG evacuation if he got worse. He didn't, but it was a bad night for both of us. I have no idea if my emergency measures had any effect, but I'll recount them anyway. My reference book encouraged giving the victim vitamins to help protect against nerve damage. I did this. I also gave him sweetened lemonade to drink (this is surprising, because I usually never have any sweet drinks on the boat). I believe that this might have had some measure of benefit, since a common element in most successful treatment measures is sugar - mannitol, sweetened condensed milk, and the lemonade that I gave to Peter.

Since there is no confirmed successful treatment for Ciguatera, I think that it is better to just not eat reef fish and avoid the possibility of being poisoned.

Next topic of discussion might be Scombroid poisoning - I mention this in my Cruiser's Dictionary, too, available as a free ebook: www.cruisingconnections.co.za/ebooks.htm

and on the World Cruising Wiki's "Cruiser's Dictionary" HERE
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Old 09-15-2007, 09:27 PM   #5
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The friends we knew that got Ciguatera in Vanuatu were a really wonderful French couple on an aluminum boat called "Frenchie". Spent the season with them up in Majuro, Marshall Islands. Lost touch with them and would enjoy connecting again.

We never did try the test kits because during the time we were in the SP they had not been approved and on the market. Yes the cost per test is really pricey. Makes the cost of a fish dinner that you catch for free really expensive.

It's a very scary illness and the researcher at UofH made such an impression on me that even to this day reef fish are not on the menu. Not only do the toxins accumulate in your system you never get rid of them! We have enough things to worry about while out cruising that eliminating one thing that we knew could cause problems in our minds seem a no brainer. I have to say we a few yachties that did fish in the lagoons, ate the fish and appeared to be ok. But you would always hear about a case that required medical treatment or evacuation.

It is very surprising how many cruisers are not aware of this problem. It's a great question by David and hopefully this will help to educate more folks.

Kind regards

Chuck

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Old 09-16-2007, 06:16 AM   #6
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This topic is cause for concern and discussion, for those that harvest and consume fish from the sea, originating from coral reef systems of about 35° N or S, or fish or preying on fish from there.

I am not an expert on this topic or in medicine. I am concerned in that I as others, planning on cruising, or already are, plan or hope to supplement the diet with "fresh ocean catch". I read about and studied this topic before. ...In time, not at sea, tend to file it, forget about it. Now is the BEST time to save it to my notes, and cross references.

The toxin Ciguatera seems to me, similar to radiation, asbestos, or some heavy metal poisoning in that it is a life time accumulation that matters. Given radiation does damage at the time, and throughout life, and L-O-N-G half lives, but all dangerous concerns. Given there is no current solution for Ciguatera, only prevention, which takes knowledge and awareness.

The toxin Ciguatera, is MOST heat resistant. One cannot cook it away by HEAT, or freeze it away with COLD, unlike other culinary hazards.

I am of the opinion, when traveling take advantage of eating the local cuisine, as it is fresher, and cheaper, and they (the locals) know how to prepare it the best wayS. Don't order fresh Alaskan King Crab, or Maine Lobster, when in the Midwest US, when next week you are going to be in Maine or Alaska, where they have Fresh Angus Beef on the Menu (at Market Price)(While you KNOW: AGED Beef is Better, more tender). When in the Midwest default to beef. When on the Coast, order the local catch. As a general rule. If you are in either region for very long, sooner or later you may want the other regions fare; that is ok too; but take great advantage of the local products, when it avails itself.

Given my opinion, it makes me wonder when one eats in the "reef zone", what the locals serve as hidden toxin, Ciguatera, in soups, stews, chowders or bouillabaisse, all based upon a fish stock, which is derived from boiling the heads, and other normally considered un-edible parts. Parts where the toxin Ciguatera collects.

I am not knocking the locals, anywhere, by any means. I am the guy that goes off the beaten tourist path, down the block, around the corner, through the jungle and swamp, or over the mountain, and see how Grand Mother, and/or Mom cooks it for HER family, and eat that, experience that.

35° N or S.

Would it be a fair statement to say that is the heart of the global band where cruisers, usually are? Or that the majority of the cruisers are in this global band, most of the time? Or more often than not? It is speculation, and an assumption on my part. From studying weather patterns and other cruisers, it does appear many seasonally flip S - N, back and forth, to avoid the predicable severe tropical weather patterns. Smartly, I think.

Be Aware.

Be Careful.

Chef, (Yes I was, am, and always will be)

Jeff

For more information Google, "Ciguatera"

On the Center for Disease Control (CDC) site, there is a link to indentify fish species of risk, and another link for the World Health Organization (WHO).

Wikipedia provides a good overview, and other links.

This does not end this topic, by any means. Lets' hear more; your, experiances, opinions, knowledge, thoughts, questions, concerns.

How do the natives of coral reef areas live?

It seems (assumed by I) they are raised and live on such a diet.

Do they build up a tolerence? (Which goes against current science and medical knowledge)

Do they die young, for unknown reasons?
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Old 09-16-2007, 07:35 AM   #7
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Ciguatera is indeed a very nasty and, for some, a long lasting poison. Don't know if it builds up in the system but it probably takes a minimum dose to cause problems. The first recorded cases of ciquatera were crews of the ships that discovered the Marquesas Island group in the 1600's. They anchored at a small uninhabited island at the north end of the chain, caught fish ate ate them, which resulted in almost the entire crews coming down with the poisoning. When we first got to the Marquesas, we caught and ate what we thought was a large (4'+) Ono (Wahoo) with fangs. Learned later that Ono don't have fangs but barracuda do. Suffered no ill effects. A number of the locals and one group of yachties all got ciquatera from fish caught in the same area we caught the barracuda. Just dumb luck we didn't get sick from the fish that everyone says is almost always infected with the poison. In the Marquesas, we did not eat reef fish and had no problems. We caught and ate a ton of Pelagic fish, Ono, Ahi, Mahi Mahi, etc. with no ill efeects, however. Lobsters were also safe to eat in the Marquesas.

The Tuamotu's were pretty much ciguatera free. We speared and ate almost every kind of reef fish you could imagine and didn't have a problem.

Tahiti and the Societies were pretty much free from ciguatera poisoning. It was there but we only heard of one outbreak of Ciguatera in the 6 months we spent there. Unfortunately, a preteen girl on one of the cruising boats died from the poison. Interestingly, the locals said fish on one side of a pass could be safe to eat and fish on the opposite weren't safe. Ciguatera has to be rare there as the big market in Papeete was loaded with locally speared reef fish without any problems.

The classic way to test for ciguatera is to feed a small portion of the fish to a cat and wait three hours or longer. If the cat doesn't get sick, chances are the fish is ciquatera free. You've got to either not love your animal or try it on someone else's animal as dogs and cats are really pathetic when they get sick.

Here in Hawaii, ciguatera is almost unheard of. About the only outbreaks that have occured are from fish caught around where a dredge has been working or there is significant disturbance of the bottom by construction. When they were excavating, blasting and filling to create Kawaihae Harbor to the north of us, there was an outbreak of Ciquatera. It has since died out and fish are now safe in the area.

Ciguatera seems to be a function of coral reefs. Anywhere where the water is warm enough for coral, there is the danger of ciquatera.

Aloha

Peter O.
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Old 09-16-2007, 10:54 AM   #8
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Quote:
Originally Posted by roverhi View Post
Ciguatera is indeed a very nasty and, for some, a long lasting poison. Don't know if it builds up in the system but it probably takes a minimum dose to cause problems .........

Aloha

Peter O.
Peter O.

...or in your tongue, Aloha! From the Rockies

...or universally:

Ya, that is what I was looking for, repsonses like yours.

Allow me to comment, if I may.

I did not know the history of the first documented case.

I am not an expert, in fact I only know what I read so far, and it maybe little, insignificant, maybe even wrong. From what I learned so far, I feel a need to address some of what you wrote:

< Don't know if it builds up in the system but it probably takes a minimum dose to cause problems. >

From what I read, I was thinking along the lines of a maximum dose. Minimum or maximum is not the point. Let's back up to your other words, more important words:

< Don't know if it builds up in the system >

That seems to be the problem. As I read it, it does; all life long.

The Toxin does not leave ones system very quickly or if ever. It just keep accumulating. One can ingest small amounts or large amounts at any given time. No where have I read what is large, or small, or toxic. So far, I assume it depends on ones body mass, or weight, and tolerence level.

Compared to other things, say rice or alcohol;, rice is ingested, digested, and rejected, as mostly solids, with some minimal liquids, extracting nutrients in the process, by normal bodily functions. Fair Biological Statment? It was my statement, I assume it true and will proceed, but accept debate later, if need be.

Grain Alcohol is ingested, digested, one becomes innebriated, depending on body mass, amount of ingestion, and alcohol proof, content, or percentage. In excess consumption, some become bulliet proof, wiser, smarter, more attractive, clever, etc. (in their own mind). This too will soon come to pass, via a filter, the liver.

The Rice and Alcohol passed thru the body, in differnat ways. Both provided some nutrition. One had a mind altering effect. (Boiled, Steamed, or Fried Does NOT cause such effect - fermented, brewed, or distilled will).

Rice, Alcohol, and Ciguatera?

Each is differant, and effects our bodies in differant ways.

From what I know, Ciguatera does not pass thru. It is like coins in a piggy bank. Just keep saving them, and saving them, except, and but in your body. Nothing passes thru; ever. Drink a bottle of beer and you may feel good, drink another and you may feel better, drink the third bottle and now much does not matter much anymore, now it is time to pee, and eat something, maybe a hamburger, or a chicken drumstick, and your favorite sides; or whatever the local place is serving or promoting. BUT the alcohol remains in your system, as does the Ciguatera Toxin. Next weekend you do the same thing. The hamburger or chicken is long gone, past last week. The alcohol remains. You already have three beers in you from last week. This evening after work you drink three more. Now you have six beers in you. You eat what ever you want. Next week it is nine, and by the end of the month it is 12, and by the end of the year it is 52 weeks x 3 beers per week = 156 drinks = in your system = you are dead! From and because of alcohol posining, because it never left your system. That is the concept of the accumulation of Ciguatera. One's body never passes it off, rejects it; it goes in, it never comes back out. And that is the problem.

< In the Marquesas, we did not eat reef fish and had no problems. >

The Smart Advice seems, do not eat "reef fish", which you did not.

< The Tuamotu's were pretty much ciguatera free. We speared and ate almost every kind of reef fish you could imagine and didn't have a problem. >

Perhaps you were lucky. Perhaps you have not accumulated your life time tolerence; yet. Perhaps you ate small fish, or those lower in the food chain. I do not know. Maybe the Tuamotu's are safe or safer. Perhaps in time, later, you may say, "OH!" Now I got it! - Now I get it".

I do not mean to castise, mearly explain and relate what I read, in comparitive terms, and that does not seem to have any alternatives. It seems there is no solution or cure, only one prevention, that being do not consume the toxin by avoiding the sources.
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Old 09-16-2007, 11:28 AM   #9
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Quote:
Originally Posted by roverhi View Post
Ciguatera is indeed a very nasty and, for some, a long lasting poison. Don't know if it builds up in the system but it probably takes a minimum dose to cause problems.

The classic way to test for ciguatera is to feed a small portion of the fish to a cat and wait three hours or longer. If the cat doesn't get sick, chances are the fish is ciquatera free. You've got to either not love your animal or try it on someone else's animal as dogs and cats are really pathetic when they get sick.

Aloha

Peter O.
The toxin is a product of an Algae that is fed upon by small algae eating fish - who are preyed upon by bigger fish - who are preyed upon by even bigger fish- each time the level of Ciguatoxin (CTx-1) is added to the level of the previous level - ie accumulating . Finally a predatory fish of a size which humans normally catch is eaten and may be affected by the toxin to a greater or lesser degree ( some fatalities recorded)

(Ciguatoxin (CTx-1)

Toxin produced by the Dinoflagellate Gambierdiscus toxicus

and isolated from the flesh and viscera of ciguatoxic fish. )


Peter , Sincerely hope you were just winding us up, in suggesting a so called "classic way to test for ciguatera" Neither your own or any one else's animals should be subjected to a test of this nature - besides being illegal - the idea would be inherently abhorrent to the cruising fraternity

Anyway thanks for you insights

Regards

Richard
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Old 09-16-2007, 01:39 PM   #10
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Thanks for all your advice. It seems abstinence is the key to survival. The accumulation of the toxin, its resistance to dissipation and the very real threat of becoming seriously ill in a remote location, is sufficient incentive for me to eat only pelagic fish.

Thanks again

David.

PS..The classic way to check for crocodiles in the NT is to chuck a stick into the water for your dog to fetch. If the dog comes back, it's much safer to swim than if the dog doesn't come back.

PPS. We don't condone feeding poisoned fish to your cat....or stupid dogs to crocodiles.
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Old 09-16-2007, 02:21 PM   #11
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Hi Folks

Forgive me (being a newbie not really sure of the protocol) for jumping in again with a few more comments.

The locals are not immune to this problem. We spent a number of weeks over a period of 3 years with a Fijian family on the island of Ono in the Kandavu area of Fiji (south of Suva). We even took them sailing for a week with us. Many nights were spent with the couple in their Bure and onboard discussing all sorts of things including Ciguatera. Jonah was the one who told me he rubs the flesh of raw fish over his lips and if it causes them to turn numb discards the fish. He was one of many who said he could tell and "no worries mate". Yet his wife Lenduah said "oh right what about that time 2 months ago when we both got sick from that fish we ate? And what about that time…."

We spoke to locals in Makemo and Raoira (Tuamotus, French Polynesia) and they said they either have gotten sick from eating reef fish or family members have. My point being these folks are in out of the way places and it's a way of life for them and not reported. Plus not speaking Tahitian with our limited vocabulary we may have not gotten the full story.

The locals all over the South Pacific and the world eat reef fish. Possibly tens of thousands of reef fish a year in one area alone. Every market, village and remote location people are living on what they catch. Why are not more people coming down with this toxin? Possibly more have problems than we know.

How did we get around not eating the reef fish when we were invited by the locals to eat with them? We would just tell them "It's against our religion". That usually gave us the leeway to not offend and still partake in the rest of the meal.

Yes the toxin is accumulated in your body and is never expelled. The UofHawaii researcher who had a severe case of ciguatera could not drink liquor 4 years after her sickness. She said occasionally she had some of the effects (hot feels cold, cold feels hot etc) for up to 6 months after coming down with ciguatera. Her case was extremely severe and she almost died.

This is a terrific discussion as if it prompts a few people to go do their own research and then make an educated choice on whether to eat the reef fish or not it will have served its purpose. Kind regards

Chuck
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Old 09-16-2007, 02:21 PM   #12
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The accumulation of the toxin, its resistance to dissipation and the very real threat of becoming seriously ill in a remote location, is sufficient incentive for me to eat only pelagic fish.
But surely barracuda and Scombridae (of which king mackerel are on the danger list) are pelagic species too?

I soya protein safe? Seems to me that will be our staple diet in the future - but for today I am having lamb so the soya will have to wait!

Aye // Stephen
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Old 09-16-2007, 02:49 PM   #13
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Hi Folks

Forgive me (being a newbie not really sure of the protocol) for jumping in again with a few more comments.

Chuck
Chuck

It is good to have you aboard and we all welcome your fantastic input. No such "protocol" here.
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