Ciguatera Fish Poisoning

Causative organisms: Gambierdiscus toxicus, Prorocentrum spp., Ostreopsis spp., Coolia monotis, Thecadinium spp. and Amphidinium carterae

Toxins produced: Ciguatoxin/Maitotoxin

Ciguatera Fish Poisoning (CFP) produces gastrointestinal, neurological, and cardiovascular symptoms. Generally, gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain occur first, followed by neurological dysfunction including reversal of temperature sensation, muscular aches, dizziness, anxiety, sweating, and a numbness and tingling of the mouth and digits. Paralysis and death have been documented, but symptoms are usually less severe although debilitating (Miller, 1991). Rapid treatment (within 24 hours) with mannitol is reported to relieve some symptoms. As there is no antidote, supportive therapy is the rule, and survivors recover. However, the recovery time is variable among individuals and may take weeks, months, or even years. Absolute prevention of intoxication depends upon complete abstinence from eating any tropical reef fish, since there is currently no practical way to routinely measure ciguatoxin or maitotoxin in any seafood product prior to consumption.

U.S. Finfish, Shellfish and Wildlife Affected by CFP
Harmful Algal Species
Geographic Area
Affected Organisms*
Gambierdiscus toxicus
Prorocentrum lima+
P. concavum+
P. hoffmannianum+
Ostreopsis lenticularis+
O. siamensis

Gulf of Mexico
Puerto Rico
U.S. Virgin Islands

Parrot fish
Goat fish
Other finfish


*Found to contain algal toxins, or to be adversely affected by toxic or harmful marine algae.
+Causative algae implicated, not confirmed.

Medical Community
CFPCiguatera Fish Poisoning
Additional Information on CFP including: Background, Clinical Presentation, Diagnosis, Management and Treatment, Chemical Structure, and Molecular Mechanism of Action.

Additional Resources
Ciguatera Fish Poisoning: Treatment, Prevention and Management
Melissa A. Friedman, Lora E. Fleming, Mercedes Fernandez, Paul Bienfang, Kathleen Schrank, Robert Dickey, Marie-Yasmine Bottein, Lorraine Backer, Ram Ayyar, Richard Weisman, Sharon Watkins, Ray Granade, Andrew Reich
    DOI: 10.3390/md20080022

Last updated: February 9, 2015