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Ciguatera: The Killer Toxin in Fish

I had never heard of Ciguatera until I traveled to the South Pacific, where it is a public health concern. Ciguatera is a food poisoning disease caused by ingesting fish contaminated by a certain micro-algae. The toxin has no taste, and cannot be destroyed by cooking or any other method.

Ocean fish is not contaminated because it doesn’t feed on coral. It is reef fish and other fishes eating them that are infected.

In French Polynesia, I have never met a person who did not have a ciguatera story to tell me. One man was plagued by terrible headaches caused by years of repetitive ciguatera poisoning. He loved eating fish so much that he could not conceive not eating it — which is the only step that can lead towards healing.

On atolls, where reef fish is one of the primary sources of nutrition, almost everyone has been intoxicated at some point. Fishermen supposedly know where the safe spots are, but even their experience is not enough to prevent ciguatera.

Although ciguatera has existed for thousands of years, it is more of a concern these days because the toxic algae grow on dead coral, and the death of coral is increasing due to climate change.

The symptoms of ciguatera poisoning are pretty straightforward, but the after-effects can last for years and turn into a debilitating illness if the person keeps getting poisoned again, as the toxin accumulates in the body.

Symptoms include:

  • Gastrointestinal symptoms
  • Muscle aches and headaches
  • Nausea, vomiting, and diarrhea

Those symptoms tend to occur immediately after poisoning, but afterward, neurological symptoms set in, such as:

  • Reversal of hot/cold sensation (drinking a cold drink will feel like drinking hot coffee, and a dive in the pool will feel like jumping into hot water!)
  • Hallucination, depression, and nightmares.
  • Numbness, vertigo

The severity of the illness will depend on the amount of the toxin consumed and also repeated exposure. A tourist visiting Bora-Bora for the first time and eating contaminated fish might not feel anything, but locals might end up visiting the emergency room because they’ve had years of previous exposure.

Repeated exposure can lead to a sort of chronic illness, like the man I met in Tahiti who had chronic headaches.

But ciguatera poisoning can happen to anyone eating fish and in some cases lead to death.

Around 15,000 Americans get the disease every year, often eating the usual suspects like red snapper or grouper.

But the problem is that around one-third of fish sold in the US is mislabeled. That means that the fish on the menu in a restaurant is not always what it claims to be and can lead to ciguatera poisoning.

Should You Worry About Ciguatera?

  • If you never eat fish, then you will never get ciguatera. That is the safest way to avoid ciguatera.
  • If you only eat ocean fish or other varieties that are not contaminated and you are 100% certain about their origin, then it’s also unlikely that you’ll get poisoned.
  • If you eat fish when traveling or eat species that can be contaminated, like red snapper, or you eat fish at a restaurant or buy it at the grocery store, and it could be possibly mislabeled, then you are also at risk.

Examples of reef fish that can be contaminated by ciguatera include barracuda, moray eel, snapper, grouper, sturgeon, and sea bass. There are of course numerous other types of fish that you only find in the lagoons of Pacific islands that could also be contaminated.

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Frederic Patenaude
Frederic Patenaude
Frederic Patenaude has been an important influence in the raw food and natural health movement since he started writing and publishing in 1998, first by being the editor of Just Eat an Apple magazine. He is the author of over 20 books, including The Raw Secrets, the Sunfood Cuisine and Raw Food Controversies. Since 2013 he’s been the Editor-in-Chief of Renegade Health.

Frederic loves to relentlessly debunk nutritional myths. He advocates a low-fat, plant-based diet and has had over 10 years of experience with raw vegan diets. He lives in Montreal, Canada.