As to the other bizarre symptoms, he said that he had no idea and that I should concentrate on stopping the diarrhea. The reason that my doc had no idea is that this is a fairly unknown disease in the U.S. except for South Florida, BUT, it’s getting more prevalent in our country as more fish species are being imported and waters around the world are becoming warmer.
Other culprits besides black, yellow fin and dusty grouper are: barracuda, amber jack, king mackerel, cuber snapper, dog snapper and hog fish. There is one treatment that lessens symptoms and that is taking Mannitol within the first 48 hours intravenously.
So, while I wait for my nerve fibers to (hopefully) regenerate, I have eliminated all the triggers from my diet that might bring back severe symptoms: fish, alcohol, nuts, chicken, pork (seems that chicken and pork eat products made from fish, who knew?) I’m making up new recipes as I’m going along on this journey that I’ll be sharing with you soon…maybe you can kick-start a better diet without going through this discomfort to get there.
Many of us travel to warm water destinations, I want you all to come home with good memories, not ciguatera! If you would like to read more information about ciguatera written in a more scientific way, you can read this from the Centers for Disease Control and Prevention and also this warning from the World Health Organization.
Any reef fish can cause ciguatera poisoning, but species such as barracuda, grouper, red snapper, moray eel, amber jack, parrot fish, dogfish, sturgeon fish, king fish, coral trout, and sea bass are the most commonly affected. The toxins do not affect the taste, texture, or odor of the fish and cannot be destroyed by cooking, smoking, freezing, salting or any other method of food preparation.
This is followed by neurological complications appearing 3 to 72 hours later, including a tingling sensation, temperature reversal (cold items feel hot and hot items feel cold), itching, metallic taste in the mouth, feeling like teeth are loosening, blurred vision, and even temporary blindness. Long term consequences include chronic fatigue, depression, muscle pain, headache, a slow or irregular heartbeat, and low blood pressure.
Do not eat the liver, intestines, heads, and roe of smaller reef fish. Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning--Implications for Prevention and Public Education.
Epelboin L, Perpignan A, Hos sen V, et al. Two Clusters of Ciguatera Fish Poisoning in Paris, France, Related to Tropical Fish Imported From the French Caribbean by Travelers, Journal of Travel Medicine, Volume 21, Issue 6, 1 November 2014, Pages 397–402. Food and Agriculture Organization: Ciguatera Fish Poisoning (CFP) Friedman MA, Fernandez M, Backer LC, et al. An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management.
The toxin may be found concentrated in large reef fish, most commonly barracuda, grouper, red snapper, eel, amber jack, sea bass, and Spanish mackerel. The area of concern includes the Caribbean Sea, Hawaii, and coastal Central America.
The toxin has the highest concentrations in fish visceral and sex organs. Ciguatera toxin is harmless to fish, but poisonous to humans.
Eating ciguatera-contaminated tropical or subtropical fish is the main way that humans are exposed to the toxin. The toxin activates voltage-dependent sodium channels causing symptoms in human (and other mammals) gastrointestinal, cardiac, and nerve tissues.
Severe cases of ciguatera poisoning may result in shortness of breath, salivation, tearing, chills, rashes, itching, and paralysis. Some investigators have suggested vomiting should be induced if the victim is awake and alert and has eaten ciguatera toxin-containing fish within the last 3 to 4 hours.
Activated charcoal may absorb the toxin if done 3 to 4 hours after ingestion. Amitriptyline (Email, Ended) and gabapentin (Neurontin, Raise, Horizon) may help reduce neural pain symptoms Diphenhydramine (Benadryl) and hydroxyzine (Atari, Vistaril) may help relieve itching.
NSAID's and acetaminophen (Tylenol and others) may reduce pain Avoid alcohol, fish, nuts, and nut oils after exposure to ciguatera toxin because they may trigger recurrent symptoms. Immediate medical attention is necessary for all cases because the symptoms may rapidly progress in a few patients.
Grouper Malabar grouper, Epimetheus malarious Scientific classification Kingdom: Animalia Phylum: Chordata Class: Actinopterygii Order: Performed Family: Serranidae Subfamily: EpinephelinaeBleeker, 1874 Tribes and genera Not all errands are called 'groupers'; the family also includes the sea basses. The common name grouper is usually given to fish in one of two large genera : Epimetheus and Mycteroperca.
In addition, the species classified in the small genera Hyperion, Completes, Dermatologist, Graciela, Scotia, and Trio are also called 'groupers'. However, some hamlets (genus Affected), the hinds (genus Cephalopods), the lyre tails (genus Various) and some other small genera (Gonioplectrus, Nippon, Paranoia) are also in this subfamily, and occasional species in other serrated genera have common names involving the word grouper “.
Nonetheless, the word grouper on its own is usually taken as meaning the subfamily Epinephrine. Groupers are Telecasts, typically having a stout body and a large mouth.
They can be quite large, and lengths over a meter and the largest is the Atlantic Goliath grouper (Epimetheus Tamara) which has been weighed at 399 kilograms (880 pounds) and a length of 2.43 m (7 ft 11 1 2 in), though in such a large group, species vary considerably. They do not have many teeth on the edges of their jaws, but they have heavy crushing tooth plates inside the pharynx.
They habitually eat fish, octopuses, and crustaceans. Reports of fatal attacks on humans by the largest species, such as the giant grouper (Epimetheus lanceolatus) are unconfirmed.
They also use their mouths to dig into sand to form their shelters under big rocks, jetting it out through their gills. The word grouper is from the Portuguese name, group, which has been speculated to come from an indigenous South American language.
In New Zealand, “groper” refers to a type of wreck fish, Poly prion oxygenate, which goes by the Mori name haiku. In the Middle East, the fish is known as hammer ', and is widely eaten, especially in the Persian Gulf region.
The species in the tribes Grammistini and Diploprionini secrete a mucus like toxin in their skin called Rammstein and when they are confined in a restricted space and subjected to stress the mucus produces a foam which is toxic to nearby fish, these fishes are often called soap fishes. Jordan, 1923 Tribe Epinephrine Sleeker, 1874 Aethaloperca Fowler, 1904 Affected Bloch & Schneider, 1801 Anyperodon Gunther, 1859 Cephalopods Bloch & Schneider, 1801 Chromites Swanson, 1839 Dermatologist Gill, 1861 Epimetheus Bloch, 1793 Gonioplectrus Gill, 1862 Graciela Randall, 1964 Hyporthodus Gill, 1861 Mycteroperca Gill, 1862 Paranoia Guillemot, 1868 Plectropomus Pen, 1817 Scotia J.L.B.
Smith, 1964 Trio Randall, Johnson & Lowe, 1989 Various Swanson, 1839 The largest males often control harems containing three to 15 females.
Groupers often pair spawn, which enables large males to competitively exclude smaller males from reproducing. As such, if a small female grouper were to change sex before it could control a harem as a male, its fitness would decrease.
If no male is available, the largest female that can increase fitness by changing sex will do so. Gonochorism, or a reproductive strategy with two distinct sexes, has evolved independently in groupers at least five times.
The evolution of gonochorism is linked to group spawning high amounts of habitat cover. Both group spawning and habitat cover increase the likelihood of a smaller male to reproduce in the presence of large males.
Fitness of male groupers in environments where competitive exclusion of smaller males is not possible is correlated with sperm production and thus testicle size. Gonochoristic groupers have larger testes than protogynous groupers (10% of body mass compared to 1% of body mass), indicating the evolution of gonochorism increased male grouper fitness in environments where large males were unable to competitively exclude small males from reproducing.
Many groupers are important food fish, and some of them are now farmed. Unlike most other fish species which are chilled or frozen, groupers are usually sold live in markets.
Groupers are commonly reported as a source of Ciguatera fish poisoning. DNA barcoding of grouper species might help in controlling Ciguatera fish poisoning since fish are easily identified, even from meal remnants, with molecular tools.
In September 2010, a Costa Rican newspaper reported a 2.3 m (7 ft 7 in) grouper in Cieneguita, Limón. The weight of the fish was 250 kg (550 lb) and it was lured using one kilogram of bait.
In November 2013, a 310 kg (680 lb) grouper had been caught and sold to a hotel in Dong yuan, China. ^ a b c d e Richard van der Loan; William N. Scholar & Ronald Cricket (2014).
^ Share, Redoubt; Honer, Andrea; Ait-El-Djoudi, Karim; Cricket, Hans (2006). “Interspecific Communicative and Coordinated Hunting between Groupers and Giant Moray Eels in the Red Sea”.
“Rammstein, the skin toxin of soap fishes, and it significance in the classification of the Grammistidae” (PDF). Publications of the Set Marine Biological Laboratory.
^ Scholar, William N. ; Cricket, Ron & van der Loan, Richard (eds.). A phylogenetic test of the size-advantage model: Evolutionary changes in mating behavior influence the loss of sex change in a fish lineage.
Estimates of body sizes at maturation and at sex change, and the spawning seasonality and sex ratio of the endemic Hawaiian grouper (Hyporthodus Quercus, f. Epinephelidae). Constant relative age and size at sex change for sequentially hermaphroditic fish.
A new version of the size-advantage hypothesis for sex change: Incorporating sperm competition and size-fecundity skew. Sex change in fishes: Its process and evolutionary mechanism.
Evidence of gonochorism in a grouper, Mycteroperca rosacea, from the Gulf of California, Mexico. ^ Molly, P. P., N. B. Goodwin, I. M. Cote, J. D. Reynolds and M. J. G. Gage.
Sperm competition and sex change: A comparative analysis across fishes. ^ Crib, T. H., Bray, R. A., Wright, T. & Michelin, S. 2002: The trematodes of groupers (Serranidae: Epinephrine): knowledge, nature and evolution.
^ Justine, J.-L., Beveridge, I., Box shall, G. A., Bray, R. A., Morale, F., Triples, J.-P. & Whittington, I. D. 2010: An annotated list of parasites (Isopod, Coppola, Monotone, Diogenes, Custody and Nematode) collected in groupers (Serranidae, Epinephrine) in New Caledonia emphasizes parasite biodiversity in coral reef fish. Folio Parasitologica, 57, 237-262. Doi : 10.14411/fp.2010.032 PDF ^ “Most consumers prefer to purchase live groupers in fish markets”.
^ Schooling, C., Kissinger, D. D., Detail, A., Fraud, C. & Justine, J.-L. 2014: A phylogenetic re-analysis of groupers with applications for ciguatera fish poisoning. ^ ^ “Photos: Fishermen catch wildly huge 686-pound fish, sell it to hotel”.