engleski

Ciguatera food poisoning in Croatian seamen

Ciguatera fish poisoning (CFP) is a clinical syndrone caused by eating fish containing ciguatoxin. Ciguatoxin arise from biotransformation in the fish of ciguatoxic-precursor gambiertoxin produced by Gambierdiscus toxicus or some other marine dinoflagellate that lives in association with macroalgae, usually attached to dead coral in tropical and subtropical sea regions.Ciguatoxin accumulates in all fishes tissues, expecially the liver and viscera. This toxins are heat stabile. The severity and duration of symptoms tends to be dose dependent, but it is complicated by the accumulation of ciguatoxins in human body. A total dose of about 0, 5 mg/kg would be quite toxic in most people. More then 400 species of fish can be vectors of ciguatoxins, such as barracuda, grouper, jacks. The Centers for Disease Control estimate that less then 10% of the cases areactually reported in the US, and relatively little is known about the epidemioogy of ciguatera. CFP is however the most commonly reported marine toxin disease, with an estimate 500 000 cases/year worldwide. In the years 2001.we had three maritims from Rijeka and in 2002. other twenty-five maritims provenient from varieous citys of Croatia (two was from Rijeka) with acute CFP after they eaten fish catched by himself in risk area. After 3 – 5 days they arrived in Rijeka and we record the clinical cours during the severe acute symptoms. The time between the ingestion of contaminated fish and symptoms varied from 30 minutes to 6 hours. The fishes (jack and barracuda) was catched in tropic region near the Carribian islands and in Mexican gulf. All suffered gastrointestinal and neurological disturbances, and two suffered cardiac symptoms. GI simptoms apeared the first, such as abdominal pain, nausea, vomiting and diarrea. The most common neurologycal symptoms was cold to hot temperature reversal dysesthesia, subjective features of metallic taste, arthralgias and myalgias, headache, pruritus, dental pain, weakness and dizziness. Two of our patient accusated bradycardia and hypotension. They was recoverated in Clinic for infections diseases in Rijeka for a week, with symptomatic treatmans, because the etiological treatmant didn't exist. Two of five of them six months after of the events still suffered of weakness in legs and periodical attack of pruritus. Affected people for another six months is racomanded not to eat any fish, drink alcohol or practis vegeterian diet, and for two months use condoms during sexually intercourse. In prevention of CFP we sugeste: to educate people about the dangers CFP and what can they do about it, expecially high risk population such as sailors and turists, for example avoidance of all fishof location that are known as risk area, avoidance of larger carnivorousfish (e.g. >2.5kg) and avoidance of head, roe and viscera of potentially toxic fish.

cigua toxin; fish; food poisoning; seamen

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