In another outbreak 29 people out of a total of U*? who ate toxic 

 fish became illo No samples of the fish could be obtained, but some from 

 a new lot from the same source were examined and found to contain Escherichia 

 coli, Staphylococcus albus, Clostridium welchii , and Monilia psilosiso No 

 feces could be obtained from any of the patientss, however, blood samples 

 from 10 of these cases were obtained for agglutination tests. Fifty percent 

 showed agglutinins for Salmonella enteriditis or some organism of the 

 Salmonella group „ 



In the third outbreak reported by Costa Mandry, 39 of the Lj2 

 people who had eaten fish became ill. It appeared that only those who ate 

 the red grouper ( Epinephelus morio ) became ill. One sample of fried fish 

 which caused poisoning was examined bacteriologically. A hemolytic yellow 

 staphylococcus, Bacillus proteus, a Salmonella belonging to Group D with a 

 somatic No. IX antigen, and an unidentified flagellar antigen were isolated. 

 Toxicity tests on monkeys with the staphylococcus were negative. A water 

 extract of the fish filtered through a fine Berkefeld filter fed to monkeys 

 in 25, 30t * n d 35 m l amounts produced no symptoms. 



Costa Mandry was of the opinion that bacteriological and 

 epidemiological studies showed that most of the fish poisoning was due to 

 contamination of the fish with food poisoning organisms during handling. 

 However, the clinical symptoms of the outbreak he reported resemble Ciguatera 

 rather than the symptoms of bacterial food poisoning. Mowbray (1916) cited 

 a Dr. Georgaghan who indicated that there were two types of fish poisoning j 

 one a ptomaine (bacterial food poisoning) and the other in the nature of a 

 toxemia (Ciguatera). He further indicated that occasionally both types are 

 combined or follow one another. Apparently the cases reported by Costa 

 Mandry were of the combined form, 



Seasonal Incidence of Poisoning 



It is commonly believed that the poisoning is seasonal,, Mowbray 

 (1916) stated that barracuda, kingfish, jacks, and rockfish are most often 

 toxic from May to October. O'Neill (1938) stated that near Puerto Rico the 

 fish are most often toxic in November, December, and January. Walker (1922) 

 noted that near St. Thomas, Y. I., the horse-eyed jack (Caranx latus) is 

 toxic most often in August and September. Gilman (19^2), on the contrary, 

 stated that natives of St. Thomas claim that the various species of jacks 

 are most often toxic in May and June and the barracuda in May. A tabulation 

 of 26 recorded outbreaks of poisoning in Puerto Rico and the Virgin Islands, 

 shown in Table Up reveals that poisoning is not nearly as seasonal as 

 indicated in the literature. 



