is always toxic in other areas « Vonfraenkel and Krick (19U5) stated that 

 barracuda from the Marshall and Marianas IsUandsarea are poisonous, but 

 those from the Carolina Islands are not „ Simmons (I9I4J4) listed many areas 

 in the Pacific where toxic fish are found 



The fact that the same species of fish are toxic in one area and 

 not in another is interesting <> Numerous explanations have been advanced to 

 explain this phenomenon! unfortunately, none is supported by concrete 

 investigative evidence <, Most of the investigators presuppose that the so- 

 called toxic areas contain toxic material on which the fish feed This 

 toxic material is then absorbed or deposited in the flesh of the fish, 

 rendering it toxic „ The fact that these fish are all pelagic makes it 

 difficult to lend credence to this hypothesise It can be pointed out at 

 this time that very little is known of the migratory behavior of these fish„ 



Symptoms of Ciguatera 



The symptoms associated with Ciguatera in the Caribbean area as 

 described by Mann (1938) and O'Neill (1938) vary slightly from the symptoms 

 of fish poisoning caused by the Pacific species The symptoms are as follows 



lo The onset occurs 1 to 10 hours after ingestion of the fish,, 

 2» The patient becomes acutely ill, with severe gastro-intestinal 



symptoms of nausea , vomitings and diarrhea „ 

 3o There is a distinct metallic taste in the moutho 

 ko The skin is flushed and there is a tingling .sensation and 



itching s which may last for a few days 

 5o Cramps may occur in the extremities o 

 60 Hyperesthesia and paresthesia are commonly presento The 



paresthesia in which cold objects feel warm, is considered as 



one of the most significant symptoms o 

 7» There may be a weakness in the legs with temporary paralysis, 



and absent or reduced knee jerks ° 

 80 There are muscular and joint aches presento 

 9o There is frequent, scalding urination, with albumin, granular 



casts, and mucus often present in the urine,, 

 10o There maybe nervousness, restlessness, and insomnia,, 



The severity of the symptoms vary with the individual „ In view of 

 the paucity of available data no correlation between the amount of fish 

 eaten and the severity of the symptoms can be made,, It is known, however, 

 that not all individuals who eat poisonous fish will become illo One attack 

 does not impart immunity to Ciguatera, since individuals have experienced a 

 second attack following closely a first attacko Usually the gastro- 

 intestinal symptoms are of short duration, while the nervous symptoms may 

 last for days or weeks with subsequent gradual recovery To date no 

 fatalities have been reported from this type of fish poisoning, ( Tetrodon 

 poisoning differs in this respect, see Yudkin 19U4)° 



