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Fish Toxin Cited as Cause of Poisonings in ’10 and ’11
On July 12, 2011, a New York
City man sat down at a Manhattan restaurant and made what seemed like a healthy
dinner choice: grouper.
The man was physically fit and just the day before had gone for a
two-mile swim.
But hours after his meal, he could barely walk.
It turned out his grouper was contaminated by a colorless,
odorless, tasteless toxin that can cause a type of fish poisoning called
ciguatera and can produce symptoms that include dizziness, vomiting and cramps.
He was one of 28 New Yorkers to fall ill from ciguatera between August 2010 and
July 2011 — more cases than had been reported in the entire preceding decade in
the city, according to a report released on Thursday by the Centers for Disease Control
and Prevention.
The reason for the spike is not exactly clear, the report said,
but “it might reflect changing sources and diversity of fish species marketed”
in the city and elsewhere.
The report highlights the detective work done by city agencies to
trace the cause of the outbreaks and stem any further spread.
The toxins that lead to ciguatera are most commonly found in coral
reef fish like barracuda, grouper, snapper, amberjack and surgeonfish. But it
is not easy to identify contaminated fish before they are consumed.
Testing fish for the presence of the toxin before it reaches the
market is not feasible, according to the report, and there is no rapid field
test that inspectors can use once the fish is being sold in restaurants or
stores.
The report focuses on six outbreaks and one individual case
reported to New York health authorities in 2010 and 2011. In those cases, the
symptoms experienced by the victims were varied, including gastrointestinal,
cardiovascular and neurological problems.
Investigators did not release the names of patients, vendors and
fish distributors. Because the toxin is not easily detectable, there was no
suggestion any of the vendors that sold toxic fish did anything wrong.
The first case was reported on Aug. 6, 2010, when a 16-year-old
girl and her 47-year-old mother went to a hospital emergency room after
experiencing diarrhea, lightheadedness and perioral tingling — which is a “pins
and needles” feeling around the mouth and lips. They had eaten barracuda bought
at a Queens fish market.
Hours later, the report said, an additional four relatives, “who
had eaten the same fish, reported tingling in their extremities.”
The victims were experiencing dizziness, headache, faintness and
vomiting, and doctors struggled to figure out what was causing the symptoms.
Since all the victims ate barracuda bought from the same market,
the doctors suspected the fish as being the most likely culprit. They alerted
the city’s Poison Control Center, which alerted the city’s health department.
Samples of the barracuda were collected from the patients’ home
and the fish market, and sales of barracuda at the market were ordered
suspended.
Tests performed at a federal Food and Drug Administration
laboratory confirmed the presence of ciguatera.
Over the next month, an additional seven cases of ciguatera were
reported and traced to barracuda bought from fish markets in three boroughs and
one restaurant.
The next outbreak was reported on Nov. 19, 2010, when 11 people
from three families fell ill after eating fish that was bought at a Queens
supermarket that was labeled grouper.
The final outbreaks in the report occurred on July 12, 2011, when
an additional four people fell ill after eating grouper at a Manhattan
restaurant. The majority of patients with ciguatera experience symptoms within
6 to 48 hours, and essentially, the report said, patients are treated according
to the best care practices for each symptom.
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