Ciguatera.

Ciguatera is a type of marine food poisoning produced by the consumption of ciguatoxic reef fish. The disease is of significant concern in many tropical areas where it has been known for centuries. Although mortality from ciguatera is low, morbidity is high and symptoms may be debilitating and prolonged. Ciguatera produces characteristic gastrointestinal, neurological, and to a lesser extent, cardiovascular symptoms. Though the symptoms are relatively well documented, the disease often goes unreported or misdiagnosed. The toxins responsible for ciguatera are produced by marine dinoflagellates associated with coral reefs. The toxins are ingested by and accumulate in the fishes which when consumed by man ultimately cause ciguatera. Recent advances in toxin pharmacology have identified ciguatoxin as a sodium channel agonist and have begun to address other aspects of ciguatera on the molecular level. Treatment with mannitol relieves the symptoms; the precise mechanism or mechanisms of action have not been proven. Immunoassays are being developed for detecting even negligible amounts of toxins in suspect fish flesh.