In a recent retrospective review of ciguatera poisoning reported to the French Poison Control Centers, 91% of patients with ciguatera poisoning after consuming fish from the Atlantic Ocean had nausea, vomiting, diarrhea and abdominal pain as their first symptoms. This was vastly different if the fish ingested was from the Pacific Ocean. What was the first signs of toxicity in patients consuming fish from the Pacific Ocean?
In patients consuming fish from the Pacific Ocean, 44% had no gastrointestinal symptoms and their first onset of symptoms were neurologic including parasthesias, dysesthesias and cold allodynia.
de Haro L et al. Ciguatera fish poisoning in France: experience from the French Poison Control Centre Network from 2012-2019. Clin Tox 2020; published online 7 Jul 2020. https://doi.org/10.1080/15563650.2020.1788052