(1) However, marmitol therapy came into question in 2002, when a randomized trial comparing it with normal saline for ciguatera poisoning
found that both provided immediate symptom relief.
The 5 family members exhibited a combination of gastrointestinal (diarrhea [4 persons], nausea/vomiting [3 persons], metallic taste [1 person]), cardiologic (heart rhythm disturbances [2 persons]), systemic (fatigue [5 persons], itching [3 persons], dizziness (1 person]), and neurologic manifestations (myalgia [3 persons], peripheral paresthesia [3 persons], perioral numbness [2 persons], and reversal of hot and cold sensations [3 persons], which is pathognomonic of ciguatera poisoning).
Ciguatera poisoning is a matter of public health concern and residents of coastal West Africa and the regional island archipelagos could be a new community at risk for this seafood intoxication syndrome.
Ciguatera poisoning: an example of a public health challenge.
Three clusters of ciguatera poisoning: clinical manifestations and public health implications.
Ciguatera poisoning starts out on the reef, at the bottom of the food chain, with the dinoflagellate (algae), Gambier-discus toxicus.
However, ciguatera poisoning is felt to be under reported, since it often resolves within days to weeks, while being misdiagnosed as some "Gl bug." Specific geographic areas of concern for Americans include South Florida (Atlantic and Gulf sides), the Bahamas, Hawaii, Guam, the Virgin Islands, Puerto Rico, and the south Pacific.
Editorial Note: Ciguatera poisoning
occurs throughout the Caribbean and tropical Pacific regions, where outbreaks have been reported among both residents and tourists.
Because of the unique symptomology and common denominator of amberjack, investigators suspected either scombroid or ciguatera poisoning