title: Identification of Caribbean ciguatoxins as the cause of an outbreak of fish poisoning among U.S. soldiers in Haiti.
abstract: On 24 February 1995, six U.S. soldiers serving with the Multinational Force in Haiti became ill after eating a locally caught fish identified as the greater amberjack Seriola dumerili. The victims presented with nausea, vomiting, watery diarrhea and abdominal cramps 5-8 hr after consumption. Also present in some victims were numbness in the extremities or perioral region, bradycardia and scalp paresthesia. Patients were treated with i.v. hydration therapy and antiemetics. All recovered without sequelae over the course of 1-3 months. A portion of the cooked fish was obtained for analysis. A semipurified lipid extract was prepared according to standard methods and analyzed for the presence of Na+ channel site 5 binding activity using a brevetoxin receptor binding assay. By this assay, the fish sample contained the equivalent of approximately 20 ng Caribbean ciguatoxin/g flesh. The presence of the major Caribbean ciguatoxin (C-CTX-1) was confirmed by liquid chromatography-mass spectrometry. Using the receptor binding assay to monitor activity in TSK and PRP-1 column fractions, two minor toxins were detected in addition to C-CTX-1. One of these minor toxins was more polar, and the other less polar, than C-CTX-1. These data provide firm evidence that a family of C-CTX-1 is responsible for ciguatera in the Caribbean.
authors.affiliation: Toxinology Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702-5011, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Poli
authors.forename: R J
authors.initials: RJ
authors.lastname: Lewis
authors.forename: R W
authors.initials: RW
authors.lastname: Dickey
authors.forename: S M
authors.initials: SM
authors.lastname: Musser
authors.forename: C A
authors.initials: CA
authors.lastname: Buckner
authors.forename: L G
authors.initials: LG
authors.lastname: Carpenter
mesh_terms: D000328:Adult; D000818:Animals; D001921:Brain / Q000166:cytology / Q000187:drug effects / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000139:chemically induced; D002462:Cell Membrane / Q000187:drug effects / Q000378:metabolism; D002851:Chromatography, High Pressure Liquid; D036841:Ciguatera Poisoning; D004196:Disease Outbreaks; D005260:Female; D005399:Fishes; D005517:Foodborne Diseases / Q000453:epidemiology*; D008401:Gas Chromatography-Mass Spectrometry; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008297:Male; D008889:Military Personnel; D009422:Nervous System Diseases / Q000139:chemically induced; D051381:Rats; D014481:United States