title: Pacific ciguatoxin-1 associated with a large common-source outbreak of ciguatera in east Arnhem Land, Australia.
abstract: We report a retrospective study of the clinical signs and symptoms associated with a point-source outbreak of fish poisoning that occurred with a fish captured from the Arafura Sea, northern Australia. Twenty cases (16 Aboriginal and 4 non-Aboriginal) characteristic of ciguatera, including 4 inpatients and 16 outpatients from the Gove Hospital, were identified based on the pattern of clinical symptoms and signs after ingestion of a large coral cod from a known ciguatera-prone coral reef. In the absence of a serologic test for the victim, laboratory analysis of a 230-g sample of the coral cod (Cephalopolis miniatus), using both mouse bioassay and HPLC/mass spectometry, showed that Pacific ciguatoxin-1 was the principal toxin involved. Intravenous mannitol was administered to one patient without clear benefit. Risk factors for ciguatera poisoning are ingestion of larger portions of reef fish from ciguatera-prone areas. Despite apparent local awareness of the distribution and etiology of the disease, large common-source outbreaks of ciguatera still occur.
authors.affiliation: Medical Unit, Alice Springs Hospital, Northern Territory, Australia.
authors.forename: R E
authors.initials: RE
authors.lastname: Lucas
authors.forename: R J
authors.initials: RJ
authors.lastname: Lewis
authors.forename: J M
authors.initials: JM
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000818:Animals; D001315:Australia / Q000453:epidemiology; D002851:Chromatography, High Pressure Liquid; D036841:Ciguatera Poisoning; D002922:Ciguatoxins / Q000032:analysis; D004196:Disease Outbreaks; D005260:Female; D005399:Fishes; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D051379:Mice; D012189:Retrospective Studies
chemical_list: D002922:Ciguatoxins