title: [Imported tropical fish causes ciguatera fish poisoning in Germany].
abstract: Ciguatera is a seafood-borne illness caused by consumption of tropical fish contaminated with ciguatoxins, lipophilic polyethers that are produced in benthic dinoflagellates and accumulate through the marine food chain. Ciguatera cases in Europe usually occur in travellers returning from tropical and subtropical regions of the Pacific and Carribean, where ciguatera is endemic. In 2012, several cases of ciguatera occurred in Germany due to sale of contaminated fish products originating from the Indian Ocean. Although the symptomatology in these cases were typical of ciguatera, with patients reporting gastrointestinal discomfort including nausea, vomiting and diarrhea as well as neurological effects including widespread intense pruritus, paresthesias, hypothermia or altered temperature sensation and diffuse pain, correct diagnosis was delayed in all cases due to lack of awareness of the treating medical practitioners. In light of increasing global mobility, trade, and occurrence of ciguatoxic fish in previously non-endemic areas, ciguatera should be considered as a possible diagnosis if gastrointestinal and neurological symptoms occur shortly after consumption of fish.
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Erlangen.
authors.forename: Katharina
authors.initials: K
authors.lastname: Zimmermann
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Erlangen.
authors.forename: Anneka
authors.initials: A
authors.lastname: Eisenblätter
authors.affiliation: Institute for Molecular Biosciences, The University of Queensland.
authors.forename: Irina
authors.initials: I
authors.lastname: Vetter
authors.affiliation: Giftinformationszentrum Nord, Göttingen.
authors.forename: Martin
authors.initials: M
authors.lastname: Ebbecke
authors.affiliation: Bundesinstitut für Risikobewertung, Berlin.
authors.forename: Miriam
authors.initials: M
authors.lastname: Friedemann
authors.affiliation: Giftinformationszentrum Nord, Göttingen.
authors.forename: Herbert
authors.initials: H
authors.lastname: Desel
mesh_terms: D015984:Causality; D036841:Ciguatera Poisoning / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009325:Nausea / Q000175:diagnosis / Q000453:epidemiology*; D010292:Paresthesia / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D014195:Travel / Q000706:statistics & numerical data*; D014839:Vomiting / Q000175:diagnosis / Q000453:epidemiology*