Fishing for Poison

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Tuesday November 07 02:06 PM EST

Fishing for Poison

By Melody

HealthScout Reporter

TUESDAY, Nov. 7 (HealthScout) -- If you're wondering why your lips went numb

and your heart skipped a beat after that barracuda feast, a simple vision

test may be able to tell you immediately if you are the victim of a poison

that some fish carry, say researchers.

It's easy to tell if someone has an immediate, bad bout of the poison,

ciguatera, but chronic ciguatera is notoriously hard to diagnose and treat.

This poisoning is caused by eating contaminated reef fish, which include

grouper, jack, barracuda and snapper. But according to a report presented

recently at the annual meeting of the American Society of Tropical Medicine

and Hygiene in Houston, a doctor can tell if you were poisoned by it using a

simple vision test. The condition then may be treated with cholestyramine, a

cholesterol-lowering drug.

" It's important because the symptoms themselves are hard to diagnose, " says

presenter Dr. Ritchie Shoemaker, of the Pfiesteria Illness Center of

McCready Outpatient Systems in Pocomoke, Md. " If you eat a big plate of

grouper, often the symptoms were easily explained by something else. This

will produce a simple bedside test for primary care doctors to start to

recognize a new class of diseases. "

If you've eaten contaminated fish, you'll usually start feeling sick within

six hours, says the Food and Drug Administration. Symptoms can include

numbness and tingling, nausea, vomiting, headache, weakness, irregular

heartbeat and other ills. In rare cases, people have died from respiratory

or heart failure.

There are between 300,000 and a million cases of ciguatera poisoning in the

world annually, experts say. Isolated cases in the United States. have

occurred from Florida to Vermont and also in Texas.

Shoemaker and his colleagues say the test for the poisoning involves using

flash cards to see whether patients can tell the difference between lines

and letters bearing muted black, gray and white. Telling the difference is

hard to do when ciguatera poisoning has occurred because the poison affects

how nerves work. The test is also used to diagnose diseases like chronic

Lyme disease, sick-building syndrome and Pfiesteria piscicida, he added.

Pfiesteria is a cousin of ciguatera and has been linked to skin problems.

If ciguatera poisoning is found, he adds, treatment for the numbness and

other nerve problems using cholestyramine will help reverse the symptoms

within 36 hours. Some of the 10 patients in the study had had symptoms for

more than 10 years, but, using the drug, all recovered within 12 weeks.

The drug and the toxin fit together like a lock and key, thereby

inactivating the poison.

Until now, accurate diagnosis of chronic ciguatera poisoning has been

impossible because no blood test exists to trace the toxin, Shoemaker says.

The new test will benefit physicians, says Hoskin, director of the

division of science and applied technology, office of seafood, for the Food

and Drug Administration in Washington, D.C., who said he was not familiar

with the details of Shoemaker's findings. The next step, he adds, would be

development of a test to spot the poison in the fish.

" It's the holy grail of marine toxins to come up with a test, a stick test

on site, " Hoskin says. " Worldwide, billions of dollars have been spent

pursuing that end. "

What To Do

If you're in an area where predator fish are commonly eaten, make sure to

take precautions, including not eating the head, eggs or guts of the fish

and cleaning the fish as soon as possible after they are caught. The toxin

cannot be destroyed by cooking and does not affect the fish that carries it.

Curious about ciguatera? Here's what the FDA has to say about it, and here's

an article that tells how it got its name.

Or, you may want to take a look at previous HealthScout stories on food

poisoning.