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Fish Poisoning Sickens 5 People Grouper With Buildup of Naturally Occurring Toxin Consumed at Restaurant

Posted on: Thursday, 28 July 2005, 21:00 CDT

In what could be the first such incident in Kane County, a rare case of fish poisoning surfaced at a county restaurant earlier this summer, sending at least one guest to a local hospital.

A Kane County Health Department investigation determined five people contracted what's called ciguatera poisoning after eating portions of grouper caught in the Gulf of Mexico and served at an unidentified restaurant.

Ciguatera poisoning is an illness caused by eating fish that contain toxins produced by marine microalgae called Gambierdiscus toxicus, according to the Centers for Disease Control and Prevention.

About 30 cases of ciguatera poisoning get reported each year, CDC statistics show, though health care providers are not required to report the illness, so the actual number of cases could be higher.

The illness can lead to severe headaches, nausea, vomiting and neurological symptoms causing tingling, numbness or temperature reversal in the mouth, where cold feels hot and hot feels cold.

This type of fish poisoning has no cure except for treatment of specific symptoms.

Fred Carlson, the county's director of environmental health, said he'd "never seen the disease before during his 30 years as a health professional."

Health officials believe the patients, who have all fully recovered, ate filets from the same large grouper during the week of June 20, said Cindy Gross, an epidemiologist with the county health department.

The grouper was delivered June 22, a Wednesday, from a Chicago distributor with portions of it served to 39 patrons that Thursday, Friday and Saturday. Reports of illness got to the county health department the following Monday, June 27, Gross said.

Five people in all - two from Kane County and three from DuPage County - showed symptoms. One was briefly hospitalized, one went to an emergency room for treatment, and the three others went to their personal physicians, Gross said.

It is believed the grouper was caught in the Gulf of Mexico and likely acquired the toxin by eating a smaller fish that had eaten marine algae, Carlson said. Health professionals say there is no way to test for the toxin and it cannot be killed through cooking or freezing.

County health officials said that is why the name of the restaurant is not being released.

"There is no culpability of the restaurant with this type of issue," Gross said.

Ciguatera poisoning occurs mostly from the consumption of barracuda, grouper, snapper, jacks, mackerel and triggerfish, the CDC said, particularly with fish caught on reefs in the Caribbean, and near Florida and Hawaii.

Overall, cases of toxic seafood poisonings are more common in the summer because the algae grows better in warmer months.

Health officials said the poisoning is rarely fatal and symptoms usually clear up in one to four weeks.

GRAPHIC: Fish poisoning

Five people who ate grouper at a Kane County restaurant contracted ciguatera poisoning. The toxin cannot be disabled by cooking, freezing, drying, marinating, smoking or salting the fish. Typically it is found in tropical or subtropical fish, including those caught near Florida, Hawaii and the Caribbean.

Fish known to carry ciguatera toxins:

- Black and yellow grouper

- Blackfin, cubera, dog and red snapper

- Barracuda

- Greater amberjack

- Hogfish

- Horse-eye jack

- King mackerel

Symptoms of ciguatera poisoning

Symptoms of the disease typically show up within six hours of ingesting the fish. Medical care consists of treating the symptoms, which usually resolve within a few weeks but can last several years and reoccur.

- Nausea

-Vomiting

-Tingling fingers and toes

- Tingling around the mouth

- Visual disturbance

- Dental pain

- Itching

-Temperature reversal: Things that should feel cold feel hot, and vice versa

-Muscular weakness

-Dizziness

-Muscle and joint pain

-Reduced blood pressure

-Heart rhythm and heartbeat disturbances

Source: The Centers for Disease Control and Prevention

Source: Daily Herald; Arlington Heights, Ill.

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