Clinical features of ciguatera fish poisoning: a study of the disease in the US Virgin Islands

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Abstract
Clinical data were obtained on 33 patients involved in 27 episodes of ciguatera fish poisoning occurring during a 14-wk period on St. Thomas in trhe USA Virgin Islands. All patients had gastrointestinal tract symptoms, with 30 patients (91%) complaining of diarrhea and 23 patients (70%) complaining of vomiting; these symptoms occurred early in the disease and were of short duration. Twenty three patients (70%) complained of malaise and 19 patients (58%) had pain and weakness in the lower extremities. Dysesthesias were noted by 19 patients (58%); the median duration of dysesthesias was .gtoreq. 2 wk, with symptoms present in some cases for > 2 mo. Cardiovascular signs and symptoms, including hypotension and bradycardia were noted in some acute cases. Therapy included antidiarrheal and antiemetic agents, i.v. fluids, atropine and pralidoxime chloride. Efficacy of pralidoxime therapy could not be established.