Symptoms of ciguatera poisoning usually appear in three to five hours after the toxic fish has been eaten. Most victims suffer nausea and vomiting, watery diarrhea, numbness and tingling about the mouth and extremities. More severe cases may suffer muscle pains, dizziness and sensations of temperature reversal, where hot objects seem cold and cold things seem hot. Normal recovery usually requires several days to several weeks. At this time, treatment is usually symptomatic, easing the distress of nausea, diarrhea and pain.
Mortalities are extremely rare.
A 1988 report in the Journal of the American Medical Association documented the use of intravenous mannitol in treating severe cases of ciguatera fish poisoning. Mannitol is apparently the only significant treatment currently available, and under close examination by medical research. Economic Importance Ciguatera is a national concern since tropical and subtropical seafood is a widely distributed product of commerce. In addition to the public health and product safety problems, ciguatera causes severe economic loss to fisheries and restricts the use of seafood protein in local diets. In the Caribbean, fishermen avoid areas known to produce ciguateric fish and the demand for seafood is met by importation.