Talk:Ciguatera fish poisoning

message: Should this be merged with Ciguatera_fish_poisoning? startaq 00:53, 2005 May 22 (UTC)
FYI ... this was mentioned on the House episode April 10, 2007. Pgrote 03:48, 11 April 2007 (UTC)
thread_title: Heading

message: Could some please clarify what the cause of this disease is. The first line states that the cause is ingesting a toxin (Ciguatoxin), but the article goes on to say that the disease can be tramsitted sexually and can persist for up to 20 years (both of these would usually imply that the disease is pathogenic).  —Preceding unsigned comment added by Holshy (talk • contribs) 14:53, 7 January 2008 (UTC)
replies: text: Does it make more sense now?  What's transmitted through body fluids is just the toxin itself.  I believe that the long-term effects are due to the damage that it does, not because individual toxin molecules persist in the body for 20 years.  (If, for example, it killed a nerve cell, you would expect that damage to be permanent, even if the nerve-cell-killing toxin went away the next day.)  WhatamIdoing (talk) 19:42, 6 February 2008 (UTC)
replies: text: I had the same reaction.  I gather from the article that the disease is neither virus nor bacteria, but instead is some kind of toxin.  The lede seems to indicate there are multiple toxins, but how they are created and how they transfer from coral reef to herbivorous to carnivorous fish, and how the process of being transferred is "magnifying" when you'd think the toxin(s) (whatever they are) would be diluted as it was transferred.  And why doesn't it kill the fish?Jonny Quick (talk) 04:32, 15 August 2015 (UTC)
replies: text: There is a link to the main toxin (ciguatoxin) involved in the condition further down the page. The science on why fish aren't harmed by the toxins isn't clear, although given that the toxin has an affinity for only certain Nav subtypes, it's possible that fish simply do not possess these channels. I don't know, and haven't ever looked. As for the 'transferring' of the toxin, it is produced by dinoflagellates. These are microscopic sea organisms, which are eaten by small fish. Each of these fish would eat tens or hundreds of thousands of these dinoflagellates over their lifetimes. Bigger fish eat the smaller fish. This process is repeated several times with bigger and bigger fish. The toxin isn't diluted, per se, since the larger fish regularly eat smaller fish, which have in turn eaten plenty of smaller ones. The toxin is hugely lipophilic, so takes enormous amounts of time for the body (both human and fish) to clear, hence why it stays around long enough to accumulate in fish, and why is causes such lasting symptoms in humans. Keep in mind we are talking toxic (symptomatic) ingested doses usually measured in nano- and micrograms. Absolutely tiny amounts.   Veni Vidi Vici (talk) 14:38, 26 May 2016 (UTC)
thread_title:  Confusing 

message: I agree, please take it out. What Englishman would say that his fish came from the Seawater, when Cuba only has Ocean water?  —Preceding unsigned comment added by 128.123.242.176 (talk) 14:34, 2 July 2009 (UTC)
thread_title:  Origin of the Name 

message: See this document
Ciguatera Fish Poisoning
Annual Review of Medicine
Vol. 33: 97-111 (Volume publication date February 1982)
(doi:10.1146/annurev.me.33.020182.000525)
N W Withers
http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.me.33.020182.000525
This attributes the name to the "cigua" or turban shell, in the Spanish Antilles.  —Preceding unsigned comment added by 203.97.57.130 (talk) 22:44, 21 October 2008 (UTC)
replies: text: The "seawater" etymology is extremely fishy.  The Spanish pronunciation of ciguatera does sound a fair bit like seawater, but if the Cubans were transliterating from English to Spanish, why put in the g or the final a?  ciuater or siuater would be closer.  Dictionaries and reference books give the completely plausible derivation from cigua, which exists and can cause the symptoms.  This sounds like another completely bogus folk etymology.  I say take it out.  —Preceding unsigned comment added by 24.106.179.126 (talk) 17:57, 18 June 2009 (UTC)
thread_title:  Origin of the Name 

message: Please forgive formatting, protocol or etiquette mistakes as this is my first post. Feel free to correct any mistakes or make suggestions to me. thanks.
In the mannitol section, there is a declarative statement that IV mannitol is no longer recommended in the treatment of ciguatera. This is just not true in the Atlantic/Caribbean/Bahamian area. Florida Poison Control/Aquatic Toxins Hotline staffers routinely provide IV Mannitol protocol information to ER Physicians and other medical practitioners in the treatment of Ciguatera within 72 hours of symptom onset. This information is often disseminated to physicians around the country.  
Furthermore, the article cited that calls doubt on the efficacy of IV Mannitol is for the Pacific ciguatoxin (P-ctx), not all types of ctx.  P-ctx is said to be more damaging than the ctx in the Atlantic according to many ciguatera experts (Dr. Donna Blythe, Larry Brand, PhD, Lora Fleming, MD, PhD, Melissa Friedman PhD, etc.) See article cited in this section Ciguatera fish poisoning: A double-blind randomized trial of mannitol therapy "Pacific ciguatoxin (P-CTX-1) has been shown in experimental animal studies to result in prolonged opening of both tetrodotoxin-sensitive (TTX-S) and tetrodotoxin-resistant (TTX-R) voltage-gated sodium channels". Which can mean more damage. P-ctx can also be fatal while Atlantic ciguatera isn't known to be deadly. 
So to say that IV mannitol is not recommended anymore because the author cited the finding of that one study on one type of ctx, isn't accurate. I think it is misleading and a potential liability to say that it is not recommended. I know of one pending law suit right now because a local boat captain did not receive IV Mannitol within the three day window because he was poorly advised. To be sure, IV Mannitol is controversial but physicians do recommended IV Mannitol to Ciguatera patients who are within the 72 hour window of exposure. 
Juju's Beans (talk) 20:43, 4 December 2009 (UTC)
thread_title:  Use of Mannitol 

message: The section on folk science detection methods for ciguatera seems to me to be outright dangerous. In addition there is nothing scientific about those methods so even the name seems wrong. I propose at the very least calling it something along the lines of 'old wives tales', if not deleting the section altogether.
I am somewhat torn because I find reading about such stuff very interesting but the current iteration just isn't right. Any suggestions?
MFdeS (talk) 04:16, 22 April 2010 (UTC)
thread_title:  Folk science detection 

message: In the intro, there is this statement: "Gabapentin or amitriptyline may be used to treat some of the symptoms."  Gabapentin also appears in a list of treatments in the infobox.
Yet gabapentin is not mentioned anywhere in the treatment section.   If it's not a treatment, why mention it in the intro? And if it is a treatment, why isn't there anything about it in the treatment section?   This makes no sense.DrHenley (talk) 12:10, 14 June 2018 (UTC)
thread_title:  Treatment 

message: Ref is fairly clear "These potent toxins originate from Gambierdiscus toxicus, a small marine organism (dinoflagellate) that grows on and around coral reefs. Dinoflagellates are ingested by herbivorous fish." Doc James (talk · contribs · email) 21:27, 1 February 2019 (UTC)
thread_title: Cause

message: There is a list of fish in the body of the article which includes sturgeon
and the list of fish in the info-box which includes surgeon fish.
While the lists are different there is an abstract from reference [2]
Fish that are most likely to cause ciguatera poisoning are large carnivorous reef fish, such as barracuda, grouper, moray eel, amberjack, sea bass, or sturgeon. Omnivorous and herbivorous fish such as parrot fish, surgeonfish, and red snapper can also be a risk.
Voyad M (talk) 20:18, 21 September 2019 (UTC)
replies: text: Sea bass also is not clear as it does not refer a particular species of fish or family of fish, it is the common marketing name used for many species of unrelated fish 73.181.250.24 (talk) 22:46, 9 August 2023 (UTC)
thread_title:  Inconsistency