Melissa A. Friedman (Mount Sinai Medical Center, USA); Mercedes Fernandez (Nova Southeastern University, USA); Lorraine C. Backer (Centers for Disease Control and Prevention, Atlanta, USA); Robert W. Dickey ( University of Texas at Austin, USA); Jeffrey Bernstein (Jackson Memorial Medical Center – University of Miami, USA; Florida Poison Information Center, University of Miami, USA); Kathleen Schrank (Jackson Memorial Medical Center – University of Miami, USA); Wendy Stephan, Richard Weisman (Florida Poison Information Center, University of Miami, USA); Steven Kibler (NOAA-National Ocean Service, Center for Coastal Fisheries and Habitat Research, USA); Matthew O. Gribble, Danielle Clarkson-Townsend (Emory University Rollins School of Public Health, Atlanta, USA); Paul Bienfang (University of Hawaii, USA); Robert E. Bowen (University of Massachusetts Boston, USA); Stacey Degrasse, Karen Swajian (Food and Drug Administration, College Park, USA); Harold A. Flores Quintana, Christopher R. Loeffler, Ronald Benner (Food and Drug Administration, Dauphin Island, USA); Donna Blythe (Private Practice, Miami, USA); Elisa Berdalet (Institut de Ciències del Mar (CSIC), Barcelona, Spain); Ram Ayyar (University of Miami, Miami, USA); Tom Brewer (Charles Darwin University, Australia and Australian Institute of Marine Science, Australia); Lora E. Fleming (University of Exeter Medical School, Truro, UK)
(Artículo de revisión)
Abstract: Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, comercial and recreational fishers, public health officials, medical professionals, and other interested parties.
Keywords: ciguatera fish poisoning, ciguatoxin, harmful algal Bloom, algae, seafood poisoning, Gambierdiscus, diagnosis, treatment, human health, natural toxins, climate change, environmental change, food poisoning, neuropsychology, neurology, neurotoxin