“Ciguatera is a food-born illness (food poisoning) caused by eating fish that is contaminated by ciguatera toxin. Ciguatera toxin is a heat-stable lipid soluble compound, produced by dinoflagellates and concentrated in fish organs, that can cause nausea, pain, cardiac, and neurological symptoms in humans when ingested.” (As described in an article by Dr. Charles Davis).

“What?” That’s what I said when we received information about a case involving a gentleman who became violently ill after buying and eating fish from one of the local South Florida grocery stores and I looked up possible causes.  Even though I’m a Florida native and an avid fisherman, I had not really heard of this before. It’s nasty and tricky stuff.

The toxin, as defined above, is a heat-stable lipid soluble compound. That means that it cannot be cooked out of the food and is capable of dissolving into the fatty tissues of fish and whomever might consume the toxin in the fish. It is colorless and odorless. It comes from dinoflagellates, single celled organisms, that live on and around certain reefs in the ocean and are fed on by small fish that are in turn eaten by larger ones. The toxin may be found concentrated in large reef fish, most commonly barracuda, grouper, red snapper, eel, amberjack, sea bass, and Spanish mackerel but there are many others as well. The toxin becomes actively toxic when it reaches certain levels in the system so that there may be no reaction until that toxic threshold is met. Since the toxin stores itself in the tissues of the body of the fish or the person eating the fish, it may sit asymptomatically in the body until enough is eaten to cause a reaction.

According to the FDA, Ciguatera poisoning “is characterized by gastrointestinal symptoms of nausea, vomiting, diarrhea, and neurological symptoms of numbness and tingling of the lips and extremities (paresthesias), itching of hands and feet (pruritis), joint pain (arthralgia), muscle pain (myalgia), headache, reversal of hot and cold sensation, acute and extreme sensitivity to temperature, dizziness, vertigo, and muscular weakness (myasthenia).  Cardiovascular symptoms may occur and include irregular heartbeat (arrhythmia) including slow heartbeat (bradycardia) or rapid heartbeat (tachycardia), and low blood pressure.  The onset of CFP usually occurs within 6 hours after consumption of toxic fish and generally subsides from several days to a few weeks.  However, severe cases have been known to cause recurring neurological symptoms lasting for months to years.” According to an article published in the United States National Library of Medicine -National Institutes of Health it is estimated that 10,000–50,000 people per year who live in or visit tropical and subtropical areas suffer from the toxin’s effects.

In order to protect the consumer from the toxin, the FDA has developed guidelines for primary seafood processors that identify food safety hazards, that are associated with fish and fishery products, and provides examples of recommended preventive measures to minimize the likelihood of the hazard’s occurrence. The Guide provides a list of fish species currently associated with the toxin and “recommends that primary seafood processors who purchase fish directly from fishermen obtain information about harvest locations to determine the potential for ciguatoxic fish based on knowledge of the regions where ciguatera occurs.  Primary seafood processors should avoid purchasing fish species associated with causing Ciguatera poisoning from established or emerging areas linked with Ciguatera poisoning.”

How is that a legal case? Food poisoning cases typically fall under the category of defective product law in Florida. The theory is that you ate a “defective product” (food) that led to your injuries (illness and any accompanying complications). These claims implicate the legal theory of “strict liability” and under that concept you do not have to show that the store’s negligence led to your injuries or illness; you only have to show that the store’s defective product made you sick.

The analysis of whether you have a case worth pursuing may be different than whether the store is liable, however. Just because you became ill for a short time, doesn’t necessarily mean that the extent of the damages that flow from the illness warrant legal action. On the other hand, there have been reported instances of cases involving significant injuries and damages associated with Ciguatera poisoning. In one such case, an airline pilot earning significant earnings was grounded by the FAA due to the neurological and cardiological effects of the toxin resulting in a substantial loss of future earnings and the need for medical care in the future. The store in that case settled the matter when faced with the idea of significant potential economic losses and both the seafood distributor and fishing company were also brought into the claim.

There is not currently a specifically reliable, economically reasonable, available test for the toxin which makes it exceedingly difficult for both the fishing industry and the consumer; although there have been several attempts to produce a commercially viable test. The best way to avoid ciguatera is not to eat large reef fish, particularly those mentioned above.