Ciguatera, Salmonella and E-coli. Oh My!

If you thought peanuts were scary, you haven't seen anything yet. Lurking in many of the tasty fish that are seafood lovers like Grouper, Kingfish, Snapper, Mackerel, Cod and Trout is a dangerous toxin that is nearly impossible to detect and only slightly less difficult to diagnose. Ciguatera poisoning, once confined to tropical regions with primarily seafood diets, is finding its way to the coastal United States.

Ciguatera is the most common fish related illness on the planet. And, even scarier, its symptoms are so bizarre and its toxins so hard to detect that it often goes undiagnosed by physicians. Or, worse, the symptoms are confused for those of Multiple Sclerosis. That's because, along with the symptoms that accompany regular food poisoning, Ciguatera causes a dangerously slow hear rate, neurological problems, and a reversed sense of hot and cold. Some patients also feel as if their teeth are loose or falling out! And these symptoms can linger for years!

Reported cases in the United States have been rare but, as Donna Schroeder discovered, that is largely due to improper diagnoses. Mere hours after enjoying a tasty grouper at a Texas restaurant, she told MSNBC, Ms. Schroeder began to feel the symptoms of something much worse than food poisoning. "It was horrible," said Schroeder, "Whatever I touched, if it was hot, it would feel cold. If it was cold, it felt hot. I couldn't walk on the tile floor. It felt like it was burning me." But doctors were unable to find the cause for her symptoms and brushed her off. Eventually, she was forced to diagnose herself.

There are only 50,000 cases of Ciguatera poisoning reported annually, but scientists estimate that the actually incidence rate is at least 100 times as high. And Ciguatera is most dramatically under-recognized in the United States.

So, what can you do to protect yourself? One option is to stay away from predatory fish like those listed above. The actual toxin is produced by sea plants that are eaten by smaller fish who are eaten by larger fish who ingest large quantities of it this way. The larger the fish, the more toxin it is likely to have ingested. And keep your eye out for reports of Ciguatera contamination in frozen fish products like School of Fish's Frozen Leatherjacket which was recalled in January.

If you do feel like you've come down with a case of Ciguatera after eating fish (which may initially just feel like food poisoning), be sure to get to your physician within 72 hours. A dose of the drug mannitol can reduce or prevent the toxins most lingering symptoms which often go away after a week or to but can linger for years or never really disappear.