Ciguatera Fish Poisoning in the Caribbean Islands and Western Atlantic

Ciguatera is a form of ichthyosarcotoxism caused by the ingestion of numerous species of tropical fishes that have accumulated toxins in their flesh and viscera. This foodborne poisoning is widespread in the tropical and subtropical Pacific, Indian, and Caribbean waters from latitudes 35 ° north to 35 ° south, affecting more than 25,000 persons annually (Lewis 1986; Lewis and Holmes 1993). Ciguatera was first reported in the Caribbean (Fig. 1) in the sixteenth century by Pedro Martyr of Anghera, an Italian ambassador in the West Indies, in his De Orbe Novo Decades Octo (MacNutt 1912). The first clinical description of the syndrome was made by the Portuguese biologist Don Antonio Parra in Descripcion de Diferentes Piezas de Historia Natural las mas del Ramo Mari-timo, Representadas en Setenta y Cinco Laminas, published in Cuba in 1787. The Cuban ichthyologist Felipe Poey in 1866 coined the name “ciguatera” for a poisoning that followed the ingestion of a mollusk (Turbo pica) known as “cigua” in the Spanish Antilles. The term was later extended to a similar clinical syndrome arising from fish in the region. Despite these early accounts, knowledge of the Caribbean ciguatera phenomenon has lagged behind our present understanding of ciguatera in the Pacific.