Ciguatera poisoning is characterized by the wide diversity of its symptoms, which are generally grouped into 5 main categories: gastrointestinal, neurological, cardiovascular, rheumatological and general symptoms. More than 175 different symptoms have been reported in the  literature.

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Organs and systems affected by ciguatoxins

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Symptoms potentially observed in ciguatera cases

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To date, there is NO BIOLOGICAL TEST to confirm the diagnosis of ciguatera.

Currently, the diagnosis of CP is based solely on the history of food poisoning; the species consumed and the nature and evolution of the symtpoms. Only the research for CTXs in leftover meals can confirm the exposure to CTXs. Certain symptoms such as paraesthesia (itching, burning, numbness) of the extremities, face, mouth and pain on contact with cold objects or liquids, as well as the  worsening of symptoms after the consumption of certain foods, can be considered characteristic of ciguatera.

Ciguatera diagnosis tools

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Usually, ciguatera has a low mortality rate (<0.1%) and so far has not been associated with the onset of critical illness (cancer, neurodegenerative pathologies,…). Rare fatal cases occur within the firts 48h after the poisoning and are usually due to  cardiovascular and central nervous failures, worsened by severe dehydration caused by intense diarrhea and vomiting.

No fatalities directy related to CP were observed during the chronic phase.

Despite that this illness may prove to be particularly debilitating for a long period, up to a decade in rare cases, the symptoms subside spontaneously.

In addition, if ciguatera is not “contagious”, it has, by some aspects, a “communicable” nature either by sexual contact (which could explain the occurence of vulvar pruritus in women during intercourse with a partner suffering from ciguatera, or pelvic pains in men during ejaculation); or by mother to child transplacental or breast milk transmission. In the latter case, it is strongly advised that mothers stop breastfeeding their child for at least 1 month.

Finally, in rare cases, ciguatera may cause premature births and miscarriages in case of poisoning during pregnancy.