Part F | 33.5
796 Part F Marine Derived Metabolites
Table 33.1 (continued)
Poisoning in
humans
Causative dinoflagellates
(examples)
Usual
transvector(s)
Distribution
Main toxins
Action target Major
references
Azaspiracid
shellfish
poisoning
(AZP)
Protoperidinium crassipes
Mussels,
oysters
Europe, Ireland,
UK, Norway,
France, Portugal,
Northern Africa
(Morocco), South
America (Chile)
and the USA
Azaspiracids
(AZAs)
Voltage-gated
calcium
channel
[33.58–62]
Palytoxin
poisoning
Ostreopsis siamensis
Crabs,
sea urchin
Brazil, Mediterranean Sea (Italy,
Spain, Greece,
and France)
Palytoxins
(PTX)
Na C -K C
ATPase
[33.63–66]
Yessotoxin
poisoning
Protoceratium reticulatum, Lingulodinium polyedrum and Gonyaulax
spinifera
Scallops,
mussels
Italy, Norway,
and Portugal
Yessotoxins
(YTXs)
Voltage-gated
calcium/
sodium
channel?
[33.67, 68]
cal oceans have also caused the disease. People may be
poisoned and have a specific syndrome by eating these
contaminated fish: CFP.
Ciguatera Fish Poisoning (CFP)
Ciguatera fish poisoning (CFP) is caused by eating contaminated tropical reef fish. CFP is considered to be
the most common seafood-borne poisoning related to
the consumption of finfish. It is most commonly associated with larger reef-dwelling fish. As the concentration
of toxin is highest in the viscera, the consumption
of whole, ungutted fish generally has the most severe
consequences. Ciguatoxic fish are not recognizable as
such by means of external features. Contaminated fish
smell and taste normal. Frying, boiling, deep-freezing,
or smoking the fish do not decontaminate it.
Source
More than 400 fish species have been described that
may contain ciguatoxin. They belong to the following
families: Murenidae (Moray eels), Sphyraenidae (barracudas), Lutjanida (snappers), Serranidae (broupers),
Carangidae (jacks), Acanthuridae (surgeon fish), Balistidae (trigger fish), Scaridae (parrot fish) and to a lesser
extent: Belonidae (needlefish), Holocentridae (soldierfish and squirrelfish), Labridae (wrasses), Mugilidae
(mullets), Mullidae (surmullets, goatfish) and Scombridae (mackerels and their allies) [33.69].
Prevalence
The last estimate of the annual global incidence of CFP
range from 25 000 to 500 000. The incidence in travelers to highly endemic areas has been estimated as
high as 3%. Due to tourism and the increased export
of tropical fish throughout the world, more and more
doctors outside endemic regions are encountering cases
of ciguatera poisoning. Regular outbreaks are reported
in the Caribbean, including Florida, the South Pacific
Islands, and Hawaii in the North Pacific, as well as
the northeast coast of Australia (Queensland, Northern
Territory). In the Pacific, the severity and incidence of
poisoning increase from west to east. Ciguatera outbreaks are difficult to predict, and cases of poisoning
often occur in the form of an epidemic. There are probably some 10 00050 000 cases each year, but estimates
show wide variation. The average incidence in endemic
regions varies from 550 cases per 100 000 inhabitants
per year, but in some years this can reach as high as
500/100 000 in the South Pacific.
Range
Ciguatera is widespread in tropical and subtropical waters, usually between the latitudes of 35
ı N and 35
ı S; it
is particularly common in the Pacific and Indian Oceans
and the Caribbean Sea.
Causative Dinoflagellates
and Poisonous Ingredients (Toxins)
The main causative marine dinoflagellate is Gambierdiscus toxicus, which originally produced maitotoxins (MTXs), the lipophilic precursors of ciguatoxin [33.70]. MTX was first isolated in 1971 from
surgeon fish (Ctenochaetus striatus), known as Maito
in Tahiti. Three forms of MTX, MTX-1, MTX-2, and
796 Part F Marine Derived Metabolites
Table 33.1 (continued)
Poisoning in
humans
Causative dinoflagellates
(examples)
Usual
transvector(s)
Distribution
Main toxins
Action target Major
references
Azaspiracid
shellfish
poisoning
(AZP)
Protoperidinium crassipes
Mussels,
oysters
Europe, Ireland,
UK, Norway,
France, Portugal,
Northern Africa
(Morocco), South
America (Chile)
and the USA
Azaspiracids
(AZAs)
Voltage-gated
calcium
channel
[33.58–62]
Palytoxin
poisoning
Ostreopsis siamensis
Crabs,
sea urchin
Brazil, Mediterranean Sea (Italy,
Spain, Greece,
and France)
Palytoxins
(PTX)
Na C -K C
ATPase
[33.63–66]
Yessotoxin
poisoning
Protoceratium reticulatum, Lingulodinium polyedrum and Gonyaulax
spinifera
Scallops,
mussels
Italy, Norway,
and Portugal
Yessotoxins
(YTXs)
Voltage-gated
calcium/
sodium
channel?
[33.67, 68]
cal oceans have also caused the disease. People may be
poisoned and have a specific syndrome by eating these
contaminated fish: CFP.
Ciguatera Fish Poisoning (CFP)
Ciguatera fish poisoning (CFP) is caused by eating contaminated tropical reef fish. CFP is considered to be
the most common seafood-borne poisoning related to
the consumption of finfish. It is most commonly associated with larger reef-dwelling fish. As the concentration
of toxin is highest in the viscera, the consumption
of whole, ungutted fish generally has the most severe
consequences. Ciguatoxic fish are not recognizable as
such by means of external features. Contaminated fish
smell and taste normal. Frying, boiling, deep-freezing,
or smoking the fish do not decontaminate it.
Source
More than 400 fish species have been described that
may contain ciguatoxin. They belong to the following
families: Murenidae (Moray eels), Sphyraenidae (barracudas), Lutjanida (snappers), Serranidae (broupers),
Carangidae (jacks), Acanthuridae (surgeon fish), Balistidae (trigger fish), Scaridae (parrot fish) and to a lesser
extent: Belonidae (needlefish), Holocentridae (soldierfish and squirrelfish), Labridae (wrasses), Mugilidae
(mullets), Mullidae (surmullets, goatfish) and Scombridae (mackerels and their allies) [33.69].
Prevalence
The last estimate of the annual global incidence of CFP
range from 25 000 to 500 000. The incidence in travelers to highly endemic areas has been estimated as
high as 3%. Due to tourism and the increased export
of tropical fish throughout the world, more and more
doctors outside endemic regions are encountering cases
of ciguatera poisoning. Regular outbreaks are reported
in the Caribbean, including Florida, the South Pacific
Islands, and Hawaii in the North Pacific, as well as
the northeast coast of Australia (Queensland, Northern
Territory). In the Pacific, the severity and incidence of
poisoning increase from west to east. Ciguatera outbreaks are difficult to predict, and cases of poisoning
often occur in the form of an epidemic. There are probably some 10 00050 000 cases each year, but estimates
show wide variation. The average incidence in endemic
regions varies from 550 cases per 100 000 inhabitants
per year, but in some years this can reach as high as
500/100 000 in the South Pacific.
Range
Ciguatera is widespread in tropical and subtropical waters, usually between the latitudes of 35
ı N and 35
ı S; it
is particularly common in the Pacific and Indian Oceans
and the Caribbean Sea.
Causative Dinoflagellates
and Poisonous Ingredients (Toxins)
The main causative marine dinoflagellate is Gambierdiscus toxicus, which originally produced maitotoxins (MTXs), the lipophilic precursors of ciguatoxin [33.70]. MTX was first isolated in 1971 from
surgeon fish (Ctenochaetus striatus), known as Maito
in Tahiti. Three forms of MTX, MTX-1, MTX-2, and