Today’s (11 April 2010) New York Times Magazine, features a “Diagnosis” article, Fish Tale by Lisa Sanders MD, in which she describes a dramatic case of ciguatera poisoning from ingestion of tainted fish. Dr Sanders attributes the first description of the effects of the ciguatara neurotoxin to Surgeon’s Mate John Anderson. A very clear description of the bizarre effects of the toxin is found in Anderson’s reports from the 1772 – 1775 expedition of exploration by Royal Navy Captain James Cook to southern Pacific islands.
Neurologist Michael Mahoney, in a 2005 Neurology article suggests an even earlier source: Portuguese explorer Pedro Fernendez de Quiros, also exploring Pacific islands, in 1606. An on line article from the United Nations Food and Agriculture Organization gives the nod for the earliest description of ciguatera fish poisoning to Peter Martyr d’ Anghera, an Italian humanist chronicler of the Spanish exploration on the Caribbean, in 1511.
Whenever the first report was made, and despite the fact that indigenous populations likely knew of the illness, early western knowledge of the matter clearly falls within the realm of “maritime medicine”.
Several ciguatera toxins have now been identified. The complex organic molecules are produced by certain strains of the motile dinoflagellate Gambierdensus toxicus, resident in coral reef areas. The organisms and their toxins are ingested by small bottom-feeding fish, with the toxins then bio-concentrated as they are ingested up the predatory fish food chain. The toxin is very durable and cooking does not destroy the toxic effects. Up to 50,000 people are affected each year, and because of widespread fish commerce, the disease is no longer confined to coastal areas near coral reefs. The toxin produces a constellation of bizarre symptoms including abdominal pain, nausea and vomiting, muscle weakness, numbness of hands and feet, and a curious feature that makes cold foods seem hot. Rarely fatal (1%), the effects usually wear off within a few months, though some victims can have persistent mild symptoms for up to 20 years.