Epidemiological and clinical aspects of certain venomous animals of Spain

From 1965 to 1978, 300 cases of snakebites were recorded and from 1974 to 1978, 100 cases of scorpion stings, 5 of Scorpaena stings and 125 of Trachinidae stings. Antivenom therapy was the most effective treatment for severe viper bites, with antihistaminics and steroids for M. monspessulanus. Antihistaminics, steroids and anesthetics were most effective for scorpions and marine animals.

[Symptomatic treatment of ichtyosarcotoxic disease by associated dexamethasone, cobalamine and tiapride (author's transl)]

Ciguatera is an ichtyosarcotoxic disease observed in South Pacific after consuming some species of fish. Common symptoms in benign forms are: asthenia, itching, subjective troubles of sensibility and digestive disorders. Rarer acute form lasts 2/6 days and then symptoms recede slowly. Symptoms might be reproduced if the same toxic fish is eaten again. A dinoflagellate seems responsible for this disease which has no specific treatment. The authors have added tiapride to dexamethasone and cobalamine, already used as symptomatic treatment. They report their experience and think that tiapride brought a noticeable improvement to the neurologic disorders.

[Ciguatera (author's transl)]

Ciguatera poisoning may occur after eating fish, mainly in the Caribbean, Pacific and Indian Ocean regions. It is caused by a toxin from a marine protozoon accumulating in fish via the food intake. The symptoms, consisting of severe gastrointestinal and neurologic manifestations, develop within a few hours; fatalities are rare. There is no specific therapy, symptomatic treatment is indicated. The disease is widely unknown in temperate climates but due to the increasing international travel the physician may be confronted with this kind of fish poisoning.

Ciguatera fish poisoning in Miami

Ciguatoxic fish constitute a continuing foodborne disease problem in Miami. Information from 129 cases of ciguatera fish poisoning reported to the Dade County (Miami) department of Public Health during 1974 to 1976 was used for epidemiologic study of the syndrome. The case definition required that both gastrointestinal and paresthetic neurological symptoms be experienced within 36 hours after eating fish. Grouper and snapper were the fish most frequently implicated. Neither methods of storage nor means of preparation seemed to affect fish toxicity. A predominantly late spring and summer seasonality was noted. The true annual incidence of this syndrome in Miami may be ten times the number reported to the health department, suggesting an average annual incidence of at least five cases per 10,000 resident population. Recent advances in ciguatoxin research may lead to much needed assays for toxin detection.

Fish poisoning with particular reference to ciguatera

An historical review of the literature concerning a type of fish poisoning found in the tropics, characteristic of perfectly fresh fish. The clinical features are briefly mentioned, and the aetiology discussed. A new epidemiological model is reported and appropriate preventative health-care measures are suggested.

Clinical observations on 3,009 cases of ciguatera (fish poisoning) in the South Pacific

Clinical observations on ciguatera were collected between 1964 and 1977 on 3,009 patients from several South Pacific island groups. Patients generally presented with neurologic symptoms such as parasthesia, vertigo, and ataxia, in addition to gastrointestinal symptoms such as diarrhea, abdominal pain, nausea, and vomiting. Patients with this illness usually became symptomatic less than 24 hours after ingestion of the fish and most patients (76.8%) developed symptoms in less than 12 hours. Significant differences in certain symptoms were noted between Melanesian and Polynesian ethnic groups, suggesting a susceptibility difference, or a difference in the nature of the toxin found in different areas of the Pacific. Being poisoned multiple times appeared to result in a clinically more severe illness than disease observed in patients experiencing ciguatera for the first time.

[A new pathophysiological explanation of ciguaterra (author's transl)]

After pointing out clinical, biochemical and biological similarities between paralytic shellfish poisoning and ciguaterra fish poisoning, the authors describe their recent discoveries in regard to ciguaterra origin. The causal agent searched without results since many years, might be a dinoflagellate, of the genus Diplopsalis.