FDA advises seafood processors about Ciguatera fish poisoning

The US Food and Drug Administration (FDA) today issued a letter to seafood processors, advising them of recent illnesses linked to consuming fish carrying the ciguatera toxin, which has led to
cases of ciguatera fish poisoning (CFP) in consumers, the toxic fish were harvested in the Northern Gulf of Mexico, near the Flower Garden Banks National Marine Sanctuary, which is located in
federal waters south of the Texas-Louisiana coastline.

FDA had considered CFP from fish in this geographical area extremely rare until recently, when several outbreaks were confirmed in Washington, D.C., and St. Louis, Mo. The illnesses were linked
to fish caught near the marine sanctuary. FDA now considers CFP to be a food safety hazard that is reasonably likely to occur in grouper, snapper, and hogfish captured within 10 miles of the
marine sanctuary and amberjack, barracuda and other wide-ranging species captured within 50 miles of the sanctuary.

FDA’s letter urges seafood processors who purchase reef fish and other potentially ciguatoxic fish directly from fishermen to reassess their current hazard analyses and update their Hazard
Analysis Critical Control Point (HACCP) plans as necessary. FDA’s seafood HACCP regulation requires processors to have and implement written plans to control food safety hazards. This updated
information differs from what is currently listed in FDA’s Fish & Fisheries Products Hazards & Controls Guidance, Third Edition.

Ciguatera poisoning is caused by the consumption of tropical reef fish that have assimilated ciguatoxins through the marine food chain from toxic microscopic algae. The toxins that cause
ciguatera cannot be destroyed by cooking or freezing, and toxic fish do not look or taste differently from nontoxic fish. The only way to detect CFP is through laboratory testing.

Symptoms of ciguatera poisoning include nausea, vomiting; diarrhea; numbness and tingling of the mouth, hands or feet; joint pain; muscle pain; headache; reversal of hot and cold sensation
(such that cold objects feel hot and vice versa); sensitivity to temperature changes; vertigo, and muscular weakness. There also can be cardiovascular problems, including irregular heartbeat
and reduced blood pressure. Symptoms usually appear within hours after eating a toxic fish and go away within a few weeks. However, in some cases, neurological symptoms can last for months to
years. There is no antidote for CFP; symptoms can be treated most effectively if diagnosed by a doctor with 72 hours. CFP is rarely fatal.

If you think you may have ciguatera poisoning, report your symptoms and what fish you ate to your doctor, local emergency room or health department. If possible, save meal remnants. For more
information on the treatment of ciguatera poisoning, contact the National Poison Control Center at (800) 222-1222.

FDA will continue to monitor the presence of ciguatera in the Northern Gulf of Mexico and the application of seafood HACCP controls by seafood processors. Failure to meet the requirements of
the HACCP regulation may result in enforcement actions by the agency.

FDA’s letter to industry is part of the agency’s efforts to take preventive steps to minimize the risk of foodborne illnesses. Prevention is the
cornerstone of the FDA’s new Food Protection Plan, launched in November 2007. The plan combines science and a risk-based approach of prevention, intervention and response to ensure the safety
of domestic as well as imported foods eaten by American consumers.

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