6301: Ciguatera toxic poison (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: Martha VanCise <mvancise@ircc.net>

While we are talking about hospitals and medical care in Haiti, I would like
to inform those of you who travel to Haiti or other Caribbean islands about
an illness that Haitian doctors are quick to diagnose but North American
doctors often fail to diagnosis. I know of people who have returned home to
North America and nearly emptied their bank accounts trying to find out what
was wrong with them, when a Haitian doctor could have given a proper
diagnosis in a matter of minutes.

While living in Haiti, I experienced muscle problems.  I felt as if my legs
were swollen (but they weren't) and I had difficulty walking. When I
explained my symptoms, the doctor said, "Have you been eating fish?" Since I
had not eaten fish for several days, I said, "No."  As he examined me, he
repeatedly asked, "Have you been eating fish?"  I repeatedly said, "No."

I went home and recalled that four days earlier I had eaten snapper at Kyona
Beach so I called him.  He asked me to return to his office and he gave me
photocopies of articles from a medical journal regarding  ciguatera toxic
poisoning.  This is commonly called "barracuda " poisoning and comes from
eating reef-feeding fish in the tropics.  The fish do not metabolize the
poisoning which affects the central nervous system but humans do. You cannot
tell if a fish has this.  It has nothing to do with the way the fish are
handled. It does seem to appear during the season when storms stir up the
reefs. I think the Haitians sometimes call it "copper poisoning."  Symptoms
often develop several days after eating the fish.

Some symptoms are bizarre and vary according to individuals.  If you vomit
or have diarrhea you rid your system of most of the poison, and will
probably suffer fewer symptoms. May people get this poisoning but only a
small percentage have lasting symptoms.  A heavy dose of the toxin though
will produce symptoms for months and even years.

I had mild diarrhea and the next day thought regular drinking water was
carbonated water. I had a fizzing sensation on the back of my tongue. About
five days latter, I had the common bizarre reversal of sensitivity to heat
and cold - the sun felt like menthol on my arms. Hot coffee felt cold.  When
I made patties from cold meat, my hands burned (Really weird!!) My feet
burned when I walked on the cool tile floors.

Visual disturbances - my eyes didn't focus.  Some have suffered temporary
blindness.

Ciguatera toxin from the Pacific can lead to cardiovascular problems.
Atlantic toxin supposedly does not lead to death, but people in Puerto Rico
told me of fishing villages that were affected and people died.  I don't
know. According to the medical journal other symptoms include parasthesias
of the face, mouth, neck; dizziness; vertigo; staggering walk; itching;
painful or seemingly loose teeth; and pains in the extremities.

My worst symptoms were difficulty in walking and extreme exhaustion. The
muscles in my legs seemed to tighten and I had trouble climbing stairs. I
experienced incredible exhaustion.  I would start out the day full of energy
but by 10:00 a.m. would feel like one of those chewed up pieces of sugar
cane you see lying on the street in Port-au-Prince.  My husband could
literally see the exhaustion sweep over me.  I would grow pale, my eyes
wouldn't focus and I would soon by lying down.  I was so tired, I couldn't
even sleep.  It was an incredible exhaustion that came in decreasing
episodes for two years.  Extreme stress or over-work would trigger another
episode even after two years.   I was just thankful that a Haitian doctor
knew exactly what was wrong with me.

Since it did seem to affect my left side, I came to Ft. Lauderdale for a
heart check-up.  While there, I stayed in the home of people who had a
cook-out for a group of New Jersey doctors who were attending a medical
convention in Miami.  They examined me like a guinea pig and admitted they
had never had a case like this.  And I think they secretly thought I had
psychosomatic symptoms.  I don't believe they would have ever diagnosed the
toxic poisoning.

As far as I know, there isn't much you can do if you get ciguatera toxic
poisoning.  You just have to hang in there until the symptoms fade.  A
nutritionist put me on a fairly heavy dose of vitamins which seemed to me to
help.  A doctor might question the validity of the treatment, but it did
seem to help me.

I just wanted to share this information with Corbateers in case someone has
run into this problem but no North American doctor has been able to make a
satisfactory diagnosis.  I'm just thankful that a very good Haitian doctor
cared for me rather than a North American doctor.

If any questions, you may reply directly to me mvancise@ircc.net.
Martha VanCise