Thursday, July 5, 2018

PRO/AH/EDR> Ciguatera toxin - Bahamas: (NW) conch, alert

CIGUATERA TOXIN - BAHAMAS: (NEW PROVIDENCE) CONCH, ALERT
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Date: Thu 5 Jul 2018
Source: EW News [edited]
<https://ewnews.com/conch-poisoning-outbreak-in-the-capital>


With 4 confirmed cases of conch poisoning in New Providence,
[Bahamas], the Ministry of Health cautioned Bahamians against
consuming the delicacy in the wake of this latest outbreak. Health
Minister Dr. Duane Sands confirmed the 4 Bahamians suffering from the
illness. The earliest case, he said, dates back to [Sat 30 Jun 2018].

Dr. Sands revealed that an additional 6 persons have been hospitalized
with symptoms of conch poisoning. He said even though the number of
cases is considered minimal, the ministry's warning is a proactive
measure to prevent future cases. The ministry, he said, is expected to
begin dialogue with local vendors to ensure they are utilizing proper
cleaning methods in the preparation of conch dishes.

"Conch should be washed with fresh water, and not salt water, to
ensure that all bacteria is removed from the conch meat," suggested
Dr. Sands. He urged Bahamians to ask local vendors about the processes
they employ during the preparation of conch dishes. "If they do not
wash the conch in fresh water during the process of preparing it, then
do not purchase the conch," he warned.

The early onset of conch poisoning is said to be accompanied by watery
diarrhea and extreme abdominal cramps. Some cases, the health minister
said, are severe and can lead to dehydration and subsequent
hospitalization.

The last major outbreak of conch poisoning dates back to the 1990s,
according to Dr. Sands.

[Byline: Theo Sealy]

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Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[The group of conchs that are sometimes referred to as "true conchs"
are marine gastropod molluscs in the family Strombidae, specifically
in the genus _Strombus_ and other closely related genera. For example,
see _Lobatus gigas_, the queen conch, and _Laevistrombus canarium_,
the dog conch (<https://en.wikipedia.org/wiki/Conch>).

In ciguatera poisoning, the poisonous ingredient is ciguatoxin. This
is a poison made in small amounts by certain algae and algae-like
organisms called dinoflagellates. Environmental conditions are right
for other organisms, mollusks, or fish to ingest the algae and
dinoflagellates. Smaller organisms may be ingested by larger
organisms, thus transferring the toxic agent to the larger animal.

Ciguatera is a foodborne illness (food poisoning) caused by eating
fish that is contaminated by ciguatera toxin. Ciguatera toxin, a
heat-stable, lipid-soluble compound produced by dinoflagellates and
concentrated in fish organs, can cause nausea, pain, and cardiac and
neurological symptoms in humans when ingested.

Ciguatera toxin is harmless to fish but poisonous to humans. The toxin
is odorless and tasteless, and cooking does not destroy the toxin. The
toxin activates voltage-dependent sodium channels, causing symptoms in
gastrointestinal, cardiac, and nerve tissues of humans and other
mammals.

Symptoms in people generally begin 6-8 hr after eating the
contaminated fish but can occur as early as 2 or as late as 24 hr
after ingestion. Symptoms include nausea, vomiting, diarrhea, muscle
pain, numbness, tingling, abdominal pain, dizziness, and vertigo.
There is no specific antitoxin available for ciguatera toxin.

Some investigators have suggested vomiting should be induced if the
victim is awake and alert and has eaten ciguatera toxin-containing
fish within the last 3-4 hr. Ipecac, a substance that causes vomiting,
was suggested as the medication to use, but many investigators now
think ipecac causes too much dehydration. Currently, some physicians
recommend gastrointestinal decontamination with activated charcoal.
Activated charcoal may absorb the toxin if administered 3-4 hr after
ingestion.

Victims should maintain hydration. Intravenous fluids may be necessary
for uncontrollable nausea and vomiting. Although there is no specific
antidote available, supportive therapy and time usually is curative.

Portions of this comment were extracted from
<https://medlineplus.gov/ency/article/002851.htm>. - Mod.TG

HealthMap/ProMED-mail map:
New Providence Island, New Providence, Bahamas:
<http://healthmap.org/promed/p/11584>]

[See Also:
2017
--
Ciguatera fish poisoning - Belize: barracuda, alert
http://promedmail.org/post/20170828.5279734
Ciguatera fish poisoning - EU: possible local fish source, RFI
http://promedmail.org/post/20170619.5115458
Ciguatera fish poisoning - China: (HK) susp.
http://promedmail.org/post/20170408.4958181
2016
----
Ciguatera poisoning - India: (KA) contaminated fish, 1st report
http://promedmail.org/post/20161005.4539230
Ciguatera fish poisoning - China: (HK)
http://promedmail.org/post/20160426.4185251
Ciguatera fish poisoning - USA: (Northern Mariana Islands)
http://promedmail.org/post/20160301.4060111
2015
----
Ciguatera fish poisoning - Canada: (NB) Panamanian ship
http://promedmail.org/post/20150414.3294428
2014
----
Ciguatera fish poisoning - USA: (FL) ex Bahamas
http://promedmail.org/post/20140730.2645767
Ciguatera fish poisoning - Australia: (NS)
http://promedmail.org/post/20140312.2328822
2013
----
Ciguatera fish poisoning - Spain: (CN)
http://promedmail.org/post/20131216.2117634
Ciguatera fish poisoning - China: (HK)
http://promedmail.org/post/20130613.1771485
Ciguatera fish poisoning - USA: FDA draft guidelines, German cluster
http://promedmail.org/post/20130418.1652965
2012
----
Ciguatera fish poisoning - Spain: (CN)
http://promedmail.org/post/20120607.1159815
Ciguatera fish poisoning - China: (HK)
http://promedmail.org/post/20120329.1084658]
.................................................sb/tg/tw/jh
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