ABSTRACT
Ciguatera is a common form of fi sh intoxication that is caused by ingestion of tropical fi shes that have bioaccumulated the lipophilic cyclic polyether toxins know as ciguatoxins (CTXs). Consumption of these temperaturestable, orally effective sodium channel activators causes the characteristic neurological, gastrointestinal and cardiovascular symptoms (Table 1) of ciguatera fi sh poisoning. The disease is estimated to affect between 50,000-500,000 people annually worldwide (Quod and Turquet 1996), however, as ciguatera is often under-recognized in non-endemic areas and under-reported in endemic areas, the true incidence remains poorly defi ned. Importantly, with climate change leading to predicted increases in ocean temperatures, the incidence of ciguatera is predicted to rise, making ciguatera an increasingly global health problem (Llewellyn 2010, Tester et al. 2010).
