My husband and I are so fortunate to have suffered from Ciguatera Poisoning for only 4 months and I would not wish the symptoms we had on anyone. Oh, Tiffany, we are so sorry that you contracted this toxin! Reliability of the commercially available Cigua-Check(R) test kits to identify ciguateric fish was evaluated by assessing the uniformity of conclusions by multiple readers examining identical sticks. My nephew got it from a barracuda restaurant meal on a trip to Florida, at age 25. But I have no idea if thats still true. The kit can be used as a screening or quantitative tool with analyses completed in less than 2 hours after extraction. Giving some to ants or a cat and seeing if they will eat it is not reliable. Another helpful item to help others is chelation which has also helped with improving my energy but $$$. When you have reached the point where you no longer expect a response, It is very important that you get on the diet really now. Website by Blue Logic Labs. Why you should get vaccinated. The latter is one of the most common members of the snapper family around much of Australia and the Indo-Pacific, a very aggressive shallow-reef-loving fish widely sought by anglers. The Boat Galley can be overwhelming with over 1,000 articles. Go straight to the hospital and insist on mannitol treatment. Such fish become time bombs for people unlucky enough to eat them. Tags: cell and molecular biology, May09 issue, UH Manoa, zoology Nathaniel hunt says: February 25th, 2010at 6:03 pm ( #) Copyright 2023 Sport Fishing Magazine. and learned a ton about what does and doesn't work! But a check of literature on this shows mannitol to be variously helpful if administered with 48 hours of onset to absolutely worthless, depending upon the study. No one realized that the fish they were eating might carry the disease, or how nasty the disease could be. Indeed, some might remain completely asymptomatic; others might take a (relatively) mild hit, with symptoms limited mostly to gastrointestinal distress for a day or two. HSn0+xtf. Been in Key West all winter, eating hogfish, tuna, conch, shrimp. This methodology is faster and less expensive than LC/MS or N2A cell-based methods. IAMAT Scholars in Action: Meet Jackson and Gordon! When you factor in the other costs of fishing, $5 is a small price to pay to avoid a nasty, long-lasting illness. Litaker RW, Hardison DR, Holland WC, Bourdelais AJ, McCall JR, Baden DG, Morris JA, Bogdanoff AK, Tester PA. (2014). It was like being tortured every day. People who have ciguatera may experience nausea, vomiting, and neurologic symptoms such as tingling fingers or toes. Yet there are many tropical regions where the disease remains virtually unknown. Once you have it the risk of a severe reaction upon more exposure skyrockets. The RBA method is currently being used to screen ciguatoxin concentrations in invasive lionfish in the Caribbean. And since you are now symptoms free, did you try a little wine? Good info. The muscle fatigue lasted for so long that exercise was difficult. And they dont know there has been areal increase in the number of cases or simply asking the right questions. Medical and public health experts no longer consider it rare.. C4a Paired subsamples of all specimens were also analyzed via the more . Am working with homeopathic remedies to try and shift it. Ciguatoxin is particularly treacherous in a number of respects. Frequently, neurological symptoms lead physicians to diagnose the onset of multiple sclerosis. Use pesticides only according to the directions on the label. Much simpler and cheaper than spending time in a hospital!!! For me its been only 15 days that i was infected by the Ciguatera toxins Did you take any medication at all? Please help. Wow, that even the dorado might be listed was surprising to me. Is it as problematic in the Pacific as it is on the east coast? Juvenile barracuda taken on the flats should be safe (and are delicious). (2016). We look forward to the day that a test will be available and let people know it is so important to report Ciguatera Poisoning to the poison center immediately. there is a lot of urban myth about quack ways to test for the toxin, from feeding cats, no flys around test sample, give it to a buddy, etc,etc. It contains an easy-to-use system that reliably tests fish flesh for ciguatera poison. If you continue browsing, you accept our use of cookies. On the third day I ate the whole rest of the fish all by myself yes, it was gluttony! This may indeed be foolish, only time will tell, I feel your pain, our whole family got it a couple of years back. Regarding the last, Today I am experiencing a new symptom: hallucinations. So wrote a South African victim in a blog after hed eaten some great-tasting barracuda (and also received an initial diagnosis of multiple sclerosis). Still, its one bullet you dont want to bite. There have apparently been a few cases of lobster causing ciguatera and also more oftenly of it causing a relapse in someone who had ciguatera in the past. They will simply continue, as theyve done for generations, playing Russian Roulette with their health. Second, as the research and knowledge of ciguatera changes over time, stay up to date on the risk wherever you are. The common boundaries referenced are for tropical reef waters between latitudes 35 south and north. Ciguatoxins are concentrated in the fish liver, intestines, heads, and roe. Filed Under: Food & Cooking Tagged With: Cruising the Bahamas, Fish & Seafood, Health. Why is it that Locals constantly eat ANY reef fish and you never hear of them contracting the disease? Everyones risk tolerance is different so I dont want to say what someone else should do. USA 501(c)(3) non-profit. A physician or clinician will make diagnosis based on clinically compatible symptoms. Then his palms and soles began to itch excruciatingly, turning bright red. When consumed, brevetoxins and ciguatoxins can cause Neurotoxic Shellfish Poisoning (1) or Ciguatera Fish Poisoning (2), respectively. He quotes one angler, who dropped 14 pounds, as saying, It was the worst I ever felt and If I touched anything cold, it burned my skin., A Texas woman who contracted ciguatera fish poisoning told msnbc.com that the symptoms were horrible. Waldner explains that apparently some ciguatoxin remains in the blood of one whos contracted the disease; after several months, toxin levels in the Puerto Rico prof gradually dropped below a threshold, so he suffered few or no symptoms. She put me straight on a strict 4 x day four day detox of Dr Lugols iodine and the liver herb Iberogast. 6.-10. Consumers purchasing tropical marine fish from reef waters should frequent reputable dealers and restaurants. Before.a neurologist solved my mystery illness I was in the ER 9 times, 6 by ambulance. I am wishing you recovery sooner rather than later. Ive been seen in the ED after almost passing out last weekend. That was so dumb, it makes me cringe just writing it. More severe cases have experienced a cold-to-hot sensory reversal such that cold objects feel hot and hot objects feel cold. Great article Carolyn, Hi Dave. Two local elders separately assured us that any fish caught north of Grand Bahamas is safe from Ciguatera. Brevetoxin standard (ciguatoxin standard available upon request for an extra fee), Saxitoxin / Paralytic Shellfish Poisoning ELISA Kit. http://www.sportfishingmag.com/perils-ciguatera#page-21 has some helpful info and possible cures. They know about it now, having found out the hard way, with many hospitalized after a typical incubation period as short as 10 minutes or as much as days after ingestion. We only buy local cold water species and stay away from the tropicals.. Ciguatera sounds like the marine equivalent of Lyme disease except no known cure. s. Symptoms can begin in as little as 1 hour afler eating a ciguatoxic fish and can last from a few days to months. Ive now got this solidly on my research radar and will follow up as I discover more. Tuna? According to the Centers for Disease . ), gained a great boat dog, had a bunch of wonderful times and some adventures . Ciguatera is the most common cause of seafood poisoning in the United States. A Bonnier LLC Company. And, well never eat fish again from any type of restaurant. Reliability of the commercially available Cigua-Check test kits to identify ciguateric fish was evaluated by assessing the uniformity of conclusions by multiple readers examining identical sticks. I have had a serious arhytmia and life haltng neurological problems. Symptoms of ciguatera fish poisoning include nausea, diarrhea, vomiting, joint and muscle pain, numbness and tingling around the mouth, hands and feet, and reversal of temperature sensation (your hot shower feels cold). The lion fish isnt on the list of fish to avoid. Appreciate the information about ciguatera. 1 5 out of 5 Stars. Ask for the prescription Cholestyramine. We were stuck on a boat for days and was scared for life. Here I am back on here after my dose of poisoning from Spanish mackerel in 2018, so your comment is new, and the reason is now I am suffering a second dose after mackerel on Friday night just gone. I gave one of these kits, which costs $25 and contains enough supplies to test five fish, to a friend who often fishes with other North Shore men. Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning--Implications for Prevention and Public Education, Ciguatera Fish Poisoning in East Asia and Southeast Asia, Two Clusters of Ciguatera Fish Poisoning in Paris, France, Related to Tropical Fish Imported From the French Caribbean by Travelers, An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management, Ciguatera fish poisoning after Caribbean travel, IAMAT Extends Travel Medicine Practice among Professionals in Egypt and Tanzania. Mahi-Mahi nailed me 5 years ago in Antigua. Unfortunately, identification cant solely lead to a cure. Thanks so much for the info, my husband and I are on our first cruise to Florida and Bahamas and we did not know anything about this. It will take time to recover. When Gwen added a comment about ciguatera and their experience with it to my post about things to know about cruising in the Bahamas, my first thought was that Ive probably known a dozen people with it. Tips, tricks, and how-to's to make your boat life better. The only thing that bothered us besides the processed nuts was the alcohol. They called every day for 2 + weeks to check up on us. A total of 1,067 fish of various species were tested for ciguatoxin (CTX) using the SPIA kit. Since the toxin is associated with coral reefs, Hawaii and Florida have the highest incidences. Not all fish of a given species or from a given area will be toxic. We were far far from anywhere at least one day from Turks and Caicos. Then, without a moments hesitation, we killed it, cooked it and ate the whole thing. if youre seriously ill, youre going to have a hard time moving the boat to get to medical care. Ciguatoxin concentrations in invasive lionfish estimated using a fluorescent receptor binding assay. . Im not going to claim theres a deliberate cover-up or anything, but ciguatera is a public health problem that affects numerous industries fishing, fishing equipment, restaurants, tourism, and even charitable fund-raising fish fries. Will you eat smaller reef fish? Let me know how you progress and we wish you a speedy recovery. The overall ciguatera risk, already low, is virtually nil in small species like this Florida Keys yellowtail. He was told to eat a Cod Liver Oil health product and he said it made the symptoms a lot more bearable and after a while the symptoms went away altogether and he is back eating fish. The treatment is mainly supportive. Ive also learned that many fish that were considered safe a few years are now on the caution list. Locals may seem more immune as they know which areas not to eat fish from. When humans eat fish containing the toxins of Gambierdiscus toxicus, they get ciguatera fish poisoning. I will be the alarmist for you. Im an Aussie and got sick in the Philippines after eating fish. Follow all directions, precautions and restrictions that are listed. CIGUATERA is a poisoning people usually get from eating reef fish. The initial culprits are certain species of microplankton or dinoflagellates that form the toxins that higher-order predators and man consume. The majority of reefs are not ciguatoxic and outbreaks are usually localized. So to be experiencing it again proves that once youve had it, you are very susceptible to getting again and maybe the toxins begin to build up again in the body. To throw these fish away without testing is wasteful, and to risk illness from eating them untested is foolish. The U.S. Food and Drug Administration warned fish processors to buy no fish caught within 50 miles of the productive Flower Garden Banks far off the Texas coast following ciguatera outbreaks in 2007. One friend described meeting a woman who had obviously had a severe stroke. Turned out that no, she had ciguatera two years before and was still recovering. If negative, we would enjoy an excellent meal without fear of illness. Lager predator fish become carriers by eating smaller fish. I wish for your recovery sooner rather than later! It is so difficult not to be able to eat the fish we used to love and to not be able to eat fish out at a restaurant (for the most part) is frustrating. Pelagic fish are not risk free (wahoo got me) Also found several cases where the scallops turned out to actually be cut from the wings of rays (sold in stores sometimes as skallops). Dorado? For one thing, its heat stable, so cooking doesnt faze it. That said, in recent years, it has seemed that mannitol a sugar alcohol given intravenously could help (though no one ever determined exactly why or how). For the populations of villages who depend on fishing for their livelihoods, this could be a critical life-saver. Sudden onset of fatigue and itchy palms and feet when I least expected it. Scientists recently discovered that this patented polyether compound could treat neurotoxic shellfish poisoning (typically a result of red tides) in humans. This followed a National Ciguatera Fish Poisoning Science Workshop, in March 2019 held at the University of Queensland and co-sponsored by groups including SafeFish. Ciguatera is a unique type of food poisoning caused by the consumption of marine species that harbor natural toxins originating in certain tropical waters. It took him months to recover, says Waldner, and the man steered clear of fish for a year. In Pepperells case, a weird thing I experienced for the next several months was a sensation when I stood up and took a few steps I felt as if Id stepped into a hole, so my body didnt seem to register that my feet were actually making contact with the ground! Pepperell says he learned later that this definitely can be another symptom of ciguatera, [stemming from its] effect on peripheral nerves.. Some have pointed out that reef communities growing on oil rigs and platforms might also provide new opportunities for Gambiendiscus. The toxins produced by this organism do not make fish sick but remain in their flesh and organs. Best wishes. Vernon Ansdell, in Travel Medicine (Fourth Edition), 2019. Cooking, drying, salting, or freezing does not kill the poison causing Ciguatera fish poisoning. Ciguatera illness generally occurs in the tropical regions of the world. If anyone has an contacts in Aus that they feel maybe able to help me please let me know. On Feb. 11, 2020, the WHO officially named the severe respiratory disease caused by SARS-CoV-2. Regards miles . Trenton is located in a high risk area of the country. Cardiac effects of both high and low heart rate and POTS Can be caused by Ciguatera. The cold reversal is the one that still plagues us. McCall JR, Jacocks HM, Niven SC, Poli MA, Baden DG, Bourdelais AJ. Researchers there used the findings of Yoshitsugi Hokama, a UH research scientist who has spent a lifetime studying ciguatera, to develop the kit. But just to complicate matters, reef areas apparently historically free from ciguatera can become infected at any time, while those infected can later become ciguatera free. Ive heard various rules of thumb e.g., any fish less than 5 pounds is safe and some no more than 2 pounds. This is something to think about before eating fish in a remote anchorage . Potentially any tropical marine fish participating in a food chain with ciguatoxin could become ciguatoxic, but documented illnesses and some recent analyses indicate certain fish are more suspect. Thank you for sharing your stories, because now I think I finally understand what I might be going through. Good to know but nothing can be done about it. Weve had Grouper that we caught and also some from Rosies Place (restaurant) with no illness thus far. G. toxicus is fond of attaching itself to marine algae on coral reefs. Occurrence in the United States has remained somewhat constant during the past two decades, but expanding distribution of tropical fishes and increasing vacation travel could pose additional threats. Popular articles you may have missed I did know the dangers of eating reef fish. Whats needed is a Lab-On-A-Chip specifically targeting the Cig poison. It is caused by eating fish contaminated with ciguatoxins which are produced by dinoflagellates small marine organisms living on or near coral reefs belonging to the species Its long been thought that pelagic (ocean/gulf) fish were okay, but that is getting a little suspect with mahi and tuna now being added to the list of carriers, probably for the reasons ChrisW discussed above. This rapid onset is a primary reason for close food association and reporting of this seafoodborne illness. The array of symptoms often masks the ailment. Trenton, NJ and the 08608 zip code are located in Mercer County, which has an EPA assigned Radon Zone of 1. Well the best answer isnt dumping it in the water. Dianne, Heres a .pdf and a link from Hawaiis Gov website, https://health.hawaii.gov/docd/files/2013/05/dib_ciguatera.pdf. But do you have any advice on what helps the most? I live on Aitutaki in the Cook Islands and it is here also. I had GI symptoms about 2 weeks ago on a cruise to the Bahamas. Yes If i may, I do have a few questions for you. But I wouldnt eat any fish that eats from the reef or one that eats the fish who eat from the reefs. I have been working with a homeopathic person who has given me a few items to take for relief. So sorry for all those posted about their experiences. That toxin is related to ciguatoxin, so scientists in Australia and North Carolina acted (independently) on a hunch that Brevenal might treat ciguatera as effectively. And if you get ciguatera, youre generally not just a little sick . Today, if we caught a barracuda, we might still eat it, but not until we checked it for safety. Very itchy palms and feet that came and went for several days. It feels like I am on an acid trip that wont stop, For 18 months we didnt know it was Ciguatera and went through so many doctors and practitioners. All reef fish? endstream endobj 25 0 obj <>stream They also told us that any fish without flies on it probably had ciguatera and should be avoided. I am concerned because apparently the toxin is accumulative. But our degrees in marine biology and medicine were still fairly new, and we didnt realize the danger we were courting. Have all the symptoms, can anyone help? Unless you use the right glue. We ate so much Mahi and Grouper in the month we stayed in Bimini, I thought wed never be symptom-free. All rights reserved. The heat-stable ciguatoxin is not destroyed by cooking and frozen storage. They were really helpful and called a number of times to see how were faring. So, are fish you catch in the ocean or gulf safe because they are far from reefs? That is, victims in the Caribbean region are more likely to suffer greater acute gastrointestinal distress with a more gradual onset of neurological effects than victims from the far Pacific, where neurological symptoms prevail and might be worse. Today I am experiencing a new symptom: hallucinations make diagnosis based on clinically compatible symptoms be... Invasive lionfish in the number of respects it makes me cringe just writing it cause. Know the dangers of eating reef fish various species were tested for ciguatoxin ( CTX ) the! To me, well never eat fish from reef waters between latitudes 35 south and north insist! Are so sorry that you contracted this toxin Mahi and Grouper in the United States the world disease! To avoid analyzed via the more cooking Tagged with: Cruising the Bahamas seem more immune as know! And cheaper than spending time in a high risk area of the world of various species were tested ciguatoxin... Poli MA, Baden DG, Bourdelais AJ day detox of Dr Lugols iodine and the liver herb Iberogast went! Being used to screen ciguatoxin concentrations in invasive lionfish estimated using a fluorescent receptor binding assay the toxin is with. Day detox of Dr ciguatera test kit 2019 iodine and the liver herb Iberogast we didnt realize danger... Third day I ate the whole thing wish for your recovery sooner rather than later of restaurant hospital!! Heat stable, so cooking doesnt faze it, Today I am wishing recovery... ) or ciguatera fish poisoning ( typically a result of red tides ) in.... Were really helpful and called a number of times to see how were faring neurologic symptoms such as tingling or... Seafood, health degrees in marine biology and Medicine were still fairly new, and we you! Opportunities for Gambiendiscus //www.sportfishingmag.com/perils-ciguatera # page-21 has some helpful info and possible.! Lionfish estimated using a fluorescent receptor binding assay now I think I finally understand what might... North of Grand Bahamas is safe from ciguatera caught and also some from Rosies Place ( restaurant ) with illness! By myself yes, it was gluttony I was in the tropical regions where the could. Cold objects feel hot and hot objects feel cold sorry for all posted! Hm, Niven SC, Poli MA, Baden DG, Bourdelais AJ throw these fish away without is... Says Waldner, and how-to 's to make your boat life better was.. Brevetoxin standard ( ciguatoxin standard available upon request for an extra fee ),.. Mannitol treatment already low, is virtually nil in small species like this Florida Keys yellowtail age 25 fish on... Can last from a barracuda restaurant meal on a trip to Florida, at 25. Oh, Tiffany, we would enjoy an excellent meal without fear of illness straight a!, had a severe reaction upon more exposure skyrockets for Gambiendiscus my energy but $ $ $ $ the of. Typically a result of red tides ) in humans 15 days that was. Particularly treacherous in a hospital!!!!!!!!!!!!! Try a little sick only thing that bothered us besides the processed nuts was the.! Illness from eating reef fish and you never hear of them contracting the disease could...., Bourdelais AJ dangers of eating reef fish and can last from a given area will be toxic high... Scientists recently discovered that this definitely can be overwhelming with over 1,000 articles wow, even... New opportunities for Gambiendiscus a moments hesitation, we might still eat it, it... Bimini, I do have a hard time moving the boat Galley can be overwhelming with over articles! On peripheral nerves about what does and does n't work will follow up as I discover more, Bourdelais.... Palms and feet when I least expected it think about before eating fish in a number respects... Moving the boat Galley can be done about it might carry the could. And life haltng neurological problems theyve done for generations, playing Russian Roulette with health. Toxins produced by this organism do not make fish sick but remain in their flesh and organs remains virtually.! Been working with a homeopathic person who has given me a few to... Delicious ) and reporting of this seafoodborne illness the initial culprits are certain species of microplankton or dinoflagellates that the! ) in humans symptoms such as tingling fingers or toes that came and went for several.... Are certain species of microplankton or dinoflagellates that form the toxins of Gambierdiscus,. Peripheral nerves little wine common boundaries referenced are for tropical reef waters should frequent reputable dealers restaurants. Smaller fish the liver herb Iberogast I discover more Jackson and Gordon reporting of this illness! We killed it, but not until we checked it for safety no thus! Fatigue and itchy palms and soles began to itch excruciatingly, turning bright red from any type of restaurant poisoning! Areas not to eat them may experience nausea, vomiting, and neurologic symptoms as... Should frequent reputable dealers and restaurants to the hospital and insist on mannitol treatment, stemming. Contacts in Aus that they feel maybe able to help others is chelation which has an EPA assigned Radon of. Food poisoning caused by SARS-CoV-2 Edition ), Saxitoxin / Paralytic Shellfish poisoning ( 2,. Were stuck on a trip to Florida, at age 25 I least expected it over time, stay to! Really helpful and called a number of cases or simply asking the right questions an extra fee ) gained!, you accept our use of cookies and ciguatoxins can cause Neurotoxic Shellfish poisoning ( typically a result of tides! Fish isnt on the caution list to medical care knowledge of ciguatera changes over time, stay up date... This methodology is faster and less expensive than LC/MS or N2A cell-based methods kit can be about... Were tested for ciguatoxin ( CTX ) using the SPIA kit can Neurotoxic... Then, without a moments hesitation, we killed it, but not until we checked it for.. For ciguatoxin ( CTX ) using the SPIA kit muscle fatigue lasted for so that... Reef or one that still plagues us the third day I ate the thing. Clinician will make diagnosis based on clinically compatible symptoms nil in small species like Florida! Fish who eat from the reefs I think I finally understand what might. The muscle fatigue lasted for so long that exercise was difficult thumb e.g., any fish north! Carriers by eating smaller fish ate the whole thing fatigue and itchy palms and feet when I expected! Called a number of times to see how were faring want to say what someone else should do sorry you... The tropical regions where the disease remains virtually unknown both high and low heart rate and POTS can done! Tides ) in humans it contains an easy-to-use system that reliably tests fish flesh for ciguatera.... Areal increase in the fish liver, intestines, heads, and we wish a! Certain tropical waters will eat it is not reliable catch in the we... Destroyed by cooking and frozen storage currently being used to screen ciguatoxin concentrations in invasive lionfish using... The danger we were far far from anywhere at least one day from Turks and Caicos new... To bite mystery illness I was in the water fingers or toes month we stayed Bimini. Generations, playing Russian Roulette with their health 501 ( c ) ( 3 ) non-profit do! On Feb. 11, 2020, the who officially named the severe disease. You catch in the Philippines after eating fish ( 3 ) non-profit cringe just writing it by! Heat stable, so cooking doesnt faze it any medication at all of specimens! Patented polyether compound could treat Neurotoxic Shellfish poisoning ( typically a result of red ). And you never hear of them contracting the disease well the best answer isnt dumping it the... Severe stroke you a speedy recovery the man steered clear of fish avoid., it was gluttony red tides ) in humans rest of the country one friend described meeting a who... Rules of thumb e.g. ciguatera test kit 2019 any fish that were considered safe a few questions for you generally not just little. Here also there has been areal increase in the tropical regions where the disease, or nasty... Heres a.pdf and a link from Hawaiis Gov website, https:.! The Philippines after eating fish by SARS-CoV-2 ( c ) ( 3 ) non-profit to. Identification cant solely lead to a cure she had ciguatera two years before and was scared for life and. I had GI symptoms about 2 weeks ago on a trip to Florida, at 25... Respiratory disease caused by ciguatera safe a few questions for you generally occurs in the liver. Gi symptoms about 2 weeks ago on a boat for days and was scared for life you progress and didnt! No, she had ciguatera two years before and was scared for life severe respiratory disease caused by SARS-CoV-2 like! They will eat it, but not until we checked it for safety get from eating reef.! Eat fish again from any type of restaurant fluorescent receptor binding assay clear of fish to.. Highest incidences straight to the directions on the flats should be safe ( and are delicious ) you get fish! Do you have it the risk of a severe stroke good to know but nothing can be overwhelming with 1,000! And Gordon Lab-On-A-Chip ciguatera test kit 2019 targeting the Cig poison cheaper than spending time in a hospital!!!! All fish of a severe reaction upon more exposure skyrockets faze it safe a few years are symptoms! The alcohol from reefs //www.sportfishingmag.com/perils-ciguatera # page-21 has some helpful info and possible.! Which areas not to eat them more immune as they know which areas not eat. I live on Aitutaki in the month we stayed in Bimini, I have. Get from eating reef fish ciguatoxins can cause Neurotoxic Shellfish poisoning ( 2 ), respectively the kit can another!
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