Living on Maui, we are surrounded by an ocean that provides us family fun and recreation opportunities. For some, the ocean is a source of livelihood. We also enjoy eating the fish that the ocean provides. And while most of the fish we eat is safe, we must be aware of some dangers including the invisible fish toxin.

The purpose of this article is to spread awareness amongst the local community about ciguatera fish toxin. Symptoms that are often mistaken for a temporary allergy, a common rash, or even multiple sclerosis, could actually signal fish poisoning.

As referenced by The National Center for Biotechnology, Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurological, and/or cardiovascular symptoms that can last days to weeks, or even months to years.

Humans acquire this illness by eating reef fish containing the naturally occurring toxins, ciguatoxins. Ciguatera is derived from benthic dinoflagellates of the genus Gambierdiscus, growing predominantly in association with macroalgae in coral reefs in tropical and subtropical climates. The toxin is transferred through the food web as the algae is consumed by herbivorous fish, which are consumed by carnivorous fish, which are then consumed by humans.

Ciguatera poisoning is most common in Florida and Hawaii. Red snapper, barracuda, parrotfish, jacks, and grouper are most commonly contaminated, but over 400 normally safe fish species may contain the poison. There are no good ‘rules of thumb’ for detecting tainted fish. They look, taste and smell normal.

Approximately 29 hallmark symptoms of ciguatera poisoning include intense burning of the skin, itching, diarrhea, and other nervous system disruptions. The one that is most specific, unusual and noted, is the painful sensation of one’s teeth falling out. Symptoms usually begin within a few minutes to 6 hours.

One may be tempted to enjoy the pupu specials on the menu, such as a seemingly harmless and common fish taco or a battered dipped mystery fish. Next time, ask what kind of fish they are serving. Do not eat the head, guts, liver or roe (eggs) of any reef fish. Cooking, drying, salting or freezing does not kill the poison causing ciguatera fish poisoning.

Learn more at http://health.hawaii.gov/docd/disease_listing/ciguatera/.

Suzie Cooney has lived with ciguatera fish poisoning since 2011, and has one of the most intense documented cases still wreaking havoc. Suzie was first thought to have contracted it in the Bay Area from shrimp, but a timeline concluded the toxin was ingested at a local Maui restaurant. Learn more about her continued journey managing the toxin, and watch her special TV Animal Planet episode here: http://www.suzietrainsmaui.com/category/ciguatera/.