This is a type of fish food poisoning caused by eating tropical fish, especially large coral trout and large cod, in tropical waters, e.g. the Caribbean and tropical Pacific. The problem is caused by a type of poison that concentrates in the fish after they feed on certain micro-organisms around reefs. Ciguatera poisoning presents as a bout of 'gastroenteritis' (vomiting, diarrhoea and stomach pains) and then symptoms affecting the nervous system such as muscle aching and weakness, paraesthesia and burning sensations of the skin, particularly of the fingers and lips. There is no cure for the problem but it can be treated with gammaglobulin. It is unwise to eat large predatory reef fish, especially their offal (mainly the liver).

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