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Ciguatera from Fish Served at Two Restaurants Sickens 10 in St. Louis

Dec 12, 2007 | Parker Waichman LLP

A food poisoning outbreak in St. Louis, Missouri has officials there scratching their heads.  At least 10 patrons of two area restaurants have fallen ill with an unusual fish-borne illness called ciguatera.  The Food & Drug Administration (FDA) is investigating the outbreak, which is unusually large, as only about 30 cases of ciguatera are reported in the US each year.

All of the people involved in the St. Louis ciguatera outbreak ate amberjack, a tropical fish, at either the Blue Water Grill in Kirkwood or Frazer's Restaurant and Lounge in St. Louis.   Ciguatera is a food poisoning caused by toxins within fish that eat other fish that have ingested toxic algae, sometimes called red tide.  Ciguatera toxin may be found in large reef fish, most commonly barracuda, grouper, red snapper, eel, amberjack, sea bass, and Spanish mackerel. The toxin that causes ciguatera cannot be cooked out of fish, and there is no way to detect its presence.

While rare in the US, ciguatera is the most common type of fish borne food poisoning in the world, and most cases occur in the Caribbean.  Ciguatera symptoms occur within six hours of consumption and range from nausea, vomiting and diarrhea, to neurological symptoms including headache, sensory disorientation, vertigo and muscular weakness. The disease is rarely fatal, but in severe cases symptoms can linger for months or years. There is no way to cure ciguatera, but the symptoms can be treated while the disease runs its course.  It is important that ciguatera victims avoid dehydration, and sometimes intravenous fluids are required.

Both St. Louis-area restaurants purchased the amberjack at Bob’s Seafood in University City, Missouri.  Bob’s Seafood in turn, had procured the amberjack from a federally inspected facility in Louisiana.  The FDA is now trying to determine the source of the ciguatera contamination.

The St. Louis Department of Health, which is expected to issue a health alert today, believes that there may be other ciguatera victims in the area, and they are working with officials in St. Louis County to get the word out to health providers so they can spot ciguatera symptoms, which can sometimes mimic more serious diseases, such as multiple sclerosis.  

There have been no recorded cases of ciguatera in the St. Louis area before now.  The health department is asking anyone who ate amberjack recently and is suffering from symptoms similar to ciguatera to call the St. Louis Department of Health at 314-612-5289.


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