Ciguatera fish poisoning (CFP) is a foodborne illness affecting humans worldwide. Humans acquire this illness by eating reef fish containing the naturally occurring toxins, ciguatoxins. Multiple ciguatoxins have been identified. CTX 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 are consumed by herbivorous fish, which are consumed by carnivorous fish, which are in turn consumed by humans.
In Norway, a study over 20 years estimated an average incidence of three cases per 10 000 inhabitant per year. During the first six months of 2000, several outbreaks occurred in many localities. From 2000 to 2007, 255 cases were reported with five requiring resuscitation. Since 2009, a CFP incidence of 0.7 per 10 000 inhabitants per year was reported.
Symptoms generally begin 6 to 8 hours after eating the contaminated fish but can occur as early as 2 or as late as 24 hours after ingestion. The symptoms of the diseases include nausea, vomiting, diarrhea, muscle pain, numbness, tingling, abdominal pain, dizziness, and vertigo. The classic finding of hot and cold sensation reversal is actually a burning sensation on contact with cold (allodynia).