{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:19:42Z","timestamp":1777447182979,"version":"3.51.4"},"reference-count":27,"publisher":"Australian Centre for Disease Control","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Commun Dis Intell"],"abstract":"<jats:p>Between 2015 and 2017, the NSW Food Authority investigated 4 ciguatera fish poisoning incidents linked to fish caught in tropical Australian and international waters and imported to New South Wales. Three of the implicated fish were caught near the Capel Bank Seamount, part of the Lord Howe Island Seamount Chain off the coast of Queensland. The fourth incident, in 2017, involved a fish caught between Cooktown and Lizard island, also off the Queensland coast. Thirteen individuals were affected. Early identification of potential Ciguatera fish poisoning (CFP) cases can facilitate a faster incident response, patient diagnosis and treatment. While different fish species were involved, and the severity and duration of symptoms varied between individuals, 3 of the 4 incidents were distinguished by those affected having consumed a fish meal prepared with the head of the fish. Affected individuals also described a sensation of hot\/cold temperature reversal or a painful \u2018sharpness\u2019 when in contact with or drinking cold water. This paper outlines a series of incidents where a case\u2019s symptoms, which can vary substantially in conjunction with their previous exposure history, the type of fish consumed and how the fish was cooked, can be used to identify potential CFP cases and hence CFP risks that may need to be addressed.<\/jats:p>","DOI":"10.33321\/cdi.2019.43.4","type":"journal-article","created":{"date-parts":[[2019,1,23]],"date-time":"2019-01-23T17:17:51Z","timestamp":1548263871000},"source":"Crossref","is-referenced-by-count":12,"title":["Four recent ciguatera fish poisoning incidents in New South Wales, Australia linked to imported fish"],"prefix":"10.33321","volume":"43","author":[{"given":"Alan","family":"Edwards","sequence":"first","affiliation":[{"name":"NSW Shellfish Program"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Zammit","sequence":"additional","affiliation":[{"name":"Food Incident Response & Complaints"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazel","family":"Farrell","sequence":"additional","affiliation":[{"name":"Shellfish Operations"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"18788","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1.\tKohli GS, Farrell H, Murray SA. Gambierdiscus, the cause of ciguatera fish poisoning: An increased human health threat influenced by climate change. In: Botana LM, Louzao C, Vilari\u00f1o N. (editors). Climate Change and Marine and Freshwater Toxins. De Gruyter; Berlin, Germany: 2015;273\u2013312.","DOI":"10.1515\/9783110333596-011"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"2.\tGillespie N, Lewis R, Pearn J, Bourke A, Holmes M, Bourke J, et al. Ciguatera in Australia. Occurrence, clinical features, pathophysiology and management. Med J Aust 1986;145(11-12):584-590.","DOI":"10.5694\/j.1326-5377.1986.tb139504.x"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"3.\tSims JK. A theoretical discourse on the pharmacology of toxic marine ingestions. Ann Emerg Med 1987;16(9):1006\u20131015.","DOI":"10.1016\/S0196-0644(87)80750-3"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4.\tFriedman MA, Fleming LE, Fernandez M, Bienfang P, Schrank K, Dickey R, et al. Ciguatera fish poisoning: treatment, prevention and management. Marine Drugs 2008;6(3):456\u2013479.","DOI":"10.3390\/md6030456"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"5.\tLehane L, Lewis RJ. Ciguatera: recent advances but the risk remains. Int J Food Microbiol 2000;61(2):91\u2013125.","DOI":"10.1016\/S0168-1605(00)00382-2"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"6.\tLindsay JA. Chronic sequelae of foodborne disease. Emerg Infect Dis 1997;3(4):443.","DOI":"10.3201\/eid0304.970405"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7.\tFriedman MA, Fernandez M, Backer, LC, Dickey RW, Bernstein J, Schrank K, et al. An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management. Marine Drugs 2017;15(72): doi:10.3390\/md15030072.","DOI":"10.3390\/md15030072"},{"key":"ref7","unstructured":"8.\tCapra M. Ciguatera Poisoning. Fisheries Research and Development Corporation; Canberra, Australia: 1995. p. 136"},{"key":"ref8","unstructured":"9.\tCameron J., Capra M. Neurological studies on the effect of ciguatoxin on mammalian nerve. In: Miller D., editor. Ciguatera Seafood Toxins. CRC Press; Boca Raton, FL, USA: 1991. pp. 21\u201332."},{"key":"ref9","unstructured":"10.\tKraa E., Campbell B. Ciguatera outbreak, NSW, 1994. NSW Public Health Bull. 1994;5:69."},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"11.\tKaralis T., Gupta L., Chu M., Campbell B.A., Capra M.F., Maywood P.A. Three clusters of ciguatera poisoning: Clinical manifestations and public health implications. Med J Aus. 2000;172:160\u2013162.","DOI":"10.5694\/j.1326-5377.2000.tb125539.x"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12.\tTobin A., Mapleston A. Exploitation Dynamics and Biological Characteristics of the Queensland East Coast Spanish Mackerel (Scomberomorus commerson) Fishery. CRC Reef Research Centre; Townsville, Australia: 2004. p. 69.","DOI":"10.1071\/mf05173"},{"key":"ref12","unstructured":"13.\tFarrell H, Zammit A, Harwood DT, McNabb P, Shadbolt C, Manning J, Turahui JA, van den Berg DJ, Szabo L. Clinical diagnosis and chemical confirmation of ciguatera fish poisoning in New South Wales, Australia. Commun Dis Intel 2016;40(1):E1-6."},{"key":"ref13","unstructured":"14.\tFarrell H, Zammit A, Harwood DT, Murray S. Is ciguatera moving south in Australia? Harmful Algal News 2016;54:5-6."},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"15.\tHussain MA, Saputra T, Szabo EA, Nelan B. An Overview of Seafood Supply, Food Safety and Regulation in New South Wales, Australia. Foods 2017;6(52).","DOI":"10.3390\/foods6070052"},{"key":"ref15","unstructured":"16.\tSydney Fish Market Pty Ltd. Schedule of ciguatera high risk areas and species size limits. 2005. Available from: http:\/\/www.sydneyfishmarket.com.au\/Portals\/0\/Ciguatera_Schedule.pdf"},{"key":"ref16","unstructured":"17.\tSydney Fish Market Pty Ltd. Seafood Handling Guidelines. 2013 Available from: http:\/\/www.sydneyfishmarket.com.au\/Portals\/0\/PDF\/seafoodhandlingguidelines.pdf"},{"key":"ref17","unstructured":"18.\tSydney Fish Market Pty Ltd. Ciguatera. 2017. Available from: http:\/\/www.sydneyfishmarket.com.au\/seafood-school\/seafood-info\/health-safety-faqs\/faq-details?cat=14&id=112"},{"key":"ref18","unstructured":"19.\tSydney Fish Market Pty Ltd. Seafood Handling Guidelines. Available from: https:\/\/www.sydneyfishmarket.com.au\/Portals\/0\/PDF\/02%2010%2015%20Seafood%20Handling%20Guidelines.pdf?ver=2016-01-25-134033-917"},{"key":"ref19","unstructured":"20.\tNSW Food Authority. Food Safety Program for Seafood Processing. Available from: http:\/\/www.foodauthority.nsw.gov.au\/industry\/seafood\/seafood-processing-businesses"},{"key":"ref20","unstructured":"21.\tNSW Health. Health Protection Report. 2016. Available from: http:\/\/www.health.nsw.gov.au\/hpr\/Pages\/default.aspx"},{"key":"ref21","unstructured":"22.\tNSW Food Authority. Food Complaints. 2017. Available from: http:\/\/www.foodauthority.nsw.gov.au\/gp\/complaints-about-food"},{"key":"ref22","unstructured":"23.\tOzFoodNet. OzFoodNet - Enhancing surveillance for foodborne disease in Australia. 2017. Available from: http:\/\/health.gov.au\/internet\/main\/publishing.nsf\/Content\/cdna-ozfoodnet.htm"},{"key":"ref23","unstructured":"24.\tHarwood et al. in prep. Toxicon."},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"25.\tFarrell H, Murray SA, Zammit A, Edwards AW. Management of Ciguatoxin Risk in Eastern Australia. Vilari\u00f1o N, ed. Toxins. 2017;9(11):367. doi:10.3390\/toxins9110367.","DOI":"10.3390\/toxins9110367"},{"key":"ref25","unstructured":"26.\tNSW Health. Foodborne-illness outbreak control guideline. 2013 Available from: http:\/\/www.health.nsw.gov.au\/Infectious\/controlguideline\/Pages\/foodborne-illness.aspx"},{"key":"ref26","unstructured":"27.\tNSW Health. Seafood poisoning factsheet. 2014. Available from: http:\/\/www.health.nsw.gov.au\/Infectious\/factsheets\/Pages\/seafood_poisoning.aspx"}],"container-title":["Communicable Diseases Intelligence"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www1.health.gov.au\/internet\/main\/publishing.nsf\/Content\/75F30C0D2C126CAECA2583940015EDE3\/$File\/Four_recent_ciguatera_fish_poisoning_incidents_in_New_South_Wales,_Australia_linked_to_imported_fish.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T18:35:09Z","timestamp":1749580509000},"score":1,"resource":{"primary":{"URL":"https:\/\/ojs.cdi.cdc.gov.au\/index.php\/cdi\/article\/view\/552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,1]]},"references-count":27,"URL":"https:\/\/doi.org\/10.33321\/cdi.2019.43.4","archive":["Portico","Portico","Portico"],"relation":{},"ISSN":["2209-6051"],"issn-type":[{"value":"2209-6051","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,1]]}}}