Ciguatera Poisoning from Grouper – Tropical Delicacy turns into Tropical Nightmare
This is not what I thought my first post of the year was going to be. I discovered three recipes in the Dominican Republic that I wanted to share with you, one of which I never will. It was going to be a recipe for coconut crusted grouper. I’ll never be able to eat grouper again, and after you read this, I think that you should consider not eating it as well to protect yourself, family and friends from ciguatera poisoning.
Grouper is a tropical reef fish. It swims at the top of the food chain in the warm waters of the Caribbean and many other warm water areas of the world. Top of the food chain means that it eats smaller fish, which eat even smaller fish, and some of those smaller fish at the bottom of the chain eat an algae called Gambierdiscus toxicus. This algae is toxic to humans. It stays in the flesh of the large predator fish and does not affect them, BUT, if you eat the meat of a fish that has eaten one of the smaller fish that have eaten the algae…you’re in trouble. I’m in trouble. I ate some grouper for lunch that contained the toxin. Within 20 minutes I was affected, and within 6 hours I was sick as the proverbial dog. Unlucky for me, I was on a plane back to Chicago when the first onset of the symptoms really hit.
Everyone wants to be really ill on a plane, right? By the time we got off the plane, I was feeling faint. Dana raced to get me a cold bottle of water. I started drinking it and realized something was horribly wrong. The water felt like it was burning my mouth! Touching the cold bottle of water was burning my hands…”Oh my God”, what was happening to me?
The burning, itchy rash did not appear till the next morning…by that time the upset stomach part was subsiding, but these other problems…what was going on? I called my internist and he recommended Imodium and Pedialyte. As to the other bizarre symptoms, he said that he had no idea and that I should concentrate on stopping the diarrhea. This was discouraging to say the least, so I did what you might do…I Googled the symptoms and dug deeper and deeper and found something that fit those symptoms exactly…AND I had eaten grouper right before I fell so ill.
The reason that my doc had no idea is because this is a fairly unknown disease in the U.S. except for South Florida, BUT, it’s getting more prevalent in our country as more fish species are being imported and waters around the world are becoming warmer. It’s not only grouper that has the potential to give you ciguatera. Other culprits besides black, yellowfin and dusty grouper are: barracuda, amberjack, king mackerel, cubera snapper, dog snapper and hog fish. There is no way to tell if a fish has been affected. It looks the same, smells the same, and tastes the same and the poison is not affected by cooking.
I’m miserable. I itch and burn (cold feels hot and hot feels cold) and am listless, but I have it a lot better than some folks. Some of the more severe symptoms are: difficulty walking, insomnia, severe pain in your legs and feeling that your teeth are falling out…yikes!
The worst part of the whole thing is there is NO cure. There is no way to determine just how long you will be affected, some people rebound within weeks, others months or years and sadly, some people never recover…no cure and you never recover! There is one treatment that lessens symptoms and that is taking Mannitol within the first 48 hours intravenously. My doc had no idea to do that…he had no idea what my bizarre symptoms meant…he’s in Chicago, for God’s sake, not the Caribbean.
So, while I wait for my nerve fibers to (hopefully) regenerate, I have eliminated all of the triggers from my diet that might bring back severe symptoms: fish, alcohol, nuts, chicken, pork (seems that chicken and pork eat products made from fish, who knew?) I’ve actually decided to use this as a springboard to better health. I’m concentrating on eating a very healthy diet and I’m getting lots of info from my uber healthy daughter, Dana (who’s working on a degree in nutrition.) No sugar, white flour, processed foods, caffeine, red meat…if I didn’t feel so darn miserable, I might be feeling very good…as it is, I just feel listless.
I’m making up new recipes as I’m going along on this journey that I’ll be sharing with you soon…maybe you can kick start a better diet without going through this discomfort to get there.
Please share this information with those you love. Many of us travel to warm water destinations, I want you all to come home with good memories, not ciguatera!
If you would like to read more information about ciguatera written in a more scientific way, you can read this from the Centers for Disease Control and Prevention and also this warning from the World Health Organization. Still want more? Here is a very comprehensive essay by Professor J. Pearn, Graduate School of Medicine, University of Queensland, Australia on the neurology of ciguatera.
In our hectic world, most of us can't commit to having dinner with our family/friends every night, but maybe we can start to put aside Sunday to be together and share our lives and good food. Let's join together to inspire others to celebrate our old traditions and create new ones. 
Elizabeth — Tuesday, January 21, 2014 @ 7:10 am
Thank you so much for sharing and educating all of us. Will certainly avoid those fish from now on. Hope that your symptoms continue to get better.
Susie replied: — January 21st, 2014 @ 11:48 am
Thanks so much for your concern! I really hope that this post lets folks know of the real danger that grouper poses to our health.
Carol Sacks — Tuesday, January 21, 2014 @ 8:12 am
Oh Susie, I’m so so sorry to hear about this. Sending healing thoughts and energy your way and hoping that you feel better soon. Take good care!
Susie replied: — January 21st, 2014 @ 11:42 am
Thanks so much for your kind thoughts, Carol!
Laura — Tuesday, January 21, 2014 @ 9:03 am
Oh my goodness, I am so sorry this happened to you Susie! I’ll keep you in my prayers for a quick recovery. Thank you for sharing the unfortunate news with us; will definitely pass on. I look forward to your healthy recipes!
Susie replied: — January 21st, 2014 @ 11:43 am
Thanks so very much!
Stephanie, The Recipe Renovator — Tuesday, January 21, 2014 @ 9:24 am
Oh Susie, what a nightmare. I am SO sorry. I hope that you recover quickly. It sounds like giving your body the healthiest of foods is your best course. I think everything on my website would be okay for you (except my recipes containing nuts), if you need more ideas. Thank you for sharing your story to help others.
Susie replied: — January 21st, 2014 @ 11:45 am
Thanks Stephanie! I’ll be reading your posts for delicious and appropriate recipes.
Juleee — Tuesday, January 21, 2014 @ 11:16 am
Oh Susie — how awful! I feel sick reading it. Hope you get back to good health soon!
Susie replied: — January 21st, 2014 @ 11:46 am
Thanks Juleee! This a a crazy illness that I hope no one else I know has to endure.
Nancy Berg — Tuesday, January 21, 2014 @ 11:22 am
Hi Sue,
It’s hard to believe this could happen to you; I didn’t know that such a thing existed! Hopefully your symptoms will go away soon and you will be able to get back to normal. You have shown great strength in writing this post when you feel so rotten. We will keep you in our prayers. xo
Susie replied: — January 21st, 2014 @ 11:50 am
Thanks Nancy! If I can prevent one other person from getting this horrible illness, I’ll be happy.
Wendy Read — Tuesday, January 21, 2014 @ 5:43 pm
Oh my goodness Susan! I have never heard of this (and I live in Florida) and I am so very sorry this happened to you!! Grouper is s very popular here, in most of the restaurants, I just feel awful for you. I am wishing you a speedy recovery and thank you so much for posting up your experience.
Susie replied: — January 22nd, 2014 @ 7:37 am
I know! Ciguatera is not found in all grouper, BUT the problem is becoming more wide spread, especially as the water becomes warmer. The algae that produces the toxin is found in warm water, not cold. I had grouper many times while we were away but it was the last piece that got me. Believe me, if I can prevent this happening to anyone else, I will be happy because having this is miserable…and I don’t even have a severe case!
Bunkycooks — Tuesday, January 21, 2014 @ 6:03 pm
I am so sorry to hear that this happened to you. Our food supply is terribly frightening and it’s so sad that we can’t enjoy our meals without worrying about what might happen to us when we eat them. I have never heard of this particular toxin, but will definitely share as I have relatives who travel to South America and eat seafood all the time. I wish you the best of luck for a full recovery.
Gwen
Susie replied: — January 22nd, 2014 @ 8:19 am
Thanks so for your comment Gwen! The more I learn about Ciguatera the more I want to warn everyone of the possibility of eating toxic grouper…it is more prevalent in the Caribbean and other warm water areas (such as Australia) but it is being imported here and the illness is showing up in areas of our country as well, especially Florida. As the temperatures of the oceans rise, the toxic algae will grow in more areas of the world.
Tina Aiello — Saturday, January 25, 2014 @ 1:58 pm
Oh Susie,
I am sooo sorry this has caused you to be sooo sick! If you want to try some integrative medicinal help, I have a wonderful doctor here in Glenview, Dr Temple Mendoza. She is head of integrative medicine for North Shore University Health System. She is wonderful. Maybe she could help you? I have truly benefited from her wisdom after shingles! (fatigue).Hope you are getting better everyday!
xo Tina
Carol H — Sunday, February 2, 2014 @ 4:37 pm
I am so sorry you are going through this. I had heard of this while on vacation in Tahiti a few years ago and forgot all about it…….thank you so much for the reminder! I didn’t realize it was on this side of the world as well. It is so kind and thougthful of you to try and help prevent this in others, but I had a feeling you were that kind of person. I hope yours is a short recovery, please keep us posted.
Susie replied: — February 3rd, 2014 @ 11:31 pm
Thank you so much for your very kind comments. I am feeling better and look forward to sharing my journey back to health.
Yesi — Monday, March 17, 2014 @ 11:24 am
hi I’m Dominican, I’m sorry you them sick. I hope’re better.
Dannielle — Saturday, March 22, 2014 @ 5:50 am
Greetings! I know this is kinda off topic but I was wondering if you knew where I could locate a captcha plugin for my comment form?
I’m using the same blog platform as yours and I’m having trouble finding one?
Thanks a lot!
Kathy A — Saturday, April 19, 2014 @ 7:51 am
Your photos are beautiful!