An outbreak of ciguatera poisoning in a group of scuba divers

Eight people developed ciguatera poisoning on a scuba diving cruise in a remote atoll in the Coral Sea. Symptoms included abdominal pain, vomiting, diarrhea, weakness, difficulty breathing, headache, myalgia, arthralgia, hypotension, bradycardia, paresthesias and pruritus. The outbreak was diagnosed by physician passengers who treated the victims during the remainder of the cruise. Intravenous mannitol on the eighth day was of no benefit. Symptoms persisted for weeks to months. Divers should be aware of ciguatera and the similarity of symptoms to those of decompression sickness. A new immunochemical method of detecting ciguatoxins in fish will be available soon in the form of a test kit.