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Fish ciguatera poisoning

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Ciguatera poisoning is a form of food poisoning. It is caused by eating warm water finfish that carry ciguatera poison (toxin). Small plant-eating fish eat toxic algae and in turn are eaten by larger, predatory fish, like Spanish Mackerel.

What are the symptoms?

Symptoms usually start 1 to 24 hours after eating a toxic fish. The time before onset of illness and the range of symptoms can depend on how much fish is eaten, which parts of the fish are eaten, how much toxin is in the fish and the individual susceptibility of the consumer.

Symptoms include:

  • sensation of hot-cold temperature reversal. This can include a burning sensation or skin pain on contact with cold water or a stinging sensation when drinking water
  • tingling and numbness in fingers, toes, around lips, tongue, mouth and throat
  • burning sensation or skin pain on contact with cold water
  • joint and muscle pains with muscular weakness
  • nausea, vomiting, diarrhoea and/or abdominal cramps
  • headache, fatigue and fainting
  • extreme itchiness, often worsened by drinking alcohol
  • difficulty breathing in severe cases.

How can you minimise the risk of ciguatera poisoning?

We know that ciguatera toxin does not affect the appearance, odour or taste of fish and that processes like cooking or freezing will not destroy the toxin and there is no method for removing it from the fish. There are some simple rules that can be followed to reduce the risk of exposure to ciguatera toxins:
  • avoid cooking and eating the head, roe, liver or other viscera of warm water ocean fish as ciguatera toxin is concentrated in these parts and may increase exposure
  • vary the type of warm water fish eaten
  • avoid eating large warm water fish such as Spanish Mackerel (in accordance with NSW industry experts) as ciguatera fish poisoning occurs more frequently when larger fish are eaten. Cases of poisoning from Spanish Mackerel caught in NSW waters have generally been linked to fish over 10kgs.
  • If ciguatera‐like symptoms develop when eating a warm water ocean fish, do not eat further portions of that fish and see your doctor
  • do not catch fish from known or high-risk ciguatera areas
  • ciguatera is more common in the warmer northern waters of Queensland and parts of the Northern Territory


Promptly seek medical attention from a hospital or GP at the onset of symptoms. If you are concerned about ciguatera poisoning contact your Local Public Health Unit on 1300 066 055 or if you would like further information contact the NSW Food Authority helpline on 1300 552 406 or

For more detailed information, access the Ciguatera Poisoning factsheet

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