CHCC warns of ciguatera fish poisoning in the CNMI

Posted on Jul 20 2020


The Commonwealth Healthcare Corp. is seeing an increase in ciguatera fish poisoning cases due to the consumption of the local red snapper.

CFP is a common food-borne illness related to the consumption of certain species of fish that have been contaminated with plankton (algae)-derived toxin associated with coral reefs. The ciguatera toxin is non-detectable as it does not harm the fish and is unrecognizable when consumed. Unlike other food-borne illnesses, CFP is not transferred from cross-contamination due to inadequate food handler hygiene, food preparation, cooking, handling, and storage. In addition, the ciguatera toxin can withstand cooking and freezing temperatures and is not preventable if the fish species already harbors the toxin.

Common symptoms of CFP are as follows:

-Nausea, vomiting, diarrhea, muscle weakness, joint aches, headache, dizziness, tingling or numbness, itching, sometimes chills or sweating, dental pain, and low blood pressure.

-A characteristic symptom is “hot-cold reversal”; hot items feel cold and cold items feel hot.

Symptoms may appear within 15 minutes to 24 hours after consuming an infected fish. Most individuals who experience symptoms feel better in a few days to a week, but in some cases, symptoms have lasted for months and sometimes years.

Individuals experiencing symptoms of CFP are urged to seek medical attention as prompt treatment can reduce the severity of symptoms, especially those with underlying medical conditions.

Fish associated with CFP

More than 400 species of fish are associated with CFP. The most common are older, larger fish that have been eating contaminated fish during their lifespan, including (but are not restricted to): barracuda, grouper, jack, hogfish, mackerel, snapper. There is no specific prevention except to eat fish smaller than about 4-6 lbs.

CHCC prepares weekly surveillance reports on communicable diseases to share with community partners to prevent and control any emerging or re- emerging diseases that may pose a threat to the CNMI community.

For more information, contact the CHCC Emergency Preparedness Program at (670)234-8950 or visit

For more information on food-borne illnesses, or about the inspections, contact the Environmental Health and Disease Prevention at 670-664-4870/2/3 or email, (PR)

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