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A Study of the Disease in the US Virgin Islands

J. Glenn Morris, Jr, MD, MPHTM; Pamela Lewin, MD; Nancy T. Hargrett, PhD; C. Warren Smith, MD, MPH; Paul A. Blake, MD, MPH; Roy Schneider, MD

Arch Intern Med. 1982;142(6):1090-1092.

Abstract
• Clinical data were obtained on 33 patients involved in 27 episodes of ciguatera fish poisoning occurring during a 14-week period on St Thomas in the US Virgin Islands. All patients had gastrointestinal tract symptoms, with 30 patients (91%) complaining of diarrhea and 23 patients (70%) complaining of vomiting; these symptoms occurred early in the disease and were of short duration. Twenty-three patients (70%) complained of malaise, and 19 patients (58%) had pain and weakness in the lower extremities. Dysesthesias were noted by 19 patients (58%); the median duration of dysesthesias was two weeks or more, with symptoms present in some cases for more than two months. Cardiovascular signs and symptoms, including both hypotension and bradycardia were noted in some acute cases. Therapy included antidiarrheal and antiemetic agents, intravenous fluids, atropine, and pralidoxime chloride. Efficacy of pralidoxime therapy could not be established on the basis of our data.

(Arch Intern Med 1982;142:1090-1092)

Author Affiliations
From the Bacterial Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta (Drs Morris, Lewin, Hargrett, and Blake); and the Department of Health, the Virgin Islands of the United States, Charlotte Amalie, St Thomas, Virgin Islands (Drs Smith and Schneider). Dr Morris is now a fellow at the University of Maryland, Baltimore.

Footnotes
Accepted for publication Nov 2, 1981.

Reprint requests to the Enteric Disease Branch, Bacterial Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Morris).

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