Fish poisoning

Ciguatera and pufferfish (or tetrodotoxin) poisoning are the two main types of poisoning that may occur after eating certain types of fish from Australian waters.
The symptoms for both can include weakness in the limbs and joints, headache, tingling and numbness of the extremities, reversal of hot versus cold sensations, nausea, vomiting, stomach pain, diarrhoea, breathing difficulties, and tightness or pain in the chest. In cases involving pufferfish, symptoms are likely to be more severe and rapid in their onset than they would be with ciguatera poisoning.

Muscle pain and cramping are features usually more associated with ciguatera poisoning, while very severe symptoms, combined with profuse sweating, dizziness, decreasing body temperature, low blood pressure, and reduced pulse rate are associated more with ingestion of pufferfish. Although often very debilitating, ciguatera poisoning rarely causes death. Severe cases of pufferfish poisoning however often lead to mortality.

The amount of toxin ingested and thus the severity of the poisoning will depend on which parts of the fish were eaten, the size of the portion and how it was prepared. The toxin is most concentrated in the gonads, liver, viscera and skin, but may also be found in the flesh. The toxin is heat stable and partially water soluble, so cooking does not reduce toxicity and soup made from the fish is likely to contain substantial amounts of toxin.
