Large outbreaks of ciguatera after consumption of brown marbled grouper.
Large outbreaks of ciguatera after consumption of brown marbled grouper.
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DOI：
10.3390/toxins6072041
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发表时间：
2014-07-11
期刊：
影响因子：
4.2
通讯作者：
Chan TY
中科院分区：
文献类型：
--
作者：
Chan TY
棕斑石斑鱼（Epinealphus fuscoguttatus）是一种生活在印度洋-太平洋地区珊瑚礁的顶级捕食者。所有五个已发表的案例系列的雪卡毒素后，消费棕色大理石石斑鱼进行了审查，以表征类型，严重程度和慢性的雪卡毒素症状与消费。这些病例系列中有三个来自大规模爆发，影响了100-200名在宴会上食用这种珊瑚鱼的受试者。受影响的受试者通常会出现胃肠道、神经系统和心血管症状（不太常见）的组合。胃肠道症状出现较早，一般在1-2天内消退。一些神经系统症状（例如，四肢感觉异常）可持续数周或数月。窦性心动过缓和低血压发生较早，但可能严重且持续时间较长，需要及时使用静脉输液、阿托品和多巴胺。其他心血管和神经系统特征包括心房异位、心室异位、呼吸困难、胸闷、PR间期>0.2 s、ST段改变、多发性肌炎和昏迷。同时饮酒与发生心动过缓、低血压和皮肤感觉改变的风险高得多相关。市民应明白进食高风险鱼类（特别是富含雪卡毒素的部分，以及同时饮酒）及反复接触雪卡毒素，会引致更严重及慢性的疾病。
Brown marbled grouper (Epinephelus fuscoguttatus) is an apex predator from coral reefs of the Indo-Pacific region. All five published case series of ciguatera after consumption of brown marbled grouper were reviewed to characterize the types, severity and chronicity of ciguatera symptoms associated with its consumption. Three of these case series were from large outbreaks affecting over 100–200 subjects who had eaten this reef fish served at banquets. Affected subjects generally developed a combination of gastrointestinal, neurological and, less commonly, cardiovascular symptoms. Gastrointestinal symptoms occurred early and generally subsided in 1–2 days. Some neurological symptoms (e.g., paresthesia of four limbs) could last for weeks or months. Sinus bradycardia and hypotension occurred early, but could be severe and prolonged, necessitating the timely use of intravenous fluids, atropine and dopamine. Other cardiovascular and neurological features included atrial ectopics, ventricular ectopics, dyspnea, chest tightness, PR interval >0.2 s, ST segment changes, polymyositis and coma. Concomitant alcohol consumption was associated with a much higher risk of developing bradycardia, hypotension and altered skin sensation. The public should realize that consumption of the high-risk fish (especially the ciguatoxin-rich parts and together with alcohol use) and repeated ciguatoxin exposures will result in more severe and chronic illness.
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影响因子：
2.8
作者：
Oshiro, Naomasa;Yogi, Kentaro;Inafuku, Yasuo
通讯作者：
Inafuku, Yasuo
影响因子：
2.8
作者：
Stewart, Ian;Eaglesham, Geoffrey K.;Shaw, Glen R.
通讯作者：
Shaw, Glen R.
影响因子：
2.8
作者：
Dickey, Robert W.;Plakas, Steven M.
通讯作者：
Plakas, Steven M.
DOI：
10.4269/ajtmh.1993.49.448
发表时间：
1993-10-01
影响因子：
3.3
作者：
KATZ, AR;TERRELLPERICA, S;SASAKI, DM
通讯作者：
SASAKI, DM
影响因子：
2.8
作者：
GLAZIOU, P;MARTIN, PMV
通讯作者：
MARTIN, PMV