Usually, the CP ”INCUBATION PERIOD”, i.e. the period between the consumption of toxic meal and the onset of symptoms, ranges from 6h to 12h, in most cases.
The FIRST SIGNS of the poisoning are generally characterized by the appearance of gastrointestinal disorders including abdominal cramps, nausea, diarrhea and/or vomiting which generally disappear after 24-48 hours.
Neurological manifestations can appear during these first hours (itching, headache, paresthesia, dysesthesia, etc.). A burning sensation or urogenital pain are also observed in some cases, from the first days.
On the cardiovascular level, cases of hypotension, bradycardia, changes in the T wave and, more rarely, tachycardia can occur from the first 24 to 48 hours.These attacks are generally associated with severe forms of intoxication.
Ciguatera does NOT cause FEVER. On the contrary, it may happen that during the first 24-48 hours following the poisoning, the patient presents a slight hypothermia, accompanied by chills.
Digestive disorders subside quickly, either spontaneously or in response to treatment.
A “STATE PHASE”, marked by the onset of pronounced rheumatological, general and neurological symptoms, such as parasthesia (tingling in extremities and the orofacial region) accompanied by dysesthesia and/or cold allodynia (causing burning sensations in contact with cold objects or liquid) is observed.
Unlike gastrointestinal symptoms, neurological symptoms may last for several weeks, months or even years.
Pruritis, dizziness, parasthesia, dysesthesia, ataxia, generalized weakness and mood disorders (i.e. depression…) are known to last for a longer period.
In addition to the main symptoms listed above, a generalized weakness evoking the Chronic Fatigue Syndrome (CFS) is also commonly reported in endemic ciguatera areas. This persistent weakness, is proposed as an explanation for the depressive tendencies observed in some patients, without excluding the possibility of a direct action of ciguatoxins on the central nervous system.