Ciguatera fish poisoning is on the rise with more than ten cases reported between the end of June and mid-July.

A spokesman said the health ministry’s Epidemiology and Surveillance Unit had received 13 reports between June 29 and July 17 — up from four reported cases for 2018 as of July 6. The news came as the ministry and Department of Environment and Natural Resources provided an update on the most recent outbreak and reminded the public about key facts of CFP.

The spokesman explained: “Between June 29 and July 17, the Epidemiology and Surveillance Unit of the Ministry of Health received 13 reports of CFP.

“The fishes implicated in this outbreak were large amberjacks and barracuda. However, it should be noted that large yellow jacks and cubera snappers have been implicated in past cases of CFP in Bermuda.

“Yellow jack and amberjack may both be mistaken for the almaco jack, which is locally called ‘bonita’. Almaco jack/bonita has not been implicated in any CFP cases in Bermuda.”

Ciguatera fish poisoning is caused by toxins from microscopic marine plants that build up in large predatory fish.

Symptoms, which can appear as little as one hour after eating toxic fish, include diarrhoea, itchy skin, numbness, burning skin, nausea, vomiting, pain to limbs and fatigue or weakness.

The reversal of hot and cold sensations, which is absent in other types of fish-related food poisoning, is also a telltale sign.

The spokesman explained that CFP does not change the taste or smell of a fish, and it is not affected by cooking or freezing and there is no simple detection test.

He added: “Whether or not an individual fish contains CFP toxins depends on the type and quantity of food that fish has eaten, as well as the prevalence of toxin-producing plants in the area where it has been feeding, so it is difficult to predict CFP risk.

“An older or larger predatory fish that has eaten many herbivorous fishes over a period of time has a greater risk of carrying CFP toxins than a younger or smaller fish of the same species.

“The fish themselves are not affected by the toxin, and the handling of the fish (ie, how it was processed and stored post-catch) does not affect the presence of the toxin.”

In a statement earlier this month, the health ministry said a total of four cases had been reported this year. It pointed out there was one case in 2017 and 20 in 2016.

The spokesman for the health ministry said yesterday: “ESU and the DENR will continue to collaborate to investigate any new reports of CFP and will provide an update if there are any ongoing concerns.

“If you or someone you know has experienced or may have experienced the symptoms listed above, contact your physician.”