Fish and shellfish poisoning is a common but often unrecognized group of illnesses related to food which includes ciguatera, scombroid, and paralytic shellfish poisoning. Ciguatera is a food-related illness that causes abdominal and neurological symptoms. It is caused by eating fish that have a toxin called ciguatoxin, usually red snapper, grouper, and barracuda. Ciguatera is common on many of the islands in the Pacific Ocean. Most cases occur one to six hours after eating the contaminated fish. Initial symptoms are abdominal cramps, nausea, vomiting, or watery diarrhea. The most common symptoms involve the nervous system and include numbness and tingling around the lips, tongue, and mouth; itching; dry mouth; metallic taste in the mouth; and blurry vision. In more prominent cases, patients may complain of temporary blindness, a slow pulse, and a feeling of loose teeth. Patients may also have the strange...