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To the Editor.—
Ten people ingested a presumed ciguatera-affected fish. Eleven people developed clinical symptoms of ciguatera fish toxicity.The 11th victim was a 4-month-old breast-feeding infant. He was nursed approximately 1 hour and 3 hours after his mother's fish meal.A large kingfish was caught at Cay Sal Bank in the Bahamas. The infant's mother and all other nine who ingested the fish developed the classic symptoms of ciguatera toxicity. This included vomiting, diarrhea, and abdominal pain approximately 14 hours after ingestion of the kingfish. Within a few hours, tingling and numbness, pin-prickling sensation of the hands and feet, and reversal of cold-hot sensory discrimination, typical of ciguatera poisoning, were noted in all 10. In addition, most developed joint and muscle pain, generalized myalgia, dizziness, intense pruritus, and weakness in the legs.Approximately 10 hours after the infant was first breast-fed following his mother's kingfish meal, he became "colicky"
Blythe DG, de Sylva DP. Mother's Milk Turns Toxic Following Fish Feast. JAMA. 1990;264(16):2074. doi:10.1001/jama.1990.03450160042019