Frenette,-C.; MacLean,-J.D.; Gyorkos,-T.W.J.  A large common-
	source outbreak of ciguatera fish poisoning.
	-INFECT.-DIS. 1988. vol. 158, no. 5, pp. 1128-1131.

Ciguatera fish poisoning is being reported with increasing 
frequency in Canadian vacationers returning from the 
Caribbean. It is probably the most common form of poisoning 
resulting from eating fish in the tropics. The disease is due 
to the production of a toxin by a dinoflagellate, 
Gambierdiscus toxicus , that is found loosely attached to 
algae growing on coral reefs. The toxin, which is harmless to 
the fish, is ingested by small herbivorous fish and passed up 
the food chain by larger carnivorous fish. The toxin is heat 
stable and is found in the flesh of > 200 species of large 
fish, including grouper, barracuda, red snapper, amberjack, 
and kingfish. Several large case series have been reported in 
the literature, but most of these have been retrospective 
reviews of small outbreaks occurring over a period of several 
years. In the present study, the authors report a large 
outbreak of ciguatera fish poisoning among Canadian tourists 
in Cuba; the outbreak resulted from a single common fish meal 
eaten on 27 March 1987. The goals of their study were to 
determine the clinical spectrum and duration of disease and 
to estimate the morbidity associated with this outbreak.