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In November 2012, the GIZ-Nord Poisons Center was consulted 11 times on cases of poisoning after ingestion of RED SNAPPER (Lutjanus malabaricus), purchased from different shops of a single trade chain in six different cities of northern and central Germany. In total, 11 patient that have eaten the fish on 2012-11-07 or few days later developed poisoning symptoms:

All patients suffered from nausea, vomiting and diarrhea, typically starting about four hours after the dish. Concomitantly paraesthesia of hands and feet and dysfunctional temperature perception developed. The latter symptoms lasted - with decreasing intensity - for 3 weeks and longer. Furthermore, most patients complained of sleeping disorder, myalgia (muscular pain), and general weakness.

Based on the very characteristic symptoms CIGUATERA POISONING was diagnosed early in most, but not in all cases. Analytical confirmation is in progress.

The symptoms of Ciguatera poisoning are caused by ciguatoxins, synthesized by dinoflagellates on coral reefs, that are ingested by edable fish, e.g. Red snapper.

Local food surveillance authorities, the trade chain and the importer were informed an the fish was withdrawn from the market:

http://www.welt.de/regionales/hamburg/article110985874/Mit-Biogift-belastete-Fische-werden-zurueckgerufen.html

The is no specific treatment for Ciguatera poisoning, all patients were treated symptomatic.

To our knowledge, this is the first occurence of Ciguatera in Germany and is caused by fish imported from tropical areas.

Further Information on Ciguatera of theUniversität Erlangen-Nürnberg (in German):
* http://blogs.fau.de/news/2012/09/14/kalteschmerz-nach-fischgenuss/