Poisoning Fish Underlying Cause
Ciguatera poisoning is caused by eating reef fish that contain a toxin. Fish consume the toxins, which are produced by algae that live in tropical ocean waters. Large reef fish (over 5 lbs.) are more likely to contain this toxin.
Reef fish include:
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- Isbister GK, Kiernan MC. Neurotoxic marine poisoning. Lancet Neurol. 2005 Apr;4(4):219-28. 
- Lewis RJ. The changing face of ciguatera. Toxicon. 2001 Jan;39(1):97-106.