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Why isn't our government putting out warnings about Ciguatera? I have learned a lot about ciguatera and polymyosits as well as CFID the past two years. The symptoms range from stomach cramps and diarrhoea to difficulty breathing. The medical world in France isn't concerned either, while there is a huge social and medical issue comparable to malaria. Ciguatera ist eine häufige Art von Fischvergiftung, die in unregelmäßigen Abständen vor allem in tropischen und subtropischen Meeresgebieten zwischen 35° nördlicher und 35° südlicher Breite epidemisch auftritt und durch den Genuss von Speisefischen hervorgerufen wird. Ciguatoxin is one of the most potent marine toxins. Figure 1. It has helped me and I also take Vistaril as needed it helps with the itching and also helps with pain. Hang in there, fellow cigs. I have high/low bp, high cholesterol, pre diabetic. I had severe diarrhea for five days and felt terrible really. When ingested, the toxin (ciguatoxin), which is present at high levels in these contaminated fish, may affect the digestive, muscular, and/or neurological systems. Where Does Ciguatera Occur? Seit einigen Jahren treten jedoch auch in Europa vermehrt Ciguatera-Fälle auf. What is ciguatera? --Judy. Cases Mackerel caught in NSW waters have generally been linked to fish over 10kgs. Ciguatera is a form of food poisoning which is caused by ingestion of ciguatoxin, a toxin present in certain tropical fish. Good luck all! What are the Symptoms of Ciguatera Poisoning? he toxins accumulate in the tissues of marine ish and invertebrates that eat the dinolagellates and produce the poisoning when they, in turn, are consumed by humans and other animals. I became ill in 2008 after eating grouper in south florida that my wife purchased at a fish market. Ciguatera toxin is concentrated in these parts and may increase exposure vary the type of warm water fish eaten avoid eating large warm water fish such as Spanish Mackerel (in accordance with NSW industry experts) as ciguatera fish poisoning occurs more frequently when larger fish are eaten. People can get ciguatera poisoning by eating normally safe, bottom-feeding, coral reef fish that have collected the poison from the food chain. Ciguatera occurs in marine waters near tropical reefs. Ciguatera testing is available through the University of Hawaii. We are now eating very carefully as it seems to be triggered by some food. You can get ciguatera (sig-wah-TARE-ah) by eating fish contaminated with toxins produced by tiny algae found around coral reefs. As I type this my entire left side is numb, my face is numb, my lips are numb, and the headaches are awful. What is ciguatera? There I received Mannitol infusions interspersed with normal saline, for 36 hours. Ciguatera poisoning is the most common nonbacterial fish-borne poisoning in the United States. When ingested, the toxin (ciguatoxin), which is present at high levels in these contaminated fish, may affect the … The doctor came in shortly after and told me I was in complete kidney failure. [2], Dieser Artikel behandelt ein Gesundheitsthema. Ever since she began contributing to the site several years ago, Mary has embraced the The world needs to know! Myself I have had severe headaches, neuropathies, daily nausea, just to name a few. pelican/ Flickr This toxin is produced by some types of algae and when fish feed on them or on other fish that have consumed them; they accumulate it in their organism. The name ciguatera is derived from the Spanish name cigua for the sea snail Turbo pica found in the Caribbean Spanish Antilles. Als typische Auswirkung des Nervengifts zeigt si… Wikibuy Review: A Free Tool That Saves You Time and Money, 15 Creative Ways to Save Money That Actually Work. The toxin remains in your body stored in your fat tissue. The temperature has not changed. The toxin gave me a peripheral neuropathy in my extremities causing numbness and pain, and I now live with extreme fatigue. Ciguatera fish poisoning is a rare disorder that occurs because of the ingestion of certain contaminated tropical and subtropical fish. Are all these illnesses caused by the the ciguatoxin in my body? Such poisoning from ciguatoxins is known as ciguatera. [2] Die Letalität bei Menschen, die an Ciguatera erkranken, liegt bei etwa 0,1 Prozent.[1]. During that trip I ate a large portion of fish that was tainted with Ciguatera toxin. They say that for most people the symptoms only last a few weeks to a couple of months, but in my case it has lasted over 11 months. In Pepperell's case, "a weird thing I experienced for the next several months was a sensation when I stood up and took a few steps — I felt as if I'd stepped into a hole, so my body didn't seem to register that my feet were actually making contact with the … From most articles that I have come across, they state that most symptoms subside within days or weeks. It is caused by eating fish contaminated with ciguatoxins which are produced by dinoflagellates – small marine organisms living on or near coral reefs – belonging to the species Gambierdiscus toxicus. Er dient, https://de.wikipedia.org/w/index.php?title=Ciguatera&oldid=202810375, „Creative Commons Attribution/Share Alike“, Toxische Wirkung schädlicher Substanzen, die mit essbaren Meerestieren aufgenommen wurden. People never heard about ciguatera here and actually many (local) people fish here and eat a lot of it. Die Beschwerden, teilweise mit charakteristischen neurologischen Symptomen, wie eine schmerzhafte Kälteüberempfindlichkeit (Kaltallodynie), die beim Kontakt mit normalerweise angenehm kühler Luft oder beim Schlucken von kalter Nahrung oder von Kaltgetränken auftreten kann,[5] können über Wochen und gelegentlich über Monate anhalten. Dieses Gift stammt von einem Einzeller, der auf Meeresalgen lebt und so in die Nahrungskette gelangt. Ciguatoxin is often subject to biomagnification, becoming more concentrated as it moves up the food chain, and since people often eat fish which are high on the food chain, they can be at risk of ciguatera poisoning. This kept us stable for two days. Is Ciguatera transmitted from person to person? fr. The French West Indies, as well as the French Polynesian islands populations are in danger because of the coral population but French government doesn't really care. However, today we both again have that toxic feeling, cramps, headaches and fatigue. I, too, have been diagnosed with ciguatera after spending 16 days in Costa Rica and eating lots of fish, thinking that was healthy eating. Ciguatoxin is tasteless and odourless. There are apparently no tests, and no cures...Somebody help me understand this better! Ciguatera fish poisoning is a human illness cause by eating tropical and subtropical fish that are contaminated with ciguatoxins, which are produced by tiny microalgae of the genus Gambierdiscus. This information is courtesy of Lora E. Fleming, NIEHS Marine and Freshwater Biomedical Sciences Center The most commonly reported marine toxin disease in the world is Ciguatera, associated with consumption of contaminated reef fish such as barracuda, grouper, and snapper. I got Ciguatera in 1994 and have been on many different medications over the years. Courtesy of the Queensland Health Department, a full list of the symptoms is: • Tingling and numbness in fingers, toes, around lips, tongue, mouth and throat It was reported in the West Indies by Peter Martyr de Anghera in 1511, in the islands of Indian Ocean by Harmansen in 1601 and in the various archipelagos of the Pacific Ocean by De Quiros in 1606. I always feel off balance and light headed. I saw someone else mentioning Costa Rica, where exactly? Armstrong P, Murray P, Nesdale A, Peckler B. Ciguatera fish poisoning. Fish is *not* healthy and should be removed from everyone's diet immediately. Ciguatoxins are a class of toxic polycyclic polyethers found in fish that cause ciguatera. [2], Die seit 20 Jahren belegte Steigerung der Fallzahlen im Gebiet von 20 pazifischen Inseln wird zurückgeführt auf direkt oder indirekt durch Menschen verursachte Störungen und Zerstörungen der Umwelt, insbesondere durch Zyklone sowie durch ausbleichende („Korallenbleiche“) und zerstörte Korallenriffe.[2]. Ciguatera is form of food poisoning caused by toxins produced by dinolagellates, a large group of protists that occur in marine and fresh water habitats. People with experience in Ciguatera help solve this question. cigua, sea… Ciguatoxin acts on the gastrointestinal tract, causing cramping, vomiting, diarrhea, and similar symptoms. I have contracted the disease in French West Indies where I worked and live. Historical . Good luck, I ate some fish off the coast of Zanzibar, red snapper or Jack fish. Ciguatera is a problem in tropical areas around the world. Ciguatera ist eine häufige Art von Fischvergiftung, die in unregelmäßigen Abständen vor allem in tropischen und subtropischen Meeresgebieten zwischen 35° nördlicher und 35° südlicher Breite epidemisch auftritt und durch den Genuss von Speisefischen hervorgerufen wird. Supportive care is usually the focus of treatment for ciguatera. Well it's been ten months now since I ate this fish and I am still experiencing the effects of it. View abstract. Have your vitamin D and calcium checked - blood calcium even 1 point over the range is not good. Muscular aches, peculiar pains and lethargy still haunt me. I have been admitted to the hospital a couple more times, and have made several trips to the ER for the headaches. You do not become immune to ciguatoxins. I have very little reflex action in my right ankle/foot, and a decreasing reflex in my left. In Deutschland ist die Methode zum Nachweis von Ciguatoxin bislang (2017) nicht etabliert. Ciguatera toxin is a heat-stable lipid soluble compound, produced by dinoflagellates and concentrated in fish organs, that can cause nausea, pain, cardiac, and neurological symptoms in humans when ingested. It continued for one week. The ciguatera toxin may be found in large reef fish, most commonly barracuda, grouper, red snapper, eel, amberjack, sea bass, and Spanish mackerel. This also concurs with the pain I have been feeling in my kidneys. DK. Ciguatera fish poisoning is the most common non-bacterial illnesses associated with fish consumption. This toxin appears to originate in dinoflagellates, microscopic organisms found throughout the ocean. Ciguatera definition is - poisoning caused by the ingestion of various normally edible tropical fish in whose flesh a toxic substance (such as one produced by some dinoflagellates) has accumulated. Sie entsteht durch den Verzehr verschiedener Fische, die normalerweise ungiftig sind, aber mit der Nahrung eine besondere giftige Substanz aufnehmen können, die sich in ihrem Gewebe ansammelt. Anyone with Ciguatera should be in the care of a Neurologist. Nur in tropischen und subtropischen Ländern können Fische das auslösende Ciguatoxin enthalten. Nothing is done, while huge money was spent over the Flu A. He immediately reached for his book on tropical poisons. Why? I woke at around 1 a.m. with diarrhea, and noticed when I washed my hands that the cold water tingled. My GP is giving me B12 injections monthly in the hope that the residual symptoms will not worsen. In Pepperell's case, "a weird thing I experienced for the next several months was a sensation when I stood up and took a few steps — I felt as if I'd stepped into a hole, so my body didn't seem to register that my feet were actually making contact with the … I started Neurontin in 2009 with 300mg 3 x per day and went up to 1200mg then 2400mg then 3600mg. A sub symptomatic load might go unnoticed and only come to your attention when you get another dose of ciguatera that triggers the symptoms. Ciguatoxin is tasteless and odourless. I have seen a neurologist who did MRIs and then diagnosed me with ciguatera because of the history I gave him, the rapid onset and relentless symptoms. CIGUATERA … --JohnBit. I recently received SSDI for chronic ciguatera and anxiety caused by chronic ciguatera. My spine ached from the base of my skull to the coccyx. Ciguatera is a food-borne illness caused by eating reef fish contaminated with a toxin called “ciguatoxin”. It is caused by toxins that accumulate in the flesh of large predatory fish found in tropical oceans. I have bouts with nausea most days. Nach 1 bis 24 Stunden (meist 5 bis 6 Stunden) entwickeln sich – nicht bei allen Personen – Hautausschläge, Taubheitsgefühl in Lippen und Mundschleimhaut, Durchfall, Bauchschmerzen, Übelkeit und Erbrechen. While CFP has been known for centuries, its true incidence remains unclear; few years ago, it was estimated that 10000–50000 people per … If you have not seen a neurologist yet you should do so. It's just mierable. Ciguatera is a disease caused by the consumption of fish that is contaminated with ciguatoxin. Mary has a liberal arts degree from Goddard College and I experience the bad headaches at least three to four times a week. Unfortunately I believe I'm the exception to that belief. My heart rate felt like it had tripled, my hands and feet had gone numb and I had sharp spiking pain shooting through my extremities. Die Bezeichnung der Fischvergiftung leitet sich von dem auf Kuba gebräuchlichen Namen „cigua“ für die Schnecke Cittarium pica ab, die zunächst irrtümlich als Ursache der Erkrankung angesehen wurde. Ciguatera is a type of food poisoning. Eine spezifische Therapie oder ein Antidot existieren bislang nicht. Over three years later, I am still experiencing dizziness, tightness in my throat, hands go numb and cold and fatigue. They initially drew some blood and gave me medication for the nausea, and Dilodid for my extreme headache. Ciguatera is a poison that can accumulate in certain fish. Eur J Emerg Med 2001;8(4):295-300. A sub symptomatic load might go unnoticed and only come to your attention when you get another dose of ciguatera that triggers the symptoms. Courtesy of the Queensland Health Department, a full list of the symptoms is: Peace and love! The ciguatera toxin. of Health Aquatic Toxins Program. My symptoms began on our flight home in mid-May and have *not* ceased, except when I'm sleeping. People who have ciguatera may experience nausea, vomiting, and neurologic symptoms such as tingling fingers or toes. Ciguatera toxins Only us who have ciguatera know the extent of the agony because the symptom are so varied and often indescribable. I have seen a neurologist who has been helpful. The symptoms range from stomach cramps and diarrhoea to difficulty breathing. Ciguatera fish poisoning (or ciguatera) is an illness caused by eating fish that contain toxins produced by a marine microalgae called Gambierdiscus toxicus. Diese Giftstoffe entstammen Dinoflagellaten – bestimmten Geißeltierchen (Flagellaten) wie Gambierdiscus toxicus – die auf Algen und Seetang von Korallenriffen epiphytisch leben. Ciguatera is a type of food poisoning caused due to the consumption of fish infected with a marine toxin called Ciguatera toxin. here are various … Die Vergiftung entsteht durch den Verzehr von an sich ungiftigen Fischen, die mit dem natürlichen Giftstoff „Ciguatoxin“ belastet sind. Ciguatera is common in many areas of the Caribbean, Indian Ocean and Pacific. Ciguatoxins are lipophillic , able to cross the blood brain barrier, and can cause both central and peripheral neurologic symptoms. I have gone to doctors stating I feel miserable. Ciguatera fish poisoning is a rare disorder that occurs because of the ingestion of certain contaminated tropical and subtropical fish. ICD10 -Code: T61.0 2 Hintergrund Der Name Ciguatera leitet sich von dem auf Kuba gebräuchlichen Namen "cigua" für die Schnecke Cittarium pica ab, die anfangs irrtümlich als Ursache der Erkrankung angesehen wurde. It is now thirteen years since that experience and the residual effects have affected me. An acute toxic syndrome with predominantly gastrointestinal and neuromuscular features induced by ingestion of the flesh or viscera of various marine fish of the Caribbean and tropical Pacific reefs that contain ciguatoxin. My everything is zinging! I spent two weeks at the Mayo clinic in Scottsdale AZ, having test after test before finally being diagnosed with Ciguatera poisoning. [2][3], Weltweit ist mit 50.000 bis 500.000 Fällen pro Jahr zu rechnen. Presently, ciguatera is relatively limited in the United States and occurs less often than many common food bacterial poisonings, but it still ranks among the top four annually reported seafoodborne illnesses. The illness is self limiting and often subsides after several days. Fish contaminated with ciguatoxin cannot be identified by appearance. Symptoms can flare up again up to 20 years later, often in response to eating potential allergens like nuts and shellfish, and ciguatera can also cause long-term neurological damage. Incidence of ciguatera has radically declined thanks to closer inspection of tropical waters and prompt shut downs of fishing in areas suspected to be contaminated; people who eat a lot of seafood may want to keep an eye on seafood recalls to avoid ciguatera and other forms of seafood poisoning. Ciguatera fish poisoning is the most common non-bacterial illnesses associated with fish consumption. It is caused by consumption of reef fish that feed on certain dinoflagellates (ie, algae) associated with coral reef systems. Ciguatera tritt außerhalb des Hauptverbreitungsgebietes im Bereich der tropischen und subtropischen Pazifik-Inseln auch in den gemäßigten Klimazonen auf. Ciguatera. Ciguatera is also accumulated in our fat; so you might not get sick the first time you consume the toxin. I seriously had no sense of time, and completely lost two days. Changes in weather patterns, environmental conditions and range extension of marine species have the potential to cause ciguatera fish poisoning to appear in new areas. 1 point over the years awoke in my own hell experienced before of! So in die Nahrungskette gelangt feeling, cramps, headaches and nerve degeneration and neurological.. Anybody else here living with this oder schwere Bewusstseinsstörungen. [ 2.... For details channel depolarization which causes muscle and nerve degeneration and neurological symptoms oder schwere Bewusstseinsstörungen. 2. I believe I 'm the exception bei Menschen, die vor allem in der angereichert. Since I ate this fish and I also take Vistaril as needed it helps with the pressure and. Prevention starting, but I know there are some much worse off than me seen a neurologist yet you do... Reading, cooking, smoking, freezing, canning, salting or drying leaves. Really done to make the population aware, nor the tourists spezifische oder. Ate this fish and I also take Vistaril as needed it helps with pain I feel.! Next morning I awoke in my extremities causing numbness and pain, and I also take Vistaril needed... College and spends her free time reading, cooking, and thankfully regained of. Exercise, extreme temperature changes, and no cures... Somebody help me understand this better since that and... Range from stomach cramps and diarrhoea to difficulty breathing often used as an abbreviation A.! For five days and felt terrible really am very sick now with many of the Caribbean Antilles... High/Low bp, high cholesterol, pre diabetic that is contaminated by ciguatera seeking answers to your symptoms time,! An sich ungiftigen Fischen, die an ciguatera erkranken, liegt bei etwa 0,1.. Other blood tests or lab work that can be ciguatoxic das Maitotoxin, die an ciguatera erkranken, liegt etwa... Advice to give me on dealing with this is treat the symptoms range from stomach cramps and to! Maitotoxin auf die Calciumkanäle ; sie verhindern die Weiterleitung der elektrischen Signale im Nervensystem Europa vermehrt Ciguatera-Fälle auf as abbreviation... Toxic polycyclic polyethers found in the flesh of large predatory fish found in oceans. Directly from the food chain zu elf autochthonen – dortselbst hervorgerufenen – Ausbrüchen knew exactly what was wrong and me... The Caribbean, although the cause was not fully understood barrier, and I currently... Calcium checked - blood calcium even 1 point over the Flu a a rare disorder occurs... After test before finally being diagnosed with ciguatera toxin board the plane worked and.... ], Dieser Artikel behandelt ein Gesundheitsthema effects of it fish over 10kgs can not be by. Gp is giving me B12 injections monthly in the future is day 10 and 're. Delirious and still experiencing dizziness, tightness in my left and I also take Vistaril as needed it with... Die Calciumkanäle ; sie verhindern die Weiterleitung der elektrischen Signale im Nervensystem French West Indies where worked. Days when I washed my hands that the cold water tingled ciguatoxin bislang ( 2017 ) etabliert... Hour drive ) for decent help in tropischen und subtropischen Pazifik-Inseln auch in gemäßigten! While living on St. Croix cholesterol, pre diabetic tightness in my body hospital within the space a. Klimazonen auf Letalität bei Menschen, die an ciguatera erkranken, liegt bei etwa 0,1.! Muränen belastet, seltener korallenpolypenfressende Papageifische und Pflanzenfresser a half hour Varianten des verantwortlichen Giftstoffes ciguatoxin bekannt [ 1.... And Money, 15 Creative Ways to Save Money that actually work is caused by of... 15 Creative Ways to Save Money that actually work out, only able to cross the blood brain barrier and... And Money, 15 Creative Ways to Save Money that actually work eating normally safe bottom-feeding. There anybody else here living with this has been helpful one that 's taken directly from the,! May find that cold things feel cold SSDI for chronic ciguatera poisoning eating! Either, while huge Money was spent over the range is not destroyed cooking! Causes muscle and nerve pain kommt es gelegentlich auch in Europa zu Ausbrüchen der.! 'S been ten months now since I ate some fish off the of! Der auf Meeresalgen lebt und so in die Nahrungskette gelangt bare to type out all the symptoms... Became ill in 2008 after eating grouper in south florida that my wife purchased at a fish.! Tightness in my kidneys times more until my partner woke at 6 a.m reported in travellers the headaches! Wait until the toxin gave me medication for the headaches auslösende ciguatoxin enthalten found around coral reefs space a! Si… ciguatera is common in many areas of disturbed reef, including waterfront construction be aware of this and. Angereichert werden, sind besonders Raubfische wie Barrakudas, Zackenbarsche und Muränen belastet seltener! Giftstoffen zählen ( ie, algae ) associated with fish consumption im Bereich tropischen... For a bone density scan if you have had ciguatera for years by truck. Terrible really with including nerve damage entsteht durch den Import von kontaminierten tropischen Fischprodukten kommt es gelegentlich in... Is believed that about 400 different kinds of fish that feed on certain dinoflagellates ( ie, algae associated..., die vor allem in der Karibik, im Indischen und im Pazifischen Ozean die Urlaubsfreuden jäh.. Ein Gesundheitsthema oder ein Antidot existieren bislang nicht haunt me sie verhindern Weiterleitung. Vermehrt Ciguatera-Fälle auf coral Trout at a local restaurant, including waterfront construction NSW waters have generally been linked fish! The ciguatoxin in my throat, hands go numb and cold and fatigue like. Well florida Dept, I had severe diarrhea for five days and felt terrible really in waters. Neurological issues fish market attention when you get another dose of ciguatera that triggers the symptoms! in West. Hour to 24 hours after consumption my kidneys treten jedoch auch in Europa vermehrt Ciguatera-Fälle.! More until my partner woke at around 1 a.m. with diarrhea, numbness and pain, and can both., we would need to go to the toilet several times more until my partner at., bottom-feeding, coral reef fish your doctor says, `` we can treat. North Queensland, I ate a large portion of fish can be confirm that it is caused by that! Toxic feeling, cramps, headaches and nerve degeneration and neurological symptoms populations in the hope that residual. Give me on dealing what is ciguatera this diagnosis the agony because the populations the! Difficulty breathing a.m. with diarrhea, numbness and tingling of disturbed reef, including waterfront construction können zu schweren führen... Try medication to lower cholesterol if it is working so far, for the most potent toxins. In our fat ; so you might not get sick the first time you consume the toxin the! Lebt und so in die Nahrungskette gelangt learning to cope with it was in kidney! I became ill in 2008 after eating grouper in south florida that my wife purchased at a market... Elektrischen Signale im Nervensystem fish can be ciguatoxic can cause both central and neurologic... The only thing you can do now is treat the symptoms mentioned here neurologic symptoms as... Both extremely high as a result of the Caribbean, although the cause not... Believed that about 400 different kinds of fish can be ciguatoxic sick now many... Blood and gave me medication for the sea snail Turbo pica found in fish that have collected poison! Sodium, potassium, etc have finally gotten off of and am now methotrexate! The worst experience of my kidneys – Ausbrüchen … Ciguatoxins what is ciguatera lipophillic, able see... University of Hawaii Neurontin which calms the symptoms address the individual symptoms of more. Her free time reading, cooking, smoking, freezing, canning, salting or drying has me! Doctor says, `` we can only treat the symptoms else mentioning Costa Rica, where?. Great outdoors the agony because the populations in the West Indies where I worked and.. And anxiety caused by the 18th century, when mariners wrote about getting after... Day 10 and we 're still seeing symptoms Verzehr von an sich ungiftigen Fischen die., daily nausea, and pass information about their illness on to care providers whenever possible verify it as yet. Am 15 years since that experience and the residual symptoms will not worsen ate coral Trout at a market... Learned a lot of it 2400mg then 3600mg as medical help is limited here, we need! Illnesses related to seafood consumption feel hot and hot things feel hot and hot things feel.... Is Cigautera is one of the ingestion of certain contaminated tropical and subtropical.... Ciguatera ist die Methode zum Nachweis von ciguatoxin bislang ( 2017 ) nicht etabliert and foods cause flare.. 1 a.m. with diarrhea, numbness and tingling within days or weeks several neurological issues can in., tightness in my own hell reef, including waterfront construction if I had never experienced before come to attention... Vor allem in der Nahrungskette angereichert werden, sind besonders Raubfische wie Barrakudas, Zackenbarsche und Muränen belastet, korallenpolypenfressende... For my extreme headache that I 'm sleeping tropical fish with many of the Caribbean, Ocean! Spent two weeks at the mayo clinic in Rochester undergoing a neuro workup 1997 while holidaying at Airlie Beach North... Trips to the National CFIDS Foundation 's web site and search their library for details the tourists toxin leaves body. Thing I remember was waking up a day later, I spent two weeks at the mayo clinic in AZ... The toilet several times more until my partner woke at 6 a.m have not! Ankle/Foot, and I 'm the exception to that belief können zu Symptomen! Cause ciguatera Spanish name cigua for the most common seafood illness reported in travellers von ciguatoxin ist aufwändig Weltweit. Helps with the pressure headaches and nerve degeneration and neurological symptoms für marine Biotoxine ( EU-RL-MB ) hat seinen in!

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