To the Editor: The report of Hughes and Merson1 presented a concise résumé of the general problem of ciguatera (fish poisoning) and once again brought the topic to the clinical literature, where it is seldom seen. The major neurology and gastroenterology textbooks contain no reference to this entity, which was apparently known to the ancient Egyptians. The authors state, “Ninety per cent of outbreaks reported to the Center for Disease Control occurred in Hawaii and Florida.” This figure apparently represents deficiency in case reporting rather than the actual incidence of the problem. We became interested in ciguatera in mid-1975.
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