Health officials and seafood suppliers confirmed that 29 people have fallen ill in the St. Louis area after eating a fish caught in the northern Gulf of Mexico, underscoring an emerging threat of ciguatera toxin, a poison that once was seldom found in fish caught in that part of the Gulf.
Although it has inspected the Louisiana supplier that originally processed the amberjack that sickened people in St. Louis, the U.S. Food and Drug Administration for the second day in a row declined to confirm plans to issue a new advisory to American seafood processors.
The FDA drafted the letter to seafood processors following months of research on fish caught near the Flower Garden Banks National Marine Sanctuary, a system of coral reefs about 100 miles off the coast of Galveston.
The tests, which confirmed ciguatera toxin in some fish, followed the poisoning of a Galveston couple that caught a grouper at the sanctuary in March, and two other cases in Alabama.
The Daily News obtained the FDA letter on Monday. Independent researchers have confirmed it has been distributed via e-mail in the scientific community, and that the FDA planned to release it soon, possibly this week.
But FDA spokeswoman Stephanie Kwisnek said Tuesday she could not confirm nor deny its existence.
Meanwhile, Bob Mepham, owner of Bob’s Seafood, where the amberjack suspected to be toxic was sold to two St. Louis-area restaurants, said fish suppliers need guidance from the federal government as soon as possible so they can make informed decisions about what fish they can market safely.
“I think they’re in the cover-your-ass business,” Mepham said, referring to the government. “I’m crying for some answers on how to tell people that they’re safe.”
He said he’s been in business for 30 years and never had this happen.
“I’ve had an outpouring of people coming and buying from me just to let me know I can be trusted,” he said.
“If this happens a second time, I don’t think they’re going to be quite on my side, and besides that, it’s just morally indefensible to be making your living getting people sick.”
Until he hears otherwise from the FDA, he’s nixing amberjack from his market.
Health officials and researchers say there was no way for the restaurants or suppliers to know the amberjack was toxic, and until samples of the fish are tested in a government laboratory, they won’t have 100 percent confirmation, either.
But the people who have fallen ill since late November have exhibited telltale signs of ciguatera, said John Shelton, spokesman for the St. Louis County Health Department.
Illness begins with symptoms similar to a run-of-the-mill stomach ailment, including vomiting and diarrhea, but later affects the central nervous system, causing a range of problems including tingling sensations, fatigue, anxiety and — a classic symptom — the reversal of hot and cold sensations. It is rarely fatal but can last weeks, months or years.
The toxin can’t be detected reliably with commercially available tests, and cooking fish won’t remove it.
It’s produced by algae that lives on hard surfaces, such as reefs or oil platforms, in warm ocean waters.
Fish consume the algae, and the toxin moves up the food chain, accumulating in large, reef-dwelling fish such as amberjack, grouper, barracuda and mackerel.
Ciguatera is well known in Florida and the Caribbean, but has long been rare in fish caught in the northern Gulf of Mexico.
Until this year, there were only a few confirmed cases stemming from the northern Gulf in the past 25 years.
Toxic algae expert Tracy Villareal at the University of Texas Marine Science Institute in Port Aransas said the number in the last 18 months has skyrocketed close to 60 with the most recent outbreak.
Confirmed cases are rare, because people are misdiagnosed, sometimes with more nefarious diseases such as multiple sclerosis or heart disease, and they don’t often save portions of the fish they ate.
That leaves scientists to a broad estimate of 50,000 to 500,000 cases annually worldwide.
But the new cases coming from the northern Gulf could signify a shift in climatological and other factors that may be allowing the toxin to proliferate in new areas, Villareal said.
“It really is some strong evidence that we probably are seeing the development of a local ciguatera problem, but again, it’s a difficult thing to prove, because you have to prove the negative: that it’s not coming from migrating fish,” he said.
His research has confirmed toxic algae on oil platforms in the northern Gulf, and FDA research this summer confirmed ciguatera toxin in multiple fish caught at Flower Garden Banks.
Karen Hopkins of Blanchard Seafood, the primary processor of the amberjack linked to the St. Louis cases, said the fish was caught within 40 miles of Flower Garden Banks.
That falls within the 50-mile radius that is the subject of the letter that the FDA won’t confirm.
In the letter, the FDA urges primary seafood processors to revamp their safety plans.
FDA first published the seafood “hazard analysis and critical control point” regulation in 1995, requiring processors to have written safety plans.
It instructs processors to avoid purchasing fish captured in areas known to have ciguatera toxin.
In the original regulation, that didn’t include the northern Gulf.
But the new letter that the FDA has yet to publicly release says ciguatera is now “a reasonably likely hazard” for 13 species in the northern Gulf within a 50-mile radius of Flower Garden Banks.
The amberjack from Blanchard Seafood in Grand Isle, La., emphasizes the significance of the FDA letter, because health officials now suspect that a single, 60-pound fish, distributed inland, processed and served in separate places, sickened 29 people.
Hopkins, who emphasized that the FDA inspection turned up no problems at Blanchard Seafood, said the business has already drafted a new purchase agreement for the fishing fleets that supply it, requiring them to pledge that the fish they supply weren’t caught near Flower Garden Banks.
She said reef fish account for about 9 percent of business.
“We definitely do make a good bit of money on that 9 percent, but it’s not what’s keeping us in business.”
She said she expects the industry to clamor for a reliable test so fleets won’t have to stop fishing certain areas.
Villareal said such a test is years away, at best.
Only a few laboratories around the country have the ability to perform complex, expensive tests to detect ciguatera toxin, and the tests aren’t practical for regular commercial use.
In the meantime, he’s trying to convince the federal government, recreational fishermen, and the academic community to team up on research to determine where the ciguatera hot spots are, whether they are seasonal, and how widespread the problem is.
“We can get these answers, but the problem is that we have to maximize the available resources because there simply is not the money available to do this,” he said.
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