If you suspect you have ciguatera poisoning:

Contact your doctor immediately;
Call your local Department of Health (in Hawaii, call 808-586-4586) or Poison Center (in Hawaii, call 808-941-4411) and
Save any uneaten portions of the fish for testing.
When you have ciguatera poisoning, you should avoid eating or drinking the following items until the symptoms of the illness are gone:

• Fish - of all types (fresh, marine, canned, dried, etc.)
• Fish sauces
• Shellfish
• Shellfish sauces (e.g., oyster sauce, clam sauce)
• Alcoholic beverages
• Nuts, nut oils (e.g., peanuts, sesame oil, etc.)

To avoid ciguatera poisoning, you should:

• Check your reef fish using Cigua-Check® before eating
• Know the most common types of reef fish that carry the poison
• Know that any reef fish can carry the poison
• Know where cases of ciguatera have been reported
• Avoid eating fish caught in areas where ciguatera poisonings have occurred
• Clean the fish very well
• Eat only small portions of large fish which may have the poison;
• Not eat the roe (eggs), liver, head or guts because they have higher levels of poison
• Know that ciguatera poison cannot be destroyed by cooking with a stove or microwave oven, freezing, smoking, salting or drying.

None of the deep-sea fish such as ahi and aku (tuna), kajiki (marlin), and ono (wahoo) have been found to carry the ciguatera fish poison. In Hawaii, the mahimahi (dolphin fish) is not associated with ciguatera; in the Caribbean, however, this fish may contain ciguatera fish poison.

The above text has been adapted from the "Ciguatera Fish Poisoning" brochure produced by the Department of Health, State of Hawaii in 1997.