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Diseases
Table 8. U.S. Peace Corps Recommendations for Food Safety
Safe
• boiled, cooked and peeled foods • hot and steaming foods • bread
• rice and noodles (if steaming hot) • fruit (if freshly peeled by you) • factory-sealed bottled water
• factory-sealed carbonated drinks
Ciguatera: Microscopic reef organisms produce a neurotoxin that causes ciguatera. Small fish feed on these organisms, and bigger fish eat the small fish. The bigger the fish, the more toxic the meat. Large predators such as barracudas, eels and groupers contain more toxins due to food-chain bioaccumulation. Symptoms are primarily neurological, such as numbness, tingling and dizziness; gastrointestinal symptoms such as nausea, vomiting and diarrhea may also occur. Symptoms can last for a few days or may persist for months or even years but are rarely fatal. Infected fish appears, smells and tastes normal—it has no unusually fishy odor. Cooking does not diminish the potency of the toxin, so travelers should avoid eating large reefbased predators. For more information on ciguatera, see DAN.org/ciguatera.
Scombroid poisoning: The scombroid family of fish includes tuna, mackerel, mahi-mahi and jack. Scombroid poisoning is caused by eating any of these fish that have not been properly refrigerated after being caught. Once such a fish is dead, bacteria that is naturally present in its gut translocate and break down a component of the meat, releasing an immune-system compound called a histamine. Ingestion of large quantities of histaminecontaminated meat triggers an allergic-like reaction. Scombroid poisoning can easily be confused with and misdiagnosed as a seafood allergy. Contaminated fish looks, smells and tastes normal—perhaps with a slight peppery or metallic taste but not unpleasant or foul. Cooking does not eliminate histamines and will not prevent symptom occurrence. While traveling, avoid eating these kinds of fish unless you are sure it was properly chilled immediately after being caught and then kept at a temperature below 40°F (4.4°C) until it was cooked. For more information on scombroid poisoning, see DAN.org/scombroid.