Ciguatera (pronounced as seegâ€whaâ€terra) poisoning occurs when you eat a fish that has eaten a certain poisonous food. This poison is not eliminated even when the fish is either cooked or frozen. The first symptoms include abdominal cramps, nausea, vomiting and diarrhea. Symptoms can then progress to headache, muscleaches and skin that is itchy, numb or tingly. One may notice a change in the ability to feel hot or cold temperatures. For example, one may think something feels hot when it is actually cold. The symptoms can last for 1 to 2 weeks and can come back any time one eats an affected fish. To avoid ciguatera poisoning, don’t eat fish that commonly carry the poison. These fish include amberjack, grouper, snapper, sturgeon, king mackerel, barracuda and moray eel. The poison is more concentrated in the fish’s internal organs of the fish, so one should never eat those parts of a fish.Scombroid poisoning is a foodâ€borne illness caused by bacterial overgrowth in improperly stored fish (stored at temperatures above 20°C for as little as two to three hours). Although associated with fresh fish, scombroid poisoning can also occur with canned fish if the fish is handled improperly. The bacteria are most commonly halophilic Vibrio species, Proteus, Klebsiella, Clostridium, E coli, Salmonella and Shigella species. Histidine that is present in the muscle of dark meat fish is broken down by the enzyme decarboxylate producing high levels of histamine. Toxins are not broken down by cooking, freezing, or subsequent refrigeration. Fish contaminated with scombroid may smell and appear fresh, although patients often report that the fish tastes peppery, salty, or bubbly. Symptoms usually develop 20 to 30 minutes after eating and include flushing of the face, nausea, vomiting, hives and abdominal pain. These symptoms are similar to other allergic reactions. However, getting scombroid poisoning does not mean one is allergic to fish. The symptoms last for 24 hours or less and can come back if one eats fish that has not been refrigerated properly. To avoid poisoning, don’t eat any fish that has not been refrigerated properly. Be especially careful when you eat fish such as tuna, sardines, mackerel, mahiâ€mahi or anchovies.