Doctors not familiar with ciguatera sometimes mistakenly give a diagnosis of chronic fatigue syndrome.

BBC: Fish food poisoning breakthrough

In addition, a drug currently used to treat high cholesterol levels could be able to deal with the toxin which causes ciguatera.

BBC: Fish food poisoning breakthrough

"The explosive onset of an acute ciguatera illness can be readily identified clinically, but there is no consistent mechanism available to confirm the diagnosis in chronic cases, " said Dr Shoemaker, of the Pfiesteria Illness Center, Maryland.

BBC: Fish food poisoning breakthrough

Giery said the hospital's diagnosis at the time of death was that his illness was caused by food poisoning from ciguatera, a toxin sometimes found in large saltwater fish including grouper, red snapper and sea bass.

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Until recently, doctors have had neither a decent test for ciguatera, or a treatment, but Dr Ritchie Shoemaker told the annual meeting of the American Society for Tropical Medicine and Hygiene both may be on the horizon.

BBC: Fish food poisoning breakthrough

He is now employing a vision test used by the US Air Force which checks the ability to discriminate between white, black and grey - the lack of which is another symptom often seen in chronic ciguatera.

BBC: Fish food poisoning breakthrough