Four people have reported ciguatera fish poisoning this year.

The health ministry issues a warning about the illness which causes vomiting, diarrhoea and neurological issues such as tingling sensations and reversal of cold and hot sensations.

It pointed out there was one case in 2017 and 20 in 2016.

Ciguatera fish poisoning is caused by toxins from microscopic marine plants that build up in large predatory fish.

CFP does not change the appearance, taste or smell of a fish and it is not affected by cooking or freezing.

Telltale signs include the reversal of hot and cold sensations, which is absent in other types of fish-related food poisoning.

Vomiting and diarrhoea may be severe, moderate or absent. Additional symptoms include nausea, vertigo, joint and muscle pain, weakness, and numbness or burning in the mouth. The poisoning is not fatal.

Symptoms may begin as little as one hour after consuming toxic fish and can persist for an extended period of time.

CFP is unpleasant, but most people that are affected recover fully over time.

The fish identified in the outbreaks to date are large amberjacks, large yellow jacks, barracuda and grey snapper.

The Epidemiology and Surveillance Unit of the Ministry of Health and Department of Environment and Natural Resources are investigating the reports.

Anyone who may have experienced the above symptoms listed should contact their physician. Physicians should then call the Epidemiology and Surveillance Unit on 332-8932 or e-mail jdwilson@gov.bm.