Anna Maria Island, Fla. – A dream visit to a Caribbean island over the July 4 weekend turned into a nightmare for a local family and family friend.
A successful day of reef fishing meant dinner to 15-year-old Austin Goncalves and 14-year-old Marlin Ellis.
However, unknown to them, the fish they caught while pole-spearing near the shore, a porgie and mutton snapper, carried ciguatera poisoning and dining on the fish sent both boys, as well as Goncalves’ mother, Karen, and her companion, Allen Smith, to the hospital.
The group’s weeklong trip to a timeshare in the Bahamas quickly turned from paddleboard tours and dive adventures to a horrific ordeal in a Nassau hospital.
According to Marianne Norman-Ellis, Marlin’s mother, the boys caught the fish on a reef near the resort. Norman-Ellis works at Mike Norman Realty — owned by her father — in Holmes Beach and co-owns Blue Marlin restaurant in Bradenton Beach with husband Adam Ellis.
Norman-Ellis received the news stateside of the group’s sudden illness in a short phone call from Karen Goncalves, her speech slurred from the neurological effects of the marine microalgae that causes ciguatera poisoning.
“We’re in the hospital. You need to come,” she said to Norman-Ellis before the phone cut off.
A look back at the events:
June 28: departure
Karen Goncalves, her boyfriend, Allen Smith, Marlin and Austin headed to the airport with bags packed. Destination: the Bahamas.
Austin, who works bussing tables at the Blue Marlin, is an avid fisher, diver and boater. He invited his friend Marlin along on the trip to his mother’s timeshare resort.
June 29: boys pull in a big catch
Marlin and Austin went free-diving on a reef off the beach fronting their resort. They caught huge fish — a porgie twice the size of any found in Florida and a 30-pound mutton snapper.
The boys’ trophy fish became dinner, but would soon prove to be less of a bragging rite.
“I think part of the reason they got so sick is because how old and big the fish were,” said Norman-Ellis.
She said in addition to the age and size of the fish, the location of the catch also contributed to their levels of ciguatera. The microalgae that causes ciguatera lives in the reef, and fish that live exclusively in the reef area and eat their prey from among the reef-dwellers, unlike fish that travel, contain have higher levels of the toxin.
The group cooked the fish for dinner, unaware of the tasteless, odorless toxin they were about to consume. They ate their catch at two meals before they felt the poison’s effects.
As the toxin worked its way into their systems, they continued their vacation plans, going on dive trips and paddleboard tours around the Caribbean paradise.
Marlin was the first to get sick. Norman-Ellis said she spoke to her son and both assumed he was seasick. As time passed, it became clear Marlin’s illness was not seasickness.
July 3: everyone is rushed to the nearest hospital
Norman-Ellis received a text message from her son that read: “We can’t stop throwing up.”
Marlin’s illness escalated and the rest of the party soon also became violently ill.
Ciguatera can cause nausea, vomiting and neurologic symptoms, including tingling fingers and toes, confusion and hallucinations, according to the U.S. Centers for Disease Control and Prevention. Ciguatera also can cause cold things to feel hot and the reverse. The toxin affects individuals differently and can be difficult to diagnose.
Norman-Ellis said Karen Goncalves remembered calling the front desk at the resort, but she didn’t recall what happened after the phone call.
Staff at the resort called an ambulance for the four guests. Marlin and Smith experienced violent hallucinations, and Austin and his mom were unconscious by the time the ambulance arrived to the timeshare. Austin was in bad shape, unable to maintain consciousness and suffering from seizures.
They were taken to a public hospital where the staff was unable to ascertain any information from them due to their conditions. Hospital staff assumed they either suffered from food poisoning or they were on drugs.
July 4: a confused phone call
About noon, Karen Goncalves made her short, confused phone call to Norman-Ellis.
“Her speech was slurred. All she said was they were at the hospital and I needed to come. She didn’t even say what hospital,” said Norman-Ellis.
Norman-Ellis and her husband bought plane tickets departing for the Bahamas from Miami that day.
Norman-Ellis was able to find out what hospital they were taken to, but was having difficulty getting directly in touch with anyone in the group.
“All they kept telling me was ‘they are stable’ and wouldn’t let me speak to them,” she said.
She contacted the U.S. Embassy and was able to speak to a doctor at the hospital. As she waited for her flight to board at the Miami airport, the doctor told her to arrive quickly: “It’s not likely they’ll make it.”
Norman-Ellis and her husband went straight from the Nassau airport to the hospital. When she arrived, Austin and Karen Goncalves were still unconscious and her son was restrained in a hospital bed. He had been experiencing “horrific hallucinations” and was reacting violently to hospital staff, requiring them to restrain him.
July 5: an air ambulance takes them stateside
“We were at the hospital for eight hours waiting for the ambulance,” Norman-Ellis said.
Mike Norman, Marlin’s grandfather, arranged for REVA, a private international air-ambulance service, to take the group to a Miami hospital. Each flight carried only one patient, and cost $10,000.
Norman-Ellis was able to gain her son’s release from the Nassau hospital, but not the rest of the group because they are not family members. Meanwhile, a friend of Norman-Ellis was able to contact Austin’s sister through Facebook, and she flew to the Bahamas to release her mother and brother. A release for Smith proved to be more difficult, but he too was eventually able to leave the hospital.
Marlin arrived at Jackson Memorial in Miami at 6 a.m. Austin was brought to the Miami hospital shortly after Marlin and the ambulance returned immediately to get his mother and her companion.
Marlin spent three days in the intensive care unit at Jackson Memorial before being relocated to the teen unit. Austin spent several days longer on life-support before he was relocated to the teen unit, where he now is undergoing speech, physical and occupational therapy.
Austin, as of July 18, was still in the hospital.
Marlin was the first to recover and return home, but was told to take precautions for three weeks following his release. He must avoid eating seafood, and also chicken and pork that may have consumed seafood.
He had no further symptoms of ciguatera after his release from the hospital.
According to the CDC, ciguatera poisoning is caused by eating fish that contain toxins produced by the marine microalgae called Gambierdiscus toxicus. It has no cure. However, the symptoms are treatable and usually go away in days or weeks, although some symptoms can remain for years.
Norman-Ellis said she has now learned that when traveling to a foreign country, it’s important to know the locations of hospitals. She later learned there was a hospital in Nassau two blocks away that may have provided more intensive care than the public hospital where the group was taken.
The ciguatera poisoning was not diagnosed until they reached the hospital in Miami.
Another important thing she said she learned from the experience: Don’t eat fish larger than a forearm that is caught in the Caribbean.
This article was published in The Islander July 22, 2014.