All you need to know about ICH!

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Marine Ich


Marine Ich, an infestation of Cryptocaryon irritans, is one of the two most common afflictions of saltwater fish. In this article, I will explain some of the biology of this parasite and discuss the multitude of treatments, remedies, cures, and elixirs that have been put forth to save your fish and sometimes empty your wallet.

Before you can decide on a treatment, you need to be fairly certain what is the infectious agent of the fish. Some of the signs of infection with Cryptocaryon irritans are rubbing or scratching against decorations or substrate (this behavior is also known as glancing or flashing), breathing problems, an increased mucous layer, loss of appetite, abnormal swimming behavior, frayed fins, cloudy eyes, and, of course, the telltale white spots. These characteristic spots are usually described as appearing like small grains of salt stuck to the body of the fish.

This disease is usually associated with several environmental triggers. Changes in water temperature, exposure to high levels of ammonia, nitrite, or nitrate, low pH levels, low dissolved oxygen, and overcrowding are all factors contributing to the onset of the disease. You could lump all of these in a general category of stress, but I find it more appropriate to think of all of these as wholly unnatural conditions. In fact, Cryptocaryon irritans is rare in the wild, and even more unlikely to be lethal. Ich is truly a disease that exploits the conditions of captivity to reproduce and easily find suitable hosts.

Host Susceptibility:
Cryptocaryon irritans has demonstrated a very low level of host specificity, meaning it will infect just about any fish in a tropical marine environment. Cartilaginous fishes (sharks and rays) appear resistant, but everything else is susceptible to infection.

Even though they are all possible hosts, experience has shown that there are definitely certain fish groups with higher and lower degrees of susceptibility. At one end of the spectrum are the eels that have shown a general resistance to Cryptocaryon irritans. On the opposite side are the surgeonfishes, with the Blue Regal/Hippo Tang (Paracanthurus hepatus) the "crowned king of Ich." I have dealt with literally hundreds of these fish, and I could probably count on one hand the number of Blue Regal Tangs that appeared to be completely free of infection. I would also place the cowfish, boxfish, and pufferfish fairly high on the susceptibility list. Generally, everything else falls somewhere in the middle.

Biology:
The lifecycle of the parasite is interesting and important to understand when evaluating a treatment. The stage where the parasite is attached to a fish is called a trophont. The trophont will spend three to seven days (depending on temperature) feeding on the fish. After that, the trophont leaves the fish and becomes what is called a protomont.

This protomont travels to the substrate and begins to crawl around for usually two to eight hours, but it could go for as long as eighteen hours after it leaves it's fish host. Once the protomont attaches to a surface, it begins to encyst and is now called a tomont.

Division inside the cyst into hundreds of daughter parasites, called tomites, begins shortly thereafter. This noninfectious stage can last anywhere from three to twenty-eight days. During this extended period, the parasite cyst is lying in wait for a host. After this period, the tomites hatch and begin swimming around, looking for a fish host. At this point, they are called theronts, and they must find a host within twenty-four hours or die. They prefer to seek out the skin and gill tissue, then transform into trophonts, and begin the process all over again.

Many hobbyists are fooled into believing they have cured their fish of the parasites, only to find Ich present again on fish a few weeks later; a reason why following through with a full treatment protocol is so important. Don't make this mistake and be lulled into a false sense of security. The parasites may be in a stage where they are merely regrouping and multiplying for their "next offensive." In the wild, this sort of massive reproductive phase ensures that a few will find a suitable host to continue on the cycle. In the close confines of our aquariums, though, it means comparatively massive infection rates.

Preventative Medicine:
The best course of treatment is prevention. All new fish should be quarantined for at least three weeks. This helps ensure that the fish are healthy, but it also gives them time to get over any shipping trauma, to get used to a new diet, and to put on weight after withstanding often insubstantial feedings at retailers, wholesalers, and collecting stations. Best of all, this will occur in a competition-free environment.

It is my strong preference and my general recommendation to never add any medications to a display tank. In my experience, it is always better to remove all the affected fish to a separate quarantine/hospital tank for treatment. This ensures that none of the display tank's other inhabitants such as corals, bacteria, worms, amphipods, copepods, or mysid shrimp are affected. Also, if you keep the fish in quarantine for one month without infection, you can be sure that any Ich parasites and their eggs have hatched and died without a host. Note that Cryptocaryon irritans requires a fish host. They cannot complete their life cycle with the rock, sand, or any invertebrates.

Treatment Option 1 - Copper:
Copper is a highly effective medication against Cryptocaryon irritans when dosed and maintained in the proper concentration. I am going to abbreviate my advice and simply suggest to: "Always follow the directions of the manufacturer of whichever brand of copper medication you employ, and always use a test kit to verify the dosages." Copper has a narrow range of effectiveness and levels must be monitored at least daily.

Copper has several disadvantages in treating Ich. First, at too low a dosage, it is ineffective. Secondly, at too high a dosage, it could kill all your fish. Daily, or better yet twice daily, testing is required to maintain an appropriate and consistent level of copper. Even when within the appropriate ranges, some fish cannot tolerate copper. Some of the fish more sensitive to copper are lionfish, pufferfish, mandarins, blennies, and any other scaleless fish. Copper is also a known immunosuppressive, making fish more susceptible to secondary infections.

Invertebrates are extremely sensitive to copper and cannot be housed in a tank undergoing this treatment. Lastly, copper cannot be used in the presence of any calcareous media. Live rock, sand, crushed coral, and dead coral skeletons will all adsorb copper, rendering it useless a treatment.

Copper specifically targets the infectious, free-swimming theront stage of this disease, as being buried deep in the skin of the host protects the trophonts; the cyst walls of the tomonts are similarly impervious. Knowing this and the life cycle of Cryptocaryon irritans, monitoring and dosing as needed in the evening right before the lights go out is going to be the most effective method. This should ensure optimal treatment concentrations at the most beneficial time.

Copper is probably the most popular method of treating Cryptocaryon irritans, but is not my first choice. It is far too labor intensive for me to recommend to the general public, has a large risk of overdose, lowers the fish's resistance to other diseases, and can cause serious damage to the kidney, liver, and beneficial intestinal flora of the fish being treated. Damage to intestinal flora is what many hobbyists point to as a possible contributing cause for Head and Lateral Line Erosion (HLLE), although there is currently no definitive cause of HLLE.

Treatment Option 2 - Formalin:
Formalin can be administered one of two ways; either in short dips with saltwater or used continually in a hospital tank. The dosage for the continuous use is 1 ml of the 37% stock solution for every 25 gallons of quarantine tank water. I prefer the formalin dip to continuous use because formalin is a fairly toxic compound. Also, with no commercially available test kits to monitor the concentration, it would be difficult to dose an entire tank and account for evaporation, absorption, etc.

To prepare the dip, I take 5 gallons of tank water and add to it 3.75 ml of 37% formalin. I also aerate the water vigorously to ensure there is maximum dissolved oxygen. The dip should last 30 to 60 minutes. As when using any medication, it is best to monitor the fish's reaction and be prepared to act if it appears in distress. When the dip is complete, net the fish, place it back into the hospital tank, and discard the dip water. This protocol should be repeated every other day for two weeks.

I would like to remind readers of a few precautions regarding the use of formalin. First, it is a carcinogen. Formalin is an aqueous solution of carcinogenic formaldehyde gas, so gloves should be worn and the area should be well ventilated when using it. Secondly, formalin should not be used if fish have open sores, wounds, or lesions. It is likely to cause tissue damage to these open wounds. And lastly, formalin can rob the water of dissolved oxygen. That is why proper aeration is so crucial. For that reason, do not use formalin if the water temperature is 82*F or higher.

Treatment Option 3 - Copper & Formalin:
It is possible and sometimes preferable, like in the case of heavy infestations to use copper in conjunction with Formalin in a quarantine/hospital tank. The same warnings about sensitive fish still apply. If a fish is sensitive to either copper or Formalin, they are not safely exposed to the combined protocol. At this point, it is "cure or kill." You will either cure your fish or kill it from poisoning. It is the most aggressive and dangerous treatment described in this article.

Treatment Option 4 - Hyposalinity:
Low salinity has been demonstrated to be an effective treatment against Cryptocaryon irritans. A salt level of 16 ppt or approximately 1.009-1.010 specific gravity at 78-80*F for 14 days was reported to kill the parasite. I have never experienced problems when placing fish into a hyposalinity treatment, but have routinely witnessed fish showing obvious signs of distress when brought back to normal salinity levels too quickly. For that reason, I try to limit the specific gravity increase 0.001-0.002 points per day.

One of the alleged benefits of this treatment is the resulting conservation of energy for the affected fish. Reef fish have to constantly drink saltwater and excrete the salt to maintain the proper osmotic balance. Lowering the salinity of the surrounding environment eases this energy demand on the sick fish, thereby allowing them to expend more energy towards fighting the infection. On the contrary, keeping fish in low salinity means that they don't "flush" their kidneys sufficiently. After long-term exposure, this can cause kidney failure and kill the fish.

The drawbacks to this treatment are the same as for many of the treatment options discussed above. Invertebrates and certain fish will not be able to tolerate it, so you should not apply a hyposalinity treatment in a display tank. Sharks and rays are two fish groups that do not tolerate this procedure. I would also not recommend this approach in the presence of live rock or live sand. The hyposalinity treatment will likely kill the worms, crustaceans, mollusks, and other life in and on the substrate, causing a severe drop in overall water quality.

I have another word of caution when using this treatment. I would strongly suggest the use of a refractometer or perhaps a salinity monitor. Swing arm style box hydrometers are notoriously inaccurate. The glass, floating style hydrometers are better, but easily broken. An accurate measure of the salinity could mean the difference between being inside the effective treatment range or being too high and ineffective or too low and jeopardizing your fish.

Even given its few drawbacks, hyposalinity is a great method of curing infected fish of ich in a proper hospital tank. Of the treatment options discussed this far, in my opinion, it is by far the safest. While none of these options is appropriate for use in a display tank, and all have their drawbacks, weighing the pros and cons of each leads me to recommend hyposalinity above the others.

Treatment Option 5 - Daily Water Changes:
John Walsh related this method in a presentation given to the Pittsburgh Marine Aquarium Society, Inc. It is safe and effective for all marine fish and is my preferred first course of action. Fish are put into a quarantine/hospital tank and then everyday for two weeks the tank is completely cleaned and a 50% water change is performed. While the size of this water change may concern some aquarists who are not accustomed to water changes of this magnitude, as long as you are careful about matching the temperature and salinity, you should not experience any problems. This method helps to remove the tomites, tomonts, and theronts from the tank and lessens the chance of reinfection. The fish should remain in quarantine for an additional month to ensure the treatment has worked and to allow them time to gain strength.

This method is best used as a preventative when a fish is first acquired. It is also useful for mild infestations or when other more aggressive treatments cannot be used due to species sensitivity. The best thing about this kind of treatment is it is safe for all fishes and invertebrates. One of the other benefits is the daily water changes should help you maintain optimum water quality and therefore should stimulate the fish's immune system to combat any secondary bacterial infections that might be attacking the vulnerable areas where the Cryptocaryon irritans parasites have burrowed into the skin. This is in contrast to copper or Formalin, which are both immunosuppressive, and may actually promote secondary infection.



Now I hope to discuss some of the newer and/or more experimental treatments that have been proposed or recently appeared in the aquarium marketplace. Please keep in mind the life cycle and accepted cures for this disease in the context of discussing the second group of treatments in part two of this series. In many cases it is difficult to separate an allegedly observed "cure" from simple variations in individuals' natural immunity.

Natural Immunity
Fish can develop immunity to Cryptocaryon irritans that can last for up to six months. It is this natural immunity that makes evaluating the effectiveness of various treatment options so difficult. How can someone ever be certain that what they dosed to their tank or fed to their fish is what caused the cure they observed? The answer is simple, they can't. Until there are controlled, scientific studies, preferably repeated a few times, we cannot be sure that any of the newer homeopathic or "reef-safe" treatments actually work.

This limited immunity is also the basis for some aquarists advocating that if a fish gets sick, to just maintain pristine water quality, feed a superb diet, and to allow the fish's own immune system to do the job. While it is possible that this could work, natural immunity is not totally foolproof. It is possible that immunity could protect the fish from massive infestation, but still allow small numbers of parasites to remain and reproduce undetected by the aquarist. This is where the 'Ich is always present' argument comes into play and why sometimes an aquarist has recurring difficulties with this pathogen.

I want to be clear on this point. I do not believe Cryptocaryon irritans is always present in our systems. With a strict quarantine protocol, it is possible keep an Ich-free aquarium. I just believe that there have been enough hobbyists who have misused a treatment or utilized an ineffective treatment option, such that they never really fully conquered their initial infestation. Their continuing problems over the course of many months, and the posting of those experiences, seem to be enough to promote this aquarium myth. Cryptocaryon irritans can be eradicated from an infected system with a proven treatment and can be kept out of the system if good quarantine practices are employed.

Most of the hobbyists who consider letting their fish fight off the infection on their own are hopeful that it will work because they find the challenge of removing all the fish and allowing the aquarium to go fallow (without any fish hosts), very daunting. If you are considering natural immunity as a treatment option, ask yourself a few simple questions.

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How big is the tank?

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How difficult would it really be to tear the display apart to capture and remove all of the fishes to a separate hospital/quarantine tank for treatment?

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How much is it going to cost to replace all of the fishes in the event of a catastrophic loss?

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What kind of moral and ethical responsibilities do you have for the pets that you purchased?

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And lastly, what in the world were you doing adding anything that had not been quarantined into your aquarium in the first place?


I cannot answer these questions for you, but it is my opinion that it is inappropriate to do nothing. I would hope for acquired or innate natural immunity to kick in when used with other less aggressive but pro-active treatments, such as using biological cleaners, medicated foods, UV, ozone, and garlic. Although I clearly don't believe this shotgun approach of unproven treatments is the most effective option available. For me, if you gamble with un-quarantined items and infect your tank, it is best to bite the bullet, remove all the fishes to a separate quarantine aquarium, fallow the tank, and use a proven treatment.

Treatment Option 6: Freshwater Dips
Freshwater dips are a highly effective form of treatment against a wide variety of parasites, although their use against Cryptocaryon irritans has been questioned. I am including them here because I still choose to employ them, as I believe they have at least some effect against Ich and because they have been proven effective against Amyloodinium, Turbellarian Worms (the so-called Black Ich), some Flukes, and Uronema. For these reasons, freshwater dips are still part of my standard operating procedure when receiving fish.

For some reason, many hobbyists are extremely reluctant and nervous about freshwater dipping their fish, yet show little concern about using toxins, poisons, and carcinogens, such as Copper or Formalin, for treatment. It is my contention that any fish that does not survive a properly conducted freshwater dip would not have lived regardless of treatment. I have dipped hundreds, perhaps thousands of fish, and have yet to kill a fish with a freshwater dip. I define this by the fish dying either in the dip bucket or within hours of the freshwater treatment. If a fish dies a day or two later, while one may claim it was the result of the dip, it is more likely that the disease was too far along and the fish too damaged to survive.

To prepare a proper freshwater dip, take demineralized water (RO or DI), aerate for an hour to maximize dissolved oxygen, heat to match the temperature of the dip water to that of the tank water, and then add buffering compounds to match the freshwater pH to your saltwater pH. The aeration should continue throughout the dip. It is crucial to match temperature and pH and to maximize dissolved oxygen. Most people that experience problems with freshwater dipping have made an error in these critical parameters.

The recommended duration of the dip varies from author to author because different species of marine fish tolerate freshwater to different degrees. Generally speaking, any dip less than two minutes is useless. Many fish will easily tolerate five, ten, even fifteen minutes or more. The least tolerant fish are wrasses, lionfish, pufferfish, drumfish, hi-hats, jackknives, firefish and many of the scaleless fish as a rule (Calfo, pers. comm.). I also choose not to dip lionfish, foxfaces, or any other venomous fishes because I don't want a flying torpedo of spines to come shooting out of a dip bucket at me.

Please only dip one fish in each bucket. If you must dip several fish, it is best to make up several smaller freshwater dips versus one large bucket, and always discard all dip water. I also would like to warn you about dipping fish that excrete toxins. There are several fish that give off toxins with their protective slime coat. Mandarins, boxfish, and the Six-line Grouper are a few. When in freshwater, they will naturally excrete more protective slime. There is a possibility that in the confines of a dip bucket, these fish could poison themselves or others, so be careful.

The best advice I can give you is to observe your fish closely. Some fish will swim around like nothing is happening. Others will go straight to the bottom and lie there. Definitive signs of trouble are manifested by the fish jumping out of the dip bucket and spitting water.

There is an alternative to standard freshwater dips that should also be mentioned. Some individuals prefer to use freshwater with methylene blue in the dip. Methylene blue is an anti-microbial dye. It is effective against a wide range of microbes such as bacteria, fungus, yeast, etc. This combination works well to rid the animal of external parasites and provides some protection against secondary infections. As I stated in part one of this series, I almost always use daily water changes. These daily cleanings tend to spur the fishes' own immune system to combat any secondary infections by helping to maintain optimum water quality, so I have not felt the need for using Methylene blue, but it is a worthwhile option to consider.

With all that I have discussed concerning freshwater dips my position on its use may seem a bit murky. Just to clarify, I do employ and advocate the use of freshwater dips when first receiving fish. I believe all fish that can be dipped should be administered this treatment prior to placement into a proper quarantine tank. This is done in an effort to minimize all possible parasitic infections. I do not, however, recommend freshwater dips as a cure for Cryptocaryon irritans. In my opinion, the repeated handling and osmotic shock of repeated dips are far too stressful to warrant its usage when other proven, but less aggressive treatments are available such as hyposalinity or daily water changes. Lastly, assuming freshwater dips can kill the embedded trophonts on a fish, once they are returned to the infected aquarium, they are just going to contract this pathogen again. So, I recommend using them and using them once only upon receiving the fish to minimize all possible parasitic infections.

Treatment Option 7: Quinine Based Drugs
Quinine Hydrochloride and Chloroquine Diphosphate are two medications commonly available, although the later is usually indicated for the treatment of Marine Velvet/Amyloodinium. Several of the references report these Quinine-based drugs as having mixed results, and I agree. I have used a commercial preparation of Quinine Hydrochloride and Malachite Green on several occasions when treating a display aquarium. In all instances, the infestation subsided, but with a few mortalities. In my opinion, I would have experienced fewer deaths with the removal of the all the fish to a separate quarantine/hospital tank.

I can say that the Quinine Hydrochloride and Malachite Green preparation is fairly invertebrate safe. Although I have never used it in a full-blown reef tank, I have used it in the presence of motile invertebrates (various shrimps and crabs), liverock, and livesand (along with the various hitchhikers; amphipods, copepods, small feather dusters, sponges, chitons, etc.) with little to no discernable adverse reactions. The only effect I witnessed was Sun Polyps (Protopalythoa grandis) turned green, although this was likely due to the Malachite Green. They did survive though, resumed their normal coloration, and have since multiplied, as did all of the little liverock hitchhikers.

I need to point out a few serious precautions regarding the use of Malachite Green. First, it is a respiratory poison, teratogen (an agent that can cause malformations of an embryo or fetus), and a suspected carcinogen. For these reasons, it is illegal to use on food fish in the United Sates, although it is still used on ornamental fish for treating eggs for mold and fungal infections. Also, Malachite Green is thought to accumulate in tissue after repeated treatments. Lastly, the original preparations of Malachite Green from the 50's were made from the mineral Malachite which contains high levels of copper. Although the compound Malachite Green does not contain copper, it is possible some aquarium preparations may contain traces of copper and could be very toxic to invertebrates.

Treatment Option 8: 5-Nitroimidazoles
There is another class of products on the market that are alleged to be a reef-safe, alternative, anti-parasitic medication for Cryptocaryon irritans. The active ingredient of this category of treatments is 5-Nitroimidazoles. I have only used this type of product a few times, but never in a reef tank, so I cannot speak to those claims. I found these to be moderately successful against Cryptocaryon, although it required twice as many applications as the manufacturer stated on the instructions to affect a complete cure. My biggest complaint is how expensive it was, in particular accounting for the amount and time needed to affect a full cure. Anyone who wishes to try one of these products should perform a search on several of the online message boards to get additional feedback prior to purchasing. Based on my own experience alone, I cannot recommend them.

Treatment Option 9: U.V. Sterilization
Ultraviolet sterilizers work by damaging most anything in the water column that passes through them. Their effectiveness is dependent on the wattage of the unit, the flow rate through the unit, the age of the lamp, the volume of the water being treated, the cleanliness of the sleeve, the clarity of the water, and the decorations (potential hiding spots for tomonts) in the aquarium.

I have found UV's to be very effective in bare bottom tanks, primarily in retail and wholesale operations. In display aquaria, the volume of the tank, the substrate and rockwork, the flow rate of the UV, and the wattage all work against its effectiveness. In commercial operations, many times, employees wipe down bare bottom tanks daily to maintain a clean appearance for customers. This has the added benefit of knocking loose the cyst stage of the parasite. The bare bottom, minimal decoration, high flow rates, and massive UV units on these systems ensure that most all the cysts and theronts pass through the sterilizer and are neutralized.

Please note that while I have drawn a comparison between freshwater and saltwater Ich, there is no taxonomic relationship. They may appear superficially similar to aquarists and they do in fact share some common features such as life cycle, mode of reproduction, and dispersal mechanism, but they are different and distinct organisms. This is a case of convergent evolution; when different organisms evolve to have a similar appearance because they occupy similar niches.

Treatment Option 10: Ozone
The use of ozone is somewhat similar to the use of ultraviolet sterilizers in that you are attempting to kill the pathogen by killing everything that passes through a reaction chamber. In this case, the reaction chamber is usually a protein skimmer, although there are some dedicated ozone reactors on the market and instructions on the Internet for DIY units. Ozone does not have as many of the variables affecting its performance as UV's do. On the contrary, if water clarity is an issue, ozone will help to improve overall water quality while at the same time, work towards neutralizing parasites.

The other big difference between ozone and UV treatments is there is a higher probability that the use of ozone can affect a cure in a single aquarium. The major drawback to the use of ozone is the potential to overdose and kill everything in the system. Ozone must be administered using a monitor/controller unit. Also, the effluent of the water and air should be run through activated carbon to ensure that any residual ozone is neutralized.

Treatment Option 11: Biological Controls
While probably not able to affect a cure in a full-blown infestation, the use of cleaner shrimp may help with a mild problem. I wish to express my dismay when seeing cleaner wrasses, Labroides species, offered for sale. The vast majority of these are doomed to waste away as they are obligate feeders of marine ectoparasites. There are many other effective cleaners available with a much better survival rate. Please leave these fish in the ocean where they can live long, happy lives and help maintain the health of the other reef fish.

The other argument against the use of Labroides wrasses is, being a fish, they are just as susceptible to infection as the fish they are "treating." In a closed, contaminated system, the cleaner wrasse will, in time, become infected too. As a result, it will eat less and become useless for combating Cryptocaryon. This same argument also rules out the use of other cleaner fish such as the various Gobiosoma species. While these make excellent aquarium residents, they are not an effective cure for parasitic diseases of fish. The cleaner shrimp, on the other hand, are not susceptible to Cryptocaryon and could therefore help to bring about a cure, while not being a complete cure in and of themselves.

Treatment Option 12: Medicated Foods
Tetra previously made a medicated food, Anti-Protozoan Medicated Flakes, which was reported to be effective against Cryptocaryon. The active ingredient was Metronidazole, also known as Flagyl. Although the Tetra Medicated Food is now discontinued, Metronidazole is available, so it is possible to obtain it and mix it into the fish's favorite food and, with luck, to elicit a feeding response.

The medicated foods are a good option for use as a preventative, for mild infestations, or when used in conjunction with one of the other less effective treatments, such as biological controls, UV, ozone, and garlic. All of these methods could be employed together in a display tank when removal is not chosen, although this is not the most effective solution, in my experience. I have always had better luck going through the trouble of removing all the fish for separate treatment or better yet, quarantining all new livestock and avoiding infection in the first place.

There is one possible drawback to this treatment that was brought to my attention. Feeding something like Metronidazole, or potentially even garlic could have deleterious affects to the beneficial microflora of a fish's intestine, much like the side effects to Copper exposure. Additionally, any medication with significant antibiotic properties will act upon the bacterial populations living in the system, and will foster the development of drug resistant bacteria.

Treatment Option 13: Garlic
Garlic is another of the alternative treatments for Cryptocaryon to be touted lately. I have read of many people reporting using it "successfully" as a preventative. The difficult part in assessing these reports is whether the fish would have developed Cryptocaryon in the first place. And, when someone claims it to be a "cure," how can they definitively rule out natural, acquired immunity or even confusion over Cryptocaryon's life cycle. At the very least, garlic does have some proven anti-bacterial, anti-fungal, anti-parasitic, and antiviral properties.

My biggest problem with the use of garlic is the mythology that has developed regarding it. This all began quite simply and innocently. Kelly Jedlicki was studying the use of garlic as an intestinal dewormer. She was examining the effectiveness of garlic against nematodes and cestodes on impacted puffers when she noticed a general decrease in Cryptocaryon irritans incidence. Later on, she proposed feeding garlic to fish as a preventative for Cryptocaryon irritans. From there the legend of garlic has spread.

Feeding garlic to fish is now an accepted cure for Marine Ich by some individuals. Furthermore, I have read of people merely hanging cloves of garlic in their tank in an effort to ward off the parasites, like some sort of bad vampire movie. And lastly, I have recently heard of a surprising number of hobbyists who soak their corals' food in garlic in an effort to combat possible pathogens when target feeding them. It goes to show that garlic has become an all-purpose wonder drug in some peoples' eyes based on little more than anecdotal observations.

Treatment Option 14: Ginger
Ginger is the newest homeopathic treatment to be suggested, but there is no evidence to support it's effectiveness.

Treatment Option 15: Pepper-Based Medications
These medications claim to work by stimulating an increased mucus layer response from the fish. This in turn is alleged to be able to slough off the parasites and prevent reinfection.

Treatment Option 16: MelaFix
I have read several threads on various message boards suggesting the use of Aquarium Pharmaceuticals' MelaFix as a treatment for all manors of disease, including Marine Ich. It is important to note, however, that not even the manufacturer recommends this product for any parasite. As such, I certainly cannot recommend it as a treatment for Cryptocaryon irritans.

Treatment Option 17: Mystery Solutions
Lastly, there are a couple of products on the market that do not list their ingredients. Sometimes they say something mysterious about being able to stimulate the immune system of the infected fish. I can only say, I won't use or recommend something unless I know specifically what it is, how it works, and preferably having some type of documentation showing its effectiveness.

Conclusion
Hopefully, you now have a more complete understanding of the disease and the range of some of its treatment options. While I have attempted to cover the entire range of options, there are likely a few that I have missed and there are always new treatments coming onto the market. Regardless of which treatment is most effective, the best medicine is to prevent the outbreak in the first place; an ounce of prevention is worth a pound of cure. Please do invest in a quarantine tank and use it. The cost is minimal compared to buying all new fish and gives you peace of mind in knowing all your additions are healthy. If you do this and keep a good, stable environment in your display tank, you should never need to treat your charges for anything. In the event that you do have a problem, armed with the above options, you should be able to wage a good fight against Cryptocaryon irritans.


from:http://www.reef-aquarium.net