What would you do??

I had an outbreak of ich 3 months ago that wiped out about $500 worth of fish and I was left with 2 clownfish which made a full recovery in quarantine.
I followed advice from this site and went 72 days fallow in my tank and reintroduced my clownfish on the 73rd day.
Shortly afterwards I purchased a hippo tang and 4 dispar anthias, which I put through the TTM following the instructions on this site AND after this put them through 21 days of cupramine/quarantine....I didn't want to take any chances so I doubled up on treatment methods.
5 days in my display tank and my tang has developed little white spots, I'm almost certain this is going to turn out to be ich.....how is this possible??!
72 days fallow + TTM + 3 weeks QT and copper treatment and still ich is present.
I've spent $15000 on my system and what is the point if I can not get ich out of the tank??
I have an aquascape that is completely bonded together, and full of acropora.....what would you do??
 
Ditch the tang (all tangs that is) - worked for me for decades.
Tangs are ich magnets - especially hippos - and most peoples tanks are too small for them anyway.

As for your experience: either you somewhere allowed the parasite to slip through or you got a ich strain that can hold out longer than 72 days. While the latter is possible, it's more likely that there was a blunder somewhere in the procedure, either in the quarantine of the clowns or in the quarantine of the new fish.
 
My clowns went through QT for 10 weeks, including copper treatment and TTM. I did follow the TTM sticky on here to the letter and no fish showed any signs of ich during 32 days of total quarantine time.
The LFS I bought the fish from has a very good reputation too, and while it is possible that ich is present in their system, I have never seen any unhealthy fish in the store (it's a small boutique style store so doesn't have a huge livestock amount to keep up with)
I voiced my distrust in the 72 day fallow period after hearing reports of others still having ich in their tanks and it looks like I might be another casualty of not going fallow long enough.
Also while tangs are considered to be 'ich magnets', if ich is supposedly not present then there shouldn't be any way for them to contract it.
 
How is it possible? Your clownfish developed immunity but were still carriers. Assuming, of course, that the tang actually has ich rather than sand or lymphocystis. Fish can develop immunity to a given strain of parasite for about six months while still carrying it.
 
Fish that survive a Cryptocaryon infection develop immunity to that particular strain of Cryptocaryon, which can prevent significant disease reoccurrence for up to 6 months (Burgess 1992; Burgess and Matthews 1995). However, these survivors may act as carriers and provide a reservoir for future outbreaks (Colorni and Burgess 1997). For details use Google Scholar.
 
So doing TTM and copper treatment will have no effect at all if fish are carriers?

Did you do TTM on the clownfish and tang? TTM would still work as the parasite would still need to follow the life cycle front end.
 
I followed TTM sticky. All fish went through TTM and copper treatment including the clownfish before going back in the display, I didn't want to take any chances. My DT is in my living area, QT1 is upstairs and QT2 was in my garage so they were a fair distance from each other. I'm very confident they were all clear of disease before they went back in the DT, all eating well, all went through TTM and 21 days QT with copper afterwards. I just can't work out where it went wrong.
 
In an opportunistic moment I just managed to remove my Hippo tang and both clownfish from the DT and into quarantine. The Anthias are going to be near impossible to catch. Is it at all possible that I caught the tang early enough that with 6 weeks in QT and further TTM treatment my DT wouldn't have been compromised? I'm wondering whether to leave the Anthias in the display and monitor them, surely if ich was present in the DT it would reveal itself on them within a couple of months?
 
The ich life cycle front end is very deterministic. It will reveal symptoms on average in a month (the average life cycle is about 3 weeks). The first behavioral symptom is usually flashing or fast gilling. Are you 100% sure that you are seeing ich on the tang? Any flashing? I am happy to work with you to try and resolve this and I apologize for all the questions but I am just trying to understand in detail.
 
The fact that is the most puzzling is that ich normally does not kill quickly, it is a parasite that overwhelms over time. How long before you noticed a problem in the initial die off?
 
If your current hepatus tang has ich, the trophont will leave the fish within 7 days, sometimes as soon as 3 days. (the trophont is under the skin but is what appears to be "white spots") If that does not happen you are looking at something else.
 
Thanks Steve I do appreciate your help. The tang went into the DT on Wednesday night, I only noticed the first symptoms this morning, which are the small white spots which are characteristic of ich...however no flashing or loss of appetite yet.
From what I can remember I first noticed ich on a white cheek tang, because my reef was full of livestock and I didn't want to tear it apart I attempted to feed the fish and catch them whenever the opportunity arose. This took time and I think after maybe 5-6 days I decided I had no option but to rip the rockwork apart. By this stage all fish were infected and within 3 days in QT I was down from 20 fish to 3. I'm not sure if it was a combination of weakness and stress from copper treatment that did the damage but it did kill fast.
 
Are the small white dots still present? P. hepatus always sleeps in weird places and can easily pick up sand. Let's keep track of the timeline. If it is ich, the dots will disappear within 7 days or sooner. Is the tang hovering near the water returns? Reclusive behavior or out and about and an aggressive eater?
 
What was the behavior of the fish that died? Behavior is always a critical factor in diagnosis. Appearance?
 
The fish that died were all displaying classic ich symptoms, white spots, loss of appetite, increased breathing, flashing.
The small dots are present on the tang, I've got it in quarantine with cupramine now, should I have held off on the copper treatment? I was going to do a course of copper, then TTM, then 28 days QT. By this time (60 days) I'm assuming that the Anthias would have displayed some symptoms of ich if it is present in the DT?
 
The fish that died were all displaying classic ich symptoms, white spots, loss of appetite, increased breathing, flashing.
The small dots are present on the tang, I've got it in quarantine with cupramine now, should I have held off on the copper treatment? I was going to do a course of copper, then TTM, then 28 days QT. By this time (60 days) I'm assuming that the Anthias would have displayed some symptoms of ich if it is present in the DT?

That sounds fine. However, keep track of when/if the white dots disappear. I assume no sand in QT?
 
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