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Mussel Poisoning
Poisoning Mussels

Presentation

Infections may result from ingesting contaminated shellfish that has been harvested from an area with K. brevis cells and brevetoxins present in the water. [floridahealth.gov]

This case series, from the Washington Poison Control Center, describes 7 patients who presented to hospital with symptoms of PSP after consuming mussels harvested at night from a local beach. [thepoisonreview.com]

NSP usually presents 30 minutes to 3 hours after eating toxic shellfish. Most cases present with gastroenteritis accompanied by minor neurologic symptoms resembling mild ciguatera poisoning or mild paralytic shellfish poisoning. [wwwnc.cdc.gov]

“Now, we can immediately establish whether the toxin is present,”Orr states. [sciencenordic.com]

Is domoic acid present in all seafood? Unsafe levels of domoic acid have been detected in razor clams and Dungeness crab in Washington coastal waters. Domoic acid has also been found in bivalves in Puget Sound areas. [sea-quest-kayak.com]

Respiratoric

  • Dyspnea

    Neurological symptoms reported include nervousness, dilated pupils, severe headache, numbness, tingling, hypersalivation, dyspnea, progressive muscular paralysis, convulsions, coma, and death. [emedicine.medscape.com]

Gastrointestinal

  • Nausea

    Dinophysis species, Prorocentrum species (okadaic acid) clams, oysters, mussels, whelk Diarrhetic Shellfish Poisoning (DSP) diarrhea, nausea, vomiting; abdominal cramps; chills No Gambierdiscus species (ciguatoxins) large reef fish species such as barracuda [myfwc.com]

    Symptoms may include: vomiting nausea diarrhoea abdominal cramps. In more severe cases, neurological symptoms can take up to 3 days to develop. [mpi.govt.nz]

    Abdominal cramps, nausea, vomiting, and diarrhea last 6 to 17 h; then, pruritus, paresthesias, headache, myalgia, reversal of hot and cold sensation, and face pain may occur. [merckmanuals.com]

    Nature Of Danger: Symptoms of diarrhetic shellfish poisoning are diarrhoea, nausea, vomiting and abdominal pain which can start between 30 minutes to a few hours after ingestion. Complete recovery occurs within a number of days. [fsai.ie]

    Synonyms and Keywords wilderness: shellfish poisoning, gastrointestinal; food poisoning ; diarrhea ; abdominal cramps; vomiting; nausea [webmd.com]

  • Diarrhea

    The frequency of diarrhea and vomiting were positively correlated with the number of mussels consumed (r = 0.424 and r = 0.562, respectively). [journals.plos.org]

    Diarrhetic shellfish poisoning (DSP) is exactly what it sounds like: diarrhea. Diarrhea, cramps, naseau, and vomitting, are all possible symptoms. Either way, somethings coming out of you or making you wish it would. [naturespoisons.com]

    Dinophysis species, Prorocentrum species (okadaic acid) clams, oysters, mussels, whelk Diarrhetic Shellfish Poisoning (DSP) diarrhea, nausea, vomiting; abdominal cramps; chills No Gambierdiscus species (ciguatoxins) large reef fish species such as barracuda [myfwc.com]

    Synonyms and Keywords wilderness: shellfish poisoning, gastrointestinal; food poisoning ; diarrhea ; abdominal cramps; vomiting; nausea [webmd.com]

    The most common symptoms, which started 1-2 hours after consumption of the mussels, were paresthesias, nausea, vomiting, diarrhea, ataxia, weakness and a “floating sensation” that is said to be characteristic of PSP. [thepoisonreview.com]

  • Food Poisoning

    Scientists fear diners who fell ill after eating mussels suffered a type of food poisoning not seen in Britain for 30 years. [news.bbc.co.uk]

    However, getting scombroid poisoning does not mean you are allergic to fish. What causes food poisoning ? There are many foods that can cause food poisoning. Foods that should be kept cool but aren’t are some of the primary causes of food poisoning. [familydoctor.org]

    Scombroid poisoning is discussed further in our fish food poisoning section. [medic8.com]

    This form of food poisoning is seen most often on the Pacific Coast of this continent, but cases are reported from the Nova Scotia area, northern Europe and South Africa. Many of the details were FULL TEXT [annals.org]

    Neurotoxic shellfish poisoning Palytoxin poisoning Paralytic shellfish poisoning Tetrodotoxin poisoning Other types of seafood food poisoning cause gastroenteritis, but do not specifically cause paraesthesiae: diarrhetic shellfish poisoning scombroid [lifeinthefastlane.com]

Face, Head & Neck

  • Circumoral Paresthesia

    Circumoral paresthesias occur 5 to 30 min after eating. Nausea, vomiting, and abdominal cramps then develop, followed by muscle weakness. Untreated respiratory paralysis may be fatal; for survivors, recovery is usually complete. [merckmanuals.com]

Neurologic

  • Headache

    These include headache, dizziness, disorientation, vision disturbances, loss of short-term memory, motor weakness, seizures, profuse respiratory secretions, hiccups, unstable blood pressure, cardiac arrhythmia and coma. [mpi.govt.nz]

    In most cases, gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain develop within 24 hours of eating toxic shellfish, followed by headache, memory loss, and cognitive impairment. [wwwnc.cdc.gov]

    Mild symptoms include numbness and tingling of the face, arms and legs, followed by headache, dizziness, nausea and muscular incoordination. Severe poisoning causes muscle paralysis and respiratory failure within 2 to 25 hours. [maine.gov]

    […] ciguatoxins) large reef fish species such as barracuda, grouper, snapper, jack, mackerel, and triggerfish Ciguatera Fish Poisoning (CFP) nausea, vomiting, diarrhea; numbness/tingling of the mouth and other extremities; reversal of hot/cold sensations; chills, headache [myfwc.com]

    Symptoms of DSP The symptoms of DSP can include: diarrhea, nausea, vomiting, headache, abdominal cramps, and chills. Symptoms usually occur 30 minutes to six hours after consumption. [inspection.gc.ca]

  • Paresthesia

    The most common symptoms, which started 1-2 hours after consumption of the mussels, were paresthesias, nausea, vomiting, diarrhea, ataxia, weakness and a “floating sensation” that is said to be characteristic of PSP. [thepoisonreview.com]

    Abdominal cramps, nausea, vomiting, and diarrhea last 6 to 17 h; then, pruritus, paresthesias, headache, myalgia, reversal of hot and cold sensation, and face pain may occur. [merckmanuals.com]

    Notes Clinical illness defined as: neurological symptoms such as paresthesia and/or paralysis involving the mouth and extremities, which may be accompanied by gastrointestinal symptoms. [bccdc.ca]

    Chronic paraesthesiae, pruritis and neuropsychiatric symptoms last for years in some patients Diarrhetic shellfish poisoning Vomiting, abdominal cramps, and severe diarrhoea Neurotoxic shellfish poisoning Gastroenteritis, ataxia, paresthesiae, seizures [lifeinthefastlane.com]

    Neurologic: paresthesias, weakness, pain in the teeth or a sensation that the teeth are loose, burning or metallic taste in the mouth, generalized itching, sweating, and blurred vision. [wwwnc.cdc.gov]

Treatment

Treatment for shellfish poisoning This often depends upon the species of shellfish and the type of toxin (or toxins). But it is important to remember that there are no specific treatments for these toxins. [medic8.com]

Paralytic Shellfish Poisoning Treatment Some experts advocate gastric emptying as an early treatment, while activated charcoal can block additional toxic absorption. [healthguidance.org]

Treatment is supportive care with attention to ventilatory assistance until the toxin is metabolized, which may take days. The toxin cannot be destroyed by cooking or freezing. [merckmanuals.com]

Shellfish Poisoning Treatment Follow these steps for someone with shellfish poisoning: Do not induce vomiting. Help the person stay well-hydrated. Encourage the person to drink frequent sips of clear fluids. [webmd.com]

Emergency treatment for PSP victims If you think someone has PSP, bring them to the nearest medical facility. Call 911 or take the victim to the emergency room. There is no medication available to treat PSP. [seagrant.uaf.edu]

Prognosis

Shellfish Poisoning Prognosis In general, most outcomes, after the symptoms subside, are good. However, the outcomes worsen according to the amount and type of poison ingested. [emedicinehealth.com]

If the victim survives the attack for 12 hours, then the prognosis is good. The illness duration may happen for a few days, but muscular weakness may persist for weeks. [healthguidance.org]

Epidemiology

Outbreak Investigation Report Paola Katrina Ching, ab Ruth Alma Ramos, ab Vikki Carr de los Reyes, b Ma Nemia Sucaldito b and Enrique Tayag b a Field Epidemiology Training Program, National Epidemiology Center, Department of Health, Sta Cruz, Manila, [ojs.wpro.who.int]

The detection of toxin in epidemiologically linked food confirms the diagnosis. There is no antidote. Respiratory support is recommended. [bccdc.ca]

Li LM (2004) Epidemiology. 5th ed.Beijing:People's medical publishing house. 90 p. 6. [journals.plos.org]

Epidemiology Frequency United States Toxic outbreaks often are associated with algal blooms of single-celled dinoflagellates, which can cause a red-brown discoloration of the water. [emedicine.medscape.com]

Louisa Castrodale, at the Department of Epidemiology, is the one who gets the call when they do. [adn.com]

Pathophysiology

Pathophysiology The toxins responsible for most shellfish poisonings are water-soluble, are heat and acid-stable, and are not inactivated by ordinary cooking methods. [emedicine.medscape.com]

Prevention

Activated charcoal may also be administered to bind to any contaminated foods that haven't yet been digested. 1 Prevent ASP by avoiding consumption of affected shellfish. [journals.lww.com]

Public awareness and education were the best alternative to prevent and control the outbreak. [journals.plos.org]

The overall death rate from ciguatera poisoning is Prevention Travelers can take the following precautions to prevent ciguatera fish poisoning: Avoid or limit consumption of reef fish. Never eat high-risk fish such as barracuda or moray eel. [wwwnc.cdc.gov]

In Canada, a monitoring and prevention program for saxitoxin (and other shellfish toxins such as those causing amnesic and diarrhetic shellfish poisoning) exists. [bccdc.ca]

Although many health care professionals suggest that people should not eat uncooked shellfish (for example, "raw" oysters) to prevent exposure to bacterial and viral diseases, cooking does not destroy the poisons in contaminated shellfish. [emedicinehealth.com]

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