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]
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]
Mussels sampled during this period were characterised and presented along with phytoplankton data from the same period and presented as a first report of PSP toxins from Icelandic waters. [arrow.dit.ie]
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]
“Now, we can immediately establish whether the toxin is present,”Orr states. [sciencenordic.com]
Entire Body System
- Malaise
Neuropsychiatric: fatigue, general malaise, insomnia. 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. [wwwnc.cdc.gov]
The first symptoms usually seen are a loss of balance and coordination and generalized malaise. [28] GI symptoms are generally mild and include nausea, abdominal pain, and diarrhea. [emedicine.medscape.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
- Vomiting
The frequency of vomiting was significantly correlated with the total amount of time the mussels were boiled (r = 0.594, P = 0.002). [journals.plos.org]
Synonyms and Keywords wilderness: shellfish poisoning, gastrointestinal; food poisoning ; diarrhea ; abdominal cramps; vomiting; nausea [webmd.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]
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]
A second type of allergy, which features nausea, vomiting and abdominal cramps, can also occur after eating mussels. [livestrong.com]
- 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]
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]
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]
A second type of allergy, which features nausea, vomiting and abdominal cramps, can also occur after eating mussels. [livestrong.com]
- Diarrhea
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]
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]
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]
Make an appointment with your doctor if: Severe diarrhea lasts for more than 3 days. Frequent vomiting lasts for more than 2 days. You see blood in your stool. You are on diuretics and have diarrhea, nausea or vomiting. You have a fever over 101°F. [familydoctor.org]
- Abdominal Pain
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]
A data collection tool was developed to record the following information: patient's name, age, gender, address, date of onset, date of exposure, diarrhea frequency (per 24 h), vomiting, abdominal pain, fever, tingling, numbness and muscle pain. [journals.plos.org]
A total of 49 people who ate at two London restaurants suffered acute nausea, vomiting, diarrhoea, abdominal pain, and feverishness lasting eight hours. [news.bbc.co.uk]
Problems can include nausea, vomiting, diarrhea, abdominal pain, and tingling or burning lips, gums, tongue, face, neck, arms, legs, and toes. [seagrant.uaf.edu]
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; abdominal pain; tearing; giddiness [myfwc.com]
- Food Poisoning
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]
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]
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]
Other reported symptoms have included dizziness, headache, disorientation, and permanent or short-term memory loss. In severe poisoning cases, seizures, focal weakness or paralysis, and death may occur. [articles.extension.org]
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]
These symptoms will be followed soon after by strange sensations that may include numbness or tingling in your mouth, headache, dizziness, and hot and cold temperature reversal. [medlineplus.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]
- Confusion
Later problems may include shortness of breath, dry mouth, a choking feeling, confused or slurred speech, and lack of coordination. If symptoms have appeared, get the victim to a medical facility, fast. U.S. [seagrant.uaf.edu]
Early symptoms of ASP include vomiting, nausea and diarrhea, but it can progress to severe problems such as dizziness, confusion, motor weakness, respiratory problems, coma and even death. [pressherald.com]
The unfortunate consumer of the bad shellfish will first experience "normal" symptoms of seafood poisoning, but may soon become confused, disoriented and even comatose. [health.howstuffworks.com]
In more severe cases, neurological symptoms develop within 48 hours and include headache, dizziness, confusion, disorientation, short-term memory loss, motor weakness, seizures, profuse respiratory secretions, cardiac arrhythmias, coma, and possible death [doh.wa.gov]
- Paresthesia
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]
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]
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]
- Ataxia
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]
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]
It may be followed by muscular weakness on the lower and upper limbs and on more serious cases, patients may also have ataxia, dysphagia and dysphonia. Paralysis can happen in less than 12 hours and won’t disappear until 3 days. [healthguidance.org]
Severe cases are associated with ingestion of large doses of toxin and clinical features such as ataxia, dysphagia, mental status changes, flaccid paralysis, and respiratory failure. [wwwnc.cdc.gov]
Further neurologic symptoms can include vertigo, ataxia, visual changes, and seizures. [emedicine.medscape.com]
- Paresis
[…] available, leftover shellfish can be tested for increased levels of the toxin. 4 Neurologic signs and symptoms include headache, dizziness, disorientation, and permanent short-term memory loss. 8 In more severe cases, patients can experience seizures, paresis [journals.lww.com]
Treatment
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]
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]
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]
Treatment of ciguatera poisoning is primarily supportive. [emedicine.medscape.com]
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]
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
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]
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]
Can food poisoning be prevented or avoided? The best way to prevent food poisoning is to always know what you are eating. The best way to always know what you are eating is to eat at home. You can better control food storage and preparation at home. [familydoctor.org]
Public awareness and education were the best alternative to prevent and control the outbreak. [journals.plos.org]
However, there is no prevention or cure for it, and it can't be detected by tests. Even a onetime episode of this type of reaction is cause for avoiding mussels in the future. [livestrong.com]