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]

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]

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

Control subjects were the neighbors of the probable cases as long as they presented with no symptoms after the consuming seafood between May 23 rd and 28 th, 2011. [journals.plos.org]

Blue mussel The purpose of this quarantine is to protect the public from deadly poisons that may be present in bivalve mollusks, such as mussels, clams, oysters and scallops. [ocbeachinfo.com]

• Rigor

  “We just continue to rigorously monitor the coast. We don’t know how long this is going to last.” [pressherald.com]

  Similar to Hong Kong [10], China has no rigorous monitoring programs for shellfish. Public awareness and education were the best alternative to prevent and control the outbreak. [journals.plos.org]

• Unconsciousness

  […] normal reflexes Grade 3 - Generalized flaccid paralysis, respiratory failure (dyspnea), aphonia, and fixed/dilated pupils; patient still conscious Grade 4 - Severe respiratory failure and hypoxia; hypotension, bradycardia, and cardiac dysrhythmias; unconsciousness [emedicine.medscape.com]

• Hunting

  That was in 1799, when a hundred Kodiak men hunting otters for the Russians died from toxic mussels, the deadliest outbreak in Alaska history. [adn.com]

• Respiratory Distress

  bivalve shellfish and puffer fish Paralytic numbness/tingling of the mouth and/or lips; nausea, vomiting; respiratory distress; drowsiness; muscle weakness; incoherent speech Yes. [myfwc.com]

  distress, myocardial injury Scombroid poisoning Gastroenteritis, flushed skin, hypotension, urticaria, wheezing Tetrodotoxin poisoning Vomiting, paraesthesiae, muscle twitching, diaphoresis, bradycardia, flaccid paralysis, respiratory paralysis Q5. [lifeinthefastlane.com]

• Dyspnea

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

• Nausea

  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]

  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 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]

  It has been known for a long time that consumption of mussels and other bivalve shellfish can cause poisoning in humans, with symptoms ranging from diarrhea, nausea, and vomiting to neurotoxicological effects, including paralysis and even death in extreme [sciencedaily.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]

• 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]

  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]

  It has been known for a long time that consumption of mussels and other bivalve shellfish can cause poisoning in humans, with symptoms ranging from diarrhea, nausea, and vomiting to neurotoxicological effects, including paralysis and even death in extreme [sciencedaily.com]

  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]

• 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]

  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]

  Living with food poisoning Food poisoning is a condition that comes and goes. However, you can be more likely to get food poisoning than other people. Children and the elderly are most likely to get food poisoning. [familydoctor.org]

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

  Marine Drugs, 6 (3), 456-79 PMID: 19005579 Lawrence DT, et al. (2007) Food poisoning. Emergency Medicine Clinics of North America, 25(2), 357. [lifeinthefastlane.com]

• Fear

  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]

• 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]

• 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]

  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]

  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]

  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]

  Paresthesia often spreads to the neck and face and sometimes to the toes and fingertips. 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. [healthguidance.org]

• Convulsions

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

• Cognitive Impairment

  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]

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]

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]

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]

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

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

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 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]

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

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]

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]

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]

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]