Activity consistent with brevetoxins was present in both urine and shellfish extracts. [ncbi.nlm.nih.gov]

Fish Nutrition aims to present the state of knowledge of basic and applied nutritional requirements of fishes. Most of the information found in this book involves salmonids, their nutrition, and metabolism of nutrients. [books.google.com]

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]

The recognized bacterial diseases associated with ingestion of contaminated bivalves include typhoid fever (not presently a public health problem), Vibrio parahemolyticus gastroenteritis, and Vibrio cholerae infection. [annals.org]

• Malaise

  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]

  […] initially include: Headache Diaphoresis Dysethesias and paresthesias of the lips, tongue, mouth, face, fingers, and toes Dysphagia, dysarthria, nausea, vomiting, abdominal pain may ensue Subsequent symptoms occur in 4-24 hours of ingestion: Generalized malaise [calpoison.org]

• Fatigue

  Once consumed by humans they cause ciguatera food poisoning – an unpleasant gastrointestinal illness which is followed by neurological symptoms such as depression and fatigue. [medic8.com]

• Disability

  Meet the needs and special considerations of specific patient populations such as children, women, elders, persons with chronic medical conditions, and the disabled. Make smart decisions about gear, navigation, nutrition, and survival. [books.google.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]

• Vomiting

  Some of the tips suggested include: Do not try and stop the vomiting. Some doctors may induce vomiting or use stomach pump to remove the toxin, especially if within three hours of ingestion of contaminated shellfish. [firstaidregina.ca]

  As all of these forms of poisoning cause vomiting and diarrhoea then fluids will need to be replaced which have become depleted as a result of these. [medic8.com]

  The characteristic symptoms appear within a few minutes and include nausea, lightheadedness, vomiting, and tingling or numbness around the mouth, followed by paralysis of the extremities and, possibly, respiratory paralysis. [medical-dictionary.thefreedictionary.com]

  A second type of allergy, which features nausea, vomiting and abdominal cramps, can also occur after eating mussels. [livestrong.com]

  DSP (Diarrheic Shellfish Poisoning) is usually a generally mild gastrointestinal disorder involving nausea, vomiting, diarrhea, and abdominal pain accompanied by chills, headache and fever. [epi.publichealth.nc.gov]

• Nausea

  […] memory loss, which may be permanent Nausea and vomiting Abdominal cramps and diarrhea Confusion In severe cases, coma and death Diarrheal shellfish poisoning Nausea and vomiting Diarrhea Treatment for Shellfish Poisoning Shellfish poisoning may or may [firstaidregina.ca]

  The characteristic symptoms appear within a few minutes and include nausea, lightheadedness, vomiting, and tingling or numbness around the mouth, followed by paralysis of the extremities and, possibly, respiratory paralysis. [medical-dictionary.thefreedictionary.com]

  Diarrhoeic poisoning Diarrhoea is the main symptom - hence the name but it also includes other symptoms such as nausea, vomiting, chills and abdominal pains. [medic8.com]

  A second type of allergy, which features nausea, vomiting and abdominal cramps, can also occur after eating mussels. [livestrong.com]

  The most distinctive and immediate symptom is a sharp metallic or bitter taste accompanied by nausea and tingling of tongue and lips. [emedicine.medscape.com]

• Diarrhea

  DSP causes severe cramping and diarrhea, along with nausea. Symptoms typically develop within 30 minutes of ingestion. While it may not be fatal, the resulting diarrhea can cause severe dehydration. [danapointfishcompany.com]

  DSP (Diarrheic Shellfish Poisoning) is usually a generally mild gastrointestinal disorder involving nausea, vomiting, diarrhea, and abdominal pain accompanied by chills, headache and fever. [epi.publichealth.nc.gov]

  Confusion In severe cases, coma and death Diarrheal shellfish poisoning Nausea and vomiting Diarrhea Treatment for Shellfish Poisoning Shellfish poisoning may or may not be an emergency. [firstaidregina.ca]

  One form, paralytic shellfish poisoning, is caused by species of Gonyaulax, and is characterized by paresthesias of the mouth, lips, face, and limbs, nausea, vomiting, and diarrhea; in rare severe cases muscle weakness or paralysis and respiratory embarrassment [medical-dictionary.thefreedictionary.com]

  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]

• Food Poisoning

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

  Your pregnancy and baby guide: foods to avoid Food poisoning Antenatal care Eating well for pregnancy Page last reviewed: 13/06/2015 Next review due: 13/06/2021 [nhs.uk]

  These can lead to conditions like Bali belly, Delhi belly, Montezuma’s revenge, traveller’s diarrhoea or just old fashioned food poisoning. [travelinsurancedirect.com.au]

  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]

  Code Type 2 Excludes nicotine dependence ( F17.- ) noxious foodstuffs - see Poisoning, food, noxious plants, noxious - see Poisoning, food, noxious, plants NEC ptomaine - see Poisoning, food radiation J70.0 ICD-10-CM Diagnosis Code J70.0 Acute pulmonary [icd10data.com]

• Abdominal Pain

  DSP (Diarrheic Shellfish Poisoning) is usually a generally mild gastrointestinal disorder involving nausea, vomiting, diarrhea, and abdominal pain accompanied by chills, headache and fever. [epi.publichealth.nc.gov]

  Consuming raw or undercooked shellfish containing the bacteria could lead to an infection with symptoms including vomiting, diarrhea, abdominal pain, and even septicemia. [foodpoisonjournal.com]

  Gastrointestinal symptoms of nausea, vomiting, diarrhea and abdominal pain are less common. Most victims are calm and conscious of their condition throughout their illness. [pac.dfo-mpo.gc.ca]

  Diarrhoeic poisoning Diarrhoea is the main symptom - hence the name but it also includes other symptoms such as nausea, vomiting, chills and abdominal pains. [medic8.com]

• Tachycardia

  This is soon followed by GI symptoms that include vomiting, abdominal pain, and severe diarrhea, which may be accompanied by tachycardia, clammy skin, hypotension, and other signs of impending vascular collapse. [emedicine.medscape.com]

• Pruritus

  These are predominantly paresthesias, but myriad other sometimes bizarre neurologic symptoms may also be observed, including pruritus; the sensation of loose painful teeth; tingling in the lips, tongue, throat, and perioral tissues; metallic taste; reversal [emedicine.medscape.com]

• Suggestibility

  These higher masses are suggestive of conjugated metabolites, but their structures have yet to be determined. [ncbi.nlm.nih.gov]

  I would test to the mollusks and suggest challenging with each food that is positive and was eaten on the day of the reaction. [aaaai.org]

  This rule of thumb suggests that it is safer to eat shellfish from September through April and to avoid it from May to August. [foodpoisonjournal.com]

  Some of the tips suggested include: Do not try and stop the vomiting. Some doctors may induce vomiting or use stomach pump to remove the toxin, especially if within three hours of ingestion of contaminated shellfish. [firstaidregina.ca]

  It is also strongly suggested by multiple individuals who consumed the same fish, with similar signs and symptoms. [emedicine.medscape.com]

• Headache

  The first evidence of PSP intoxication usually begins with a tingling sensation or numbness around lips within 5-30 minutes of ingestion, gradually spreading to face and neck, a prickly sensation in fingertips and toes as well as headache and dizziness [pac.dfo-mpo.gc.ca]

  These are then followed by neurological symptoms which include: Headache Mental confusion Dizziness/disorientation Memory loss Visual disturbances Seizures In severe cases, paralysis and even death may occur. [medic8.com]

  […] breathing In some cases, nausea and vomiting If ingested in large amounts, paralysis of chest and abdomen, which may lead to death Neurotoxic shellfish poisoning Nausea and vomiting Slurred speech In some cases, tingling sensation or numbness in the mouth, headaches [firstaidregina.ca]

  DSP (Diarrheic Shellfish Poisoning) is usually a generally mild gastrointestinal disorder involving nausea, vomiting, diarrhea, and abdominal pain accompanied by chills, headache and fever. [epi.publichealth.nc.gov]

  After eating clams from Starrigavan Beach in Sitka, a man reported tingling in his left hand and lips, and a woman reported tingling along with a headache -- the most benign effects of the poisoning, which can kill a person just a few hours after ingesting [adn.com]

• Dizziness

  If you experience difficulty breathing, swollen lips or tongue, dizziness, fainting, a feeling of impending doom or a rapid pulse after eating mussels, MayoClinic.com advises calling 911. [livestrong.com]

  The first evidence of PSP intoxication usually begins with a tingling sensation or numbness around lips within 5-30 minutes of ingestion, gradually spreading to face and neck, a prickly sensation in fingertips and toes as well as headache and dizziness [pac.dfo-mpo.gc.ca]

  […] cases, nausea and vomiting If ingested in large amounts, paralysis of chest and abdomen, which may lead to death Neurotoxic shellfish poisoning Nausea and vomiting Slurred speech In some cases, tingling sensation or numbness in the mouth, headaches and dizziness [firstaidregina.ca]

  Dizziness. Fainting. Anaphylaxis: sudden, severe, potentially fatal, systemic allergic reaction that can involve several areas of the body. Cleveland Clinic News & More Cleveland Clinic News & More [my.clevelandclinic.org]

  NSP (Neurotoxic Shellfish Poisoning) causes both gastrointestinal and neurological symptoms, including tingling and numbness of lips, tongue and throat; muscular aches; dizziness; reversal of the sensations of hot and cold; diarrhea; and vomiting. [epi.publichealth.nc.gov]

• Confusion

  For DASP, gastrointestinal symptoms begin within 24 hours of ingestion and may be followed within 48 hours by neurological symptoms including confusion, short-term memory loss, seizures, respiratory secretions, and coma. [doh.wa.gov]

  Nausea and vomiting Slurred speech In some cases, tingling sensation or numbness in the mouth, headaches and dizziness Amnestic shellfish poisoning(lethal) Short term memory loss, which may be permanent Nausea and vomiting Abdominal cramps and diarrhea Confusion [firstaidregina.ca]

  ASP (Amnesic Shellfish Poisoning) causes gastrointestinal disorders (vomiting, diarrhea, abdominal pain) and neurological problems (confusion, memory loss, disorientation, seizure or coma). [epi.publichealth.nc.gov]

  […] ingestion. [1] Symptoms can appear ten to 30 minutes after ingestion, and include nausea, vomiting, diarrhea, abdominal pain, tingling or burning lips, gums, tongue, face, neck, arms, legs, and toes. [1] Shortness of breath, dry mouth, a choking feeling, confused [en.wikipedia.org]

  Confused about what kinds of seafood to buy? What the healthiest seafood choices are? Which ones are free from toxins? Which ones are sustainably caught? You aren’t alone. Without a doubt, our oceans are polluted and over-fished. [foodrenegade.com]

• Paresthesia

  One form, paralytic shellfish poisoning, is caused by species of Gonyaulax, and is characterized by paresthesias of the mouth, lips, face, and limbs, nausea, vomiting, and diarrhea; in rare severe cases muscle weakness or paralysis and respiratory embarrassment [medical-dictionary.thefreedictionary.com]

  […] were gathered 3.2 Probable case Clinical illness within 12 hours of consumption of bivalve mollusk shellfish (e.g. oysters, clams, mussels) 4.0 Laboratory Comments 5.0 Clinical Evidence Clinical illness is characterized by neurological symptoms such as paresthesia [canada.ca]

  Shortly after ingestion, she developed lip and tongue paresthesias. Four hours after ingestion, she became nauseated, vomited, and had abdominal pain. She presented with decreased strength in both of her legs. [calpoison.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]

  Symptoms included numbness of mouth (five men), vomiting (four), paresthesia of extremities (four), numbness and tingling of tongue (two), numbness of face (two), numbness of throat (one), and periorbital edema (one). [cdc.gov]

• Flaccid Paralysis

  paralysis, respiratory paralysis Q5. [lifeinthefastlane.com]

  […] and incoordination; slurred speech; 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 [emedicine.medscape.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]

Evidence-based treatment recommendations enable you to manage diseases confidently. Pocket-sized format provides access to need-to-know information quickly and easily. Highlights new evidence and content surrounding mental health and traveling. [books.google.com]

The evidence base for these treatments is purely anecdotal. [lifeinthefastlane.com]

Anaphylasis is a medical emergency that requires treatment with an epinephrine (adrenaline) injection (experienced travelers often carry an “epi” pen) and a trip to the emergency room. [healthytravelblog.com]

The prognosis is favorable for patients who survive beyond 12-18 hours (3). Because PSP has no specific treatment or antidote, treatment is supportive. [cdc.gov]

The prognosis is good if the patient survives the first 12 hours. Muscle weakness may persist for weeks in surviving victims. Management includes supportive care and early intervention for respiratory failure. [calpoison.org]

The prognosis of shellfish-associated infections is generally good, except for outbreaks of Vibrio vulnificus infection, which have a mortality rate of up to 50% in vulnerable people. [academic.oup.com]

While evaluating patients with seafood poisoning with neurological symptoms, health care providers must consider other etiologies as well. [calpoison.org]

The majority of reported seafood-associated illnesses have unidentified etiologies and are assumed to be viral. [academic.oup.com]

[…] related, ingested shellfish OR detection of high levels of dinoflagellates associated with shellfish poisoning in water from which epidemiologically related shellfish were gathered 3.2 Probable case Clinical illness within 12 hours of consumption of [canada.ca]

On June 6, 2011, the Section of Epidemiology (SOE) of the Alaska Division of Public Health was notified of a case of paralytic shellfish poisoning (PSP) in southeast Alaska. [ncbi.nlm.nih.gov]

Part II covers impacts of toxins regarding epidemiology, toxicology, economics, and surveillance. Part III explores available detection technologies, such as functional assays, biosensors, mass spectrometry, nanotechnology, and more. [books.google.com]

Enteric Diseases Br, Div of Bacterial and Mycotic Diseases, Center for Infectious Diseases; Div of Field Epidemiology, Epidemiology Program Office, CDC. [cdc.gov]

Local health jurisdictions: immediately notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) (1-877-539-4344 or 206-418-5500). [doh.wa.gov]

[…] comprise the A. tamarense species complex. [4] In Asia, PSP is mostly associated with the occurrence of the species Pyrodinium bahamense. [5] Also some pufferfish, including chamaeleon puffer, contain saxitoxin, making their consumption hazardous. [6] Pathophysiology [en.wikipedia.org]

The pathophysiology of the syndrome is complex and not completely understood. [emedicine.medscape.com]

This has important implications for the understanding of the pathophysiology of this disease and for therapeutic recommendations. J Clin Invest. 1986 Jun;77(6):1864-72. Shellfish questions Q. [raysahelian.com]

Prevention: Before harvesting shellfish check the Marine Biotoxin Hotline (1-800-562-5632) or web site for updates on affected sites and site closures, which may not always have signs posted. [doh.wa.gov]

Get the skills you need now with new information on global humanitarian relief and expedition medicine, plus expanded coverage of injury prevention and environmental preservation. [books.google.com]

Prevention involves proper refrigeration of fish at temperatures of less than 4.4º C (40ºF). [emedicine.medscape.com]

How to prevent food poisoning when travelling Avoid the greens Good news for salad haters, when you’re in places that are known for having unsanitary tap water, like Southeast Asia, you have to be wary about the greens (or any raw produce). [travelinsurancedirect.com.au]