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Shellfish and Mollusk Poisoning

Shellfish Toxic Effect


Presentation

  • 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]
  • الصفحة 304 - Committee therefore concluded that the irradiation of any food commodity up to an overall average dose of 10 kGy presents no toxicological hazard; hence, toxicological testing of foods so treated is no longer required. ‏[books.google.com]
  • Activity consistent with brevetoxins was present in both urine and shellfish extracts.[ncbi.nlm.nih.gov]
  • The neoSTX was not present in the gastric content sample, indicating that the oxidation of N(1) in the STX tetrahydropurine nucleus resulted neoSTX, in a similar way that GTX3/GTX2 epimers were transformed in GTX4/GTX1 epimers.[ncbi.nlm.nih.gov]
  • 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]
Fishing
  • This chapter also tackles the diet and general fish husbandry. This topic is very important, because an adequate diet for fish husbandry is the foundation of fish farming.[books.google.com]
  • Temprosa ‏ لا تتوفر معاينة - 1989 عبارات ومصطلحات مألوفة Abstracts Anderson Anon Australia Bangkok blooms compressa Council of Thailand Crisostomo Cronulla CSIRO Marine Laboratories Elsevier Science Publishing Environmental Science Fish Fukuyo Gulf of[books.google.com]
  • Canned fish should be refrigerated after opening. Smoked fish, pickled fish, vacuum-packed fish, and modified-atmosphere-packed fish products should always be refrigerated. Keep cooked and raw seafood separate.[thebody.com]
  • Also included in this second list are fish roe (eggs), available fresh or canned. They’re an essential part of most native fertility diets — and for good reason! THIRD: Fish — any fish.[foodrenegade.com]
  • The incidence of puffer fish poisoning is decreasing, presumably because of heightened awareness and proper preparation of fish.[emedicine.medscape.com]
Fever
  • Covers emerging hot topics such as Ebola virus disease, viral hemorrhagic fevers, the role of point-of-care testing in travel medicine, and antibiotic-resistant bacteria in returning travelers and students traveling abroad.[books.google.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]
  • 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]
  • So if it’s been a while since you sat down to crunch some crustaceans (crab, lobster, shrimp) or munch some mollusks (clams, oysters mussels, snails, squid, conch), consider the following: If you have family history of allergies (including hay fever or[healthytravelblog.com]
  • Other symptoms include abdominal cramps, nausea, vomiting, headache, fever, and bloody diarrhea. Sepsis due to V. parahaemolyticus is quite rare and occurs primarily in patients with cirrhosis and neutropenia.[academic.oup.com]
Swelling
  • Mildly allergic persons may have itching and a few hives, while severely allergic persons can have severe, life-threatening symptoms such as breathing problems or swelling of the throat.[my.clevelandclinic.org]
  • Symptoms of anaphylaxis can include: throat swelling, making it difficult or impossible to breathe drop in blood pressure rapid pulse dizziness loss of consciousness If you suspect a shellfish allergy, make an appointment with your doctor—even when symptoms[healthline.com]
  • Symptoms of a reaction to seafood can include flushing and swelling in the face, mouth and throat; digestive tract symptoms such as nausea and diarrhea; itching and hives; difficulty breathing; lightheadedness or faintness; a sudden drop in blood pressure[allergicliving.com]
  • A separate but related observation is that several patients have delayed reactions to shrimp, i.e. eating it for dinner, going to bed without symptoms and awaking the next morning with facial hives and/or lip swelling.[aaaai.org]
Anemia
  • Some of these diseases include thyroid tumor, gill disease, anemia, lipoid liver degeneration, and visceral granuloma. In Chapter 11, the relationship of nutrition and pathology is given emphasis.[books.google.com]
  • […] due to glucose-6-phosphate dehydrogenase [G6PD] deficiency 2016 2017 2018 2019 Billable/Specific Code Applicable To Favism G6PD deficiency anemia fish (noxious) T61.9- ICD-10-CM Diagnosis Code T61.9- Toxic effect of unspecified seafood 2016 2017 2018[icd10data.com]
  • That makes them excellent for nerve and blood cell health, treating or preventing iron-deficiency anemia, protecting against cellular damage, forming connective tissue and sex hormones, and supporting carbohydrate and fat metabolism.[thepaleomom.com]
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]
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]
  • 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]
  • 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]
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]
  • A second type of allergy, which features nausea, vomiting and abdominal cramps, can also occur after eating mussels.[livestrong.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]
  • 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]
  • 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]
Food Poisoning
  • Scombroid poisoning is discussed further in our fish food poisoning section.[medic8.com]
  • Avoid raw shellfish It's best not to eat raw shellfish while you're pregnant to reduce the risk of food poisoning, which can be particularly unpleasant during pregnancy.[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]
  • Code A05.9 Bacterial foodborne intoxication, unspecified 2016 2017 2018 2019 Billable/Specific Code berries, noxious - see Poisoning, food, noxious, berries botulism A05.1 ICD-10-CM Diagnosis Code A05.1 Botulism food poisoning 2016 2017 2018 2019 Billable[icd10data.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]
Diarrhea
  • 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]
  • 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]
  • 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]
  • Signs of neurotoxic shellfish poisoning include numbness, tingling in the mouth, arms and legs, nausea, vomiting and diarrhea. It is rarely fatal, and recovery usually occurs in two to three days.[livestrong.com]
  • 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]
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]
  • Abdominal pain. Nausea, vomiting or diarrhea. 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]
  • 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]
  • 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]
Eruptions
  • Improve your competency and readiness with the latest guidance on volcanic eruptions, extreme sports, splints and slings, wilderness cardiology, living off the land, aerospace medicine, mental health in the wilderness, tactical combat casualty care, and[books.google.com]
Erythema
  • Physical signs may include a diffuse blanching erythema, tachycardia, wheezing, and hypotension or hypertension. More severe cardiovascular manifestations attributed to scombroid poisoning have been reported but are rare.[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]
  • Recent studies suggest that fatty, not lean fish provided significant benefits. It's ok to eat lean, low-fat seafood, but don't expect much omega-3." Do you agree? A.[raysahelian.com]
Headache
  • 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]
  • The following symptoms have been reported after ciguatera poisoning: Nausea, vomiting, profuse water diarrhea Abdominal pain with cramps Diaphoresis Myalgias, arthralgias, ataxia, weakness Headaches, blurry vision, vertigo Seizure Peripheral dysthesias[calpoison.org]
  • […] 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]
  • 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]
  • 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]
Paresthesia
  • 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]
  • 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]
  • 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]
Flaccid Paralysis
  • paralysis, respiratory paralysis Q5.[lifeinthefastlane.com]
  • 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 may occur No antidote is available[emedicine.medscape.com]
Neurologic Manifestation
  • Gastrointestinal (GI) symptoms and neurological manifestations are common. Knowing where the fish or shellfish was caught can often aid in establishing the diagnosis. However, refrigerated transport of seafood now complicates the assessment.[calpoison.org]

Treatment

  • 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]
  • […] normally consumed as a food in itself and not normally used as a characteristic ingredient of food whether or not it has nutritive value, the intentional addition of which to food for a technological purpose in the manufacture, processing, preparation, treatment[books.google.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]
  • 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]

Prognosis

  • 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]

Etiology

  • 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]

Epidemiology

  • 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]
  • […] 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]
  • Viruses Epidemiological evidence gathered in recent years suggests that human enteric viruses are the most common pathogens transmitted by bivalve shellfish [ 25 ].[academic.oup.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]
Sex distribution
Age distribution

Pathophysiology

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

Prevention

  • 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]
  • Prevent, evaluate, and manage diseases that can be acquired in tropical environments and foreign countries with The Travel and Tropical Medicine Manual.[books.google.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]
  • 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]
  • 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]

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