Mussel Beach: Paralytic Shellfish Poisoning

July 11, 2014, 6:06 pm

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Paralytic Shellfish Poisoning: A Case Series. Hurley W et al. West J Emerg Med 2014 Jul;15:378-381.

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Paralytic shellfish poisoning (PSP)is caused by saxitoxin,  an alkaloid produced by certain marine dinoflagellates and released during algae blooms that produce a so-called “red tide.” (Actually, the water can be various colors, or even clear, during these blooms.) The toxin is then taken up and concentrated by filter-feeding mollusks, including oysters, clams and mussels.

Like tetrodotoxin, saxitoxin is a sodium-channel blocker. It causes mostly neurotoxicity and gastrointestinal symptoms.

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. Because of an on-going “red tide,” warning signs had been set up closing the beach to harvesting of mollusks but were not noticed. 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. Four patients were admitted to the intensive care unit, one of whom required intubation and assisted ventilation. All patients recovered within 24 hours.

This is an interesting case series. I did have a question concerning why the clinicians monitored ventilatory capacity by meaning peak flow rates. My understanding was that the negative inspiratory force was a much more helpful parameter.
Related posts;

Paralytic Shellfish Poisoning in Alaska 

Angry Birds? or Domoic Acid Toxicity

Saxitoxin invades Seattle!

 

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