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Paralytic Shellfish Poisoning - Symptoms, Causes, Diagnosis, Treatment, and Prevention

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A foodborne sickness called paralytic shellfish poisoning often arises after consuming shellfish that has been exposed to saxitoxin. Read to know more.

Written by

Dr. Vennela. T

Medically reviewed by

Dr. Penchilaprasad Kandikattu

Published At July 20, 2023
Reviewed AtJuly 20, 2023

Introduction

A naturally occurring marine biotoxin called paralytic shellfish poison (PSP) is created by specific types of tiny algae. Shellfish can retain the poison after consuming these algae. Eating seafood tainted with paralytic shellfish poison can make people sick. The phrase "paralytic" shellfish poison refers to the biotoxin's effects on the neurological system and paralysis of the muscles. Paralytic shellfish poison can result in severe disease and even death at high doses.

Which Kind of Shellfish Are Impacted?

Paralytic shellfish poison can build up in Bivalve molluscan shellfish like clams, mussels, oysters, geoducks, and scallops. The same is true for other gastropods and moon snails. Sea cucumbers and other marine creatures could be impacted. Due to their diet of shellfish, crabs can also develop poisonous qualities. Even though the crab flesh is harmless, toxins often build up in the crab gut and butter (the white-yellow fat found in the shell's back). Avoid eating the fat and guts of the crab, and properly clean it.

Why Are Paralytic Shellfish Poison Levels So High?

It is typical for seawater to include algae that produce biotoxins. They often exist in small populations that pose no issues. But when the algae "blooms," the number of algae that produce biotoxins may rise. Shellfish now have a better food source thanks to the increasing algae. The amount of biotoxin that shellfish ingest depends on how much algae they consume. Shellfish are not harmed by biotoxins. Therefore, their tissue level will increase until the bloom dies down. The shellfish gradually flush the toxin from their bodies when the number of toxin-producing algae cells returns to normal low levels. It may take a few days, a few months, or even longer before they are once more safe to eat.

What Are the Symptoms of Paralytic Shellfish Poisoning?

  • Tingling, sometimes known as paresthesia or a pins-and-needles sensation.

  • Lips and mouth numbness that extends to the face, neck, and limbs.

  • Dizziness.

  • Paralysis weakened arms and legs.

  • Breathing problems, and in extreme circumstances, death.

  • Headache.

  • Nausea.

  • Vomiting.

The average period between consumption and the onset of symptoms is one hour (between 30 minutes and three hours). The rate of symptom progression and severity varies according to the severity of the toxin poisoning. In severe situations, death, respiratory failure, and muscle paralysis can happen within 12 hours.

What Are the Causes of Paralytic Shellfish Poisoning?

Bivalve shellfish and crustaceans that have been tainted with a toxin can result in paralytic shellfish poisoning. Dinoflagellate algal blooms, which typically occur from June through October when the weather is warmer, cause an accumulation of toxins in filter feeders like bivalves. Clams, mussels, whelks, moonshell, dog winkles, oysters, entire scallops, crabs, and lobster hepatopancreas (tomalley) are the fish species most frequently afflicted.

In some species of shellfish, the toxin bioaccumulates in specific tissues and can last for a very long time. Butter clams, for instance, which go by the Latin name Saxidomus and are the source of the term saxitoxin, can retain toxin for up to a year after an algal bloom that produces it. Butter clams acquire toxins in the siphon, throat, and gills; it is advised to remove and discard them before eating. Avoid giving the pets these substances. Butter clams have been connected to sea otter deaths in Alaska.

What PSP Tests Are Available Right Now?

Liquid chromatographic post-column oxidation (LC PCOX) is the method used in laboratories to test for PSP in shellfish. This innovative test isolates fluid samples at the molecular level, allowing for the identification and measurement of specific hazardous chemicals. It replaces the conventional mouse bioassay approach that has been in use since the 1950s. Human PSP is primarily diagnosed based on clinical manifestation and recent shellfish exposure.

What Can Be Done for People Who Are Suspected to Have PSP Sickness?

The accompanying healthcare professional is in charge of the treatment. People should get medical help right away. PSP has no recognized antitoxin. Supportive care is provided. Serious patients should be admitted to the hospital and given breathing support. The foundation of PSP treatment is typically supportive measures, including ventilator support in severe cases. Up to 75 percent of severely affected people pass away within 12 hours without supportive care.

Staff from public health will carry out an investigation to identify any potential sources of the sickness and to talk about contacts. Even though the infection cannot be passed from person to person, contact follow-up is advised for anyone else who may have eaten tainted food. These people ought to get education on disease symptoms when to seek medical help, transmission, the length of the incubation period, and preventative actions.

How Can One Be Safeguarded From Paralytic Shellfish Poisoning?

One can safeguard from PSP poisoning with a certain method.

  • Do Not Eat Them: Avoiding eating bivalves (such as clams, mussels, scallops, and cockles) from beaches is the simplest and most effective strategy to prevent PSP poisoning. PSP testing is necessary for shellfish sold at wholesale and retail marketplaces, and they are thought to be safe for human consumption.

  • Know the Species: One can lower the risk if they consume bivalves from beaches by staying away from the two most deadly species, butter clams, and blue mussels. Littleneck clam toxicity levels often rise less in littleneck clams than in butter clams and decline more quickly in littleneck clams. Under Alaska's official policy, eating untested shellfish is dangerous. Since the quantities of toxicity have been documented, this also applies to littleneck clams. Littleneck clams are less prone to PSP than other shellfish. However, this does not mean they are always safe when other species nearby are also affected. One should become familiar with all the clam species if one gathers or consume clams from Alaskan beaches. Consuming any clams, scallops, or mussels from Alaska's shores requires extreme caution.

It is advisable to remove the crab's back shell and clean out all the dark soft tissues that make up the digestive system and crab butter before cooking since crabs that eat hazardous shellfish can accumulate PSP toxin in their digestive systems.

Conclusion

In conclusion, eating shellfish tainted with saxitoxins can result in paralytic shellfish poisoning, a dangerous condition. It is critical to be informed about shellfish harvesting advisories, to stay away from locations that are closed or contaminated, and to seek medical help if PSP symptoms appear after consuming shellfish. Pay attention to regional advice and stay away from eating shellfish from known contaminated locations to prevent PSP.

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Dr. Penchilaprasad Kandikattu
Dr. Penchilaprasad Kandikattu

Internal Medicine

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