Puffer Fish Poisoning

Puffer Fish poisoning is an illness seen mostly in Japan caused by a toxin called tetrodotoxin produced by bacteria and present in the liver, ovaries, intestines and skin of certain fish species; puffer fish, porcupine fish, salamanders and ocean sunfish.

The fish can only be prepared by specially skilled chefs and fishmongers who are trained to avoid contaminating the flesh with this toxin.

The illness can range from burning sensation on lips to abdominal pains with nausea and vomiting to paralysis and death.

Where does it occur?

It is mostly reported in Japan, a few cases have been reported in California.

How is it transmitted?

It is transmitted through the ingestion of fish that contains tetrodotoxin; like puffer fish, porcupine fish, salamanders and ocean sunfish.

Is it contagious from person to person?

It is not contagious from person to person.

What is the risk for travelers?

The risk is generally low for travelers unless eating fish like puffer, porcupine, salamander and sunfish.

How soon after exposure will one develop symptoms?

One develops symptoms generally a few hours after ingestion.

What are the signs and symptoms?

Symptoms are of numbness and tingling around the lips and limbs, excessive salivation, nausea, vomiting, diarrhea, and unsteady gait. In severe cases one progresses to paralysis, coma and death.

Are there any lab tests to diagnose the illness?

There are no specific lab tests to diagnose the illness, it is based on symptoms.

Is there any treatment?

There is no specific treatment, all measures are entirely supportive.

What preventive measures can be taken?

Avoid eating fish like puffer fish.

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