Chapter 26: Natural ToxinsUpdated: 03/08/11
There are five recognized fish poisoning syndromes in the United States: paralytic shellfish poisoning (PSP), neurotoxic shellfish poisoning (NSP), diarrhetic shellfish poisoning (DSP), amnesic shellfish poisoning (ASP), and ciguatera fish poisoning (CFP). Scombrotoxin formation, the subject of Chapter 27, is not considered a natural toxin (FDA, 2001).
Domoic acid produced by dense growth of an algae in the genus Pseudonitzschia causes ASP. In the early stages of ASP, the individual usually experiences intestinal distress. Severe ASP can cause a facial grimace or chewing motion, short-term memory loss and difficulty breathing. Death can occur (Ward et al., 1997).
A number of algae species in the genera Dinophysis and Prorocentrum have been associated with DSP. These algae are responsible for the production of a number of toxins, including okadaic acid and its derivatives. The symptoms of DSP are diarrhea, nausea, vomiting, moderate to severe abdominal pain and cramps, and chills. No known fatalities have occurred, and total recovery is expected within three days, with or without medical assistance (Ward et al., 1997).
NSP is caused by Gymnodinium breve. Blooms of this algae usually result in fish kills and can make shellfish toxic to humans. The blooms generally begin offshore and move inshore. G. breve produces three known toxins (brevetoxins). NSP resembles a mild case of ciguatera or PSP. Symptoms begin within three hours of consuming contaminated shellfish. Symptoms include: tingling of the face that spreads to other parts of the body, cold-to-hot sensation reversal, dilation of the pupils, and a feeling of inebriation. Less commonly, victims may experience: prolonged diarrhea, nausea, poor coordination, and burning pain in the rectum (Ward et al., 1997).
PSP is caused by many species of toxic algae. These include Alexandrium, Pyrodinium and Gymnodinium. PSP can be caused by a combination of any of 18 toxins (saxitioxins), depending on the species of algae, geographic area and type of shellfish involved. Symptoms of PSP initially involve numbness and a burning or tingling sensation of the lips and tongue that spreads to the face and fingertips. This leads to a general lack of muscle coordination in the arms, legs, and neck. A variety of other less commonly reported symptoms also exist. Severe cases of PSP have resulted in respiratory paralysis and death (Ward et al., 1997).
CFP is caused by certain species of tropical and subtropical fish that consume toxic algae or other fish that have become toxic. The algae species most often associated with CFP is Gambierdiscus toxicus, but others are occasionally involved. There are at least four known toxins that concentrate in the viscera, head, or central nervous system of affected fish. Ciguatera causes: diarrhea, abdominal pain, nausea, vomiting, abnormal or impaired skin sensations, vertigo, lack of muscle coordination, cold-to-hot sensation reversal, muscular pain, and itching. Some of the symptoms may recur for as long as six months. Death is infrequent, but may occur (Ward et al., 1997).
Symptoms of poisoning usually begin within 10 minutes of consuming puffer fish. The victim first experiences numbness and tingling of the mouth. This is followed by weakness, paralysis, decreased blood pressure, and quickened and weakened pulse. Death can occur within 30 minutes (Ward et al., 1997).
There are no validated, rapid methods that are suitable for shipboard, dockside, or commercial testing of lots of fish for any of these toxins (FDA, 2001).ASP, DSP, NSP, PSP, and CFP
Natural toxins cannot be reliably eliminated by heat. However, severe heating processes, such as retorting, may be effective at reducing the levels of some natural toxins.
To minimize the risk of molluscan shellfish containing natural toxins from the harvest area, State and foreign government agencies, called Shellfish Control Authorities, classify waters in which molluscan shellfish are found, based, in part, on the presence of natural toxins. As a result of these classifications, molluscan shellfish harvesting is allowed from some waters, not from others, and only at certain times, or under certain conditions, from others. Shellfish Control Authorities then exercise control over the molluscan shellfish harvesters to ensure that harvesting takes place only when and where it has been permitted. Molluscan shellfish include oysters, clams, mussels, and scallops, except where the scallop product contains the shucked adductor muscle only.
Significant elements of Shellfish Control Authorities' efforts to control the harvesting of molluscan shellfish include: 1) a requirement that containers of in-shell molluscan shellfish (shellstock) bear a tag that identifies the type and quantity of shellfish, harvester, harvest location, and date of harvest; 2) a requirement that molluscan shellfish harvesters be licensed; 3) a requirement that processors that shuck molluscan shellfish or ship, reship, or repack the shucked product be certified; and, 4) a requirement that containers of shucked molluscan shellfish bear a label with the processor's name, address, and certification number.
An established water classification system similar to the molluscan shellfish system is not in place for controlling CFP in fin fish. However, some states issue advisories regarding reefs that are known to be toxic. In areas where there is no such advisory system, fishermen and processors must depend on first-hand knowledge about the safety of the reefs from which they obtain fish.
Where PSP or ASP have become a problem in fin fish or crustaceans, states generally have closed or restricted the appropriate fisheries. In addition, removal and destruction of the viscera will eliminate the hazard (FDA, 2001)
FDA advises against importation of escolar (i.e. Lepidocybium flavobrunneum, Ruvettus pretiosus) (FDA, 2001).Tetramine and Tetrodotoxin
FDA makes no recommendations and has no specific expectations with regard to controls for tetrodotoxin or tetramine in processors' HACCP plans (FDA, 2001).
All molluscan shellfish must have been harvested from waters authorized for harvesting by a shellfish control authority. For U.S. Federal waters, no molluscan shellfish may be harvested from waters that are closed to harvesting by an agency of the federal government.
All containers of shucked molluscan shellfish must bear a label that identifies the name, address, and certification number of the packer or repacker of the product.
All molluscan shellfish must be from a harvester that is licensed as required (note that licensing may not be required in all jurisdictions) or from a processor that is certified by a shellfish control authority.
(Note: only the primary processor [the processor that takes possession of the molluscan shellfish from the harvester] need apply controls relative to the identification of the harvester, the harvester's license, or the approval status of the harvest waters.) (FDA, 2001)
FDA issued an industry advisory on puffer fish. (October 2007)NEW
Commercial test products for Ciguatoxin.
As of March 8, 2011, currently there are no test kits for ciguatoxins that are reliable and thus none successfully validated either. There is an effort in Japan to develop an ELISA kit based on synthesized ciguatoxins and impressive progress, but to date it has not reached adequate sensitivity to detect the ciguatoxins at levels to protect human health. There are powerful research tools, for example cytotoxicity assay that have the required sensitivity and together with LC-MS/MS have been applied in studying outbreaks, but these are not rapid portable tests. New action levels and more guidance are being proposed but have not been released yet. The current guidance from FDA for those who haven't seen it is at: http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/Seafood/FishandFisheriesProductsHazardsandControlsGuide/default.htm
Research on ciguatera and method development for the ciguatoxins severely impacted by lack of the purified toxins.
Commercial test products for Diarrhetic Shellfish Poison.
Commercial test products for Domoic Acid
Commercial test products for Okadaic Acid.
Commercial test products for Saxitoxin.
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