Case Report: Paralytic Shellfish Poisoning in Sabah, Malaysia

Abstract

During the months of January-February and May-June 2013 coinciding with the red tide occurrence in Kota Kinabalu, Sabah, Malaysia, six episodes involving 58 cases of paralytic shellfish poisoning (PSP) or saxitoxin (STX) poisoning and resulting in four deaths were reported. Many of them were intoxicated from consuming shellfish purchased from the markets, whereas others were intoxicated from eating shellfish collected from the beach. Levels of STX in shellfish collected from the affected areas were high (mean 2,920 ± 780 and 360 ± 140 µg STX equivalents/100 g shellfish meat respectively for the two periods). The count of toxic dinoflagellates ( var ) of the sea water sampled around the coast was also high (mean 34,200 ± 10,300 cells/L). Species of shellfish containing high levels of STX were, , and. The age of victims varied from 9 to 67 years. Symptoms presented were typical of PSP, such as dizziness, numbness, vomiting, and difficulty in breathing. Recommended steps to prevent or reduce PSP in future red tide season include better monitoring of red tide occurrence, regular sampling of shellfish for determination of STX level, wider dissemination of information on the danger of eating contaminated shellfish among the communities, fishermen, and fishmongers.

A Review of Published Literature Regarding Health Issues of Coastal Communities in Sabah, Malaysia

“…A total of 11 articles were finally considered and included in this review. Overall, the most recent articles were published in 2017 [13][14][15][16][17], and the oldest article was published in 2010 [18]. All of the included articles were descriptive studies.…”

“…Five out of the 11 articles reported on malaria infection [13,[19][20][21][22], two of the articles reported on seafood poisoning [15,16], and two articles reported on tuberculosis (TB) disease [18,23]. A study assessed the antenatal care practice and pregnancy outcome [17], and another study measured iodine status among pregnant women [14].…”

“…A paralytic shellfish poisoning (PSP) or saxitoxin poisoning was also reported in the coastal communities in Sabah [16]. A total of 58 poisoning cases with four deaths were reported in Kota Kinabalu from 1 January to 6 June 2013.…”

A New Perspective: Revealing the Algicidal Properties of Bacillus subtilis to Alexandrium pacificum from Bacterial Communities and Toxins

“…Numerous fatal cases of PSTs have been reported globally [ 12 ]. Toxic blooms with PSTs in Basha in 2013 have resulted in the intoxication of 58 people with 4 fatalities (records from the Sabah Health Department, Malaysia) [ 13 ]. With continuous research on the algae–bacteria relationship, bacteria with algicidal activity have been shown to play an important role in controlling HABs by lysing algal cells [ 14 , 15 ].…”

Microcystis Sp. Co-Producing Microcystin and Saxitoxin from Songkhla Lake Basin, Thailand

“…Saxitoxins, comprising 57 compounds, are a potent neurotoxin blocking ionic sodium and calcium channels, resulting in rapid paralysis and respiratory failure [ 7 ]. The passing of either MCs and/or STXs through the aquatic food web leads to animal deaths and human poisonings [ 8 , 9 ]. The World Health Organization (WHO) and the United States Environmental Protection Agency (EPA) have set guidelines to minimize MCs’ hazards [ 10 , 11 ].…”