Puffer Fish (Tetrodotoxin) Poisoning Clinical Record and Suggested Management

Puffer Poisoning: Epidemiology and Treatment

“…Several researchers report that administration of the anticholinesterases, edrophonium and neostigmine, enhance the recovery of motor power and markedly reduce paresthesia and numbness (25)(26)(27)(28)(29). Although these reports are contrary to those of Kao (30), it is suggested that TTX causes a competitive reversible Toxin Reviews Downloaded from informahealthcare.com by Mcgill University on 11/19/14…”

Never eat an ugly fish: three cases of tetrodotoxin poisoning from Western Australia

“…Up until the 1950s all seven patients with TTX poisoning died. Two severe cases reported by Torda 29 and Tibballs 16 in 1973 and 1988 respectively, made complete recoveries.…”

“…The puffer fish has been responsible for most case reports of TTX poisoning from Thailand 23 , Japan 15,24,25 , Fiji 26 , Singapore 5 , Malaysia 27 , Taiwan 28 , Italy 8 , California 4 , Hong Kong 16 and Australia 16,21,22,29 . Other marine creatures responsible include the horseshoe crab in Thailand 11 , Californian newt 30 , the gastropod mollusc from Taiwan 31 and the Australian blue ringed octopus 19 .…”

Tetrodotoxin Poisoning Associated With Eating Puffer Fish Transported from Japan— California, 1996

“…7 Although arriving travelers are re¬ quired to declare all food products brought into the United States, control measures rely primarily on the trav¬ eler. A cooperative agreement with the Japa¬ nese Ministry of Health and Welfare ensures fugu is properly processed and certified safe for consumption before ex¬ port by the government of Japan.…”