Saxitoxin Puffer Fish Poisoning in the United States, with the First Report of Pyrodinium bahamense as the Putative Toxin Source

Abstract

BackgroundFrom January 2002 to May 2004, 28 puffer fish poisoning (PFP) cases in Florida, New Jersey, Virginia, and New York were linked to the Indian River Lagoon (IRL) in Florida. Saxitoxins (STXs) of unknown source were first identified in fillet remnants from a New Jersey PFP case in 2002.MethodsWe used the standard mouse bioassay (MBA), receptor binding assay (RBA), mouse neuroblastoma cytotoxicity assay (MNCA), Ridascreen ELISA, MIST Alert assay, HPLC, and liquid chromatography-mass spectrometry (LC-MS) to determine the presence of STX, decarbamoyl STX (dc-STX), and N-sulfocarbamoyl (B1) toxin in puffer fish tissues, clonal cultures, and natural bloom samples of Pyrodinium bahamense from the IRL.ResultsWe found STXs in 516 IRL southern (Sphoeroides nephelus), checkered (Sphoeroides testudineus), and bandtail (Sphoeroides spengleri) puffer fish. During 36 months of monitoring, we detected STXs in skin, muscle, and viscera, with concentrations up to 22,104 μg STX equivalents (eq)/100 g tissue (action level, 80 μg STX eq/100 g tissue) in ovaries. Puffer fish tissues, clonal cultures, and natural bloom samples of P. bahamense from the IRL tested toxic in the MBA, RBA, MNCA, Ridascreen ELISA, and MIST Alert assay and positive for STX, dc-STX, and B1 toxin by HPLC and LC-MS. Skin mucus of IRL southern puffer fish captive for 1-year was highly toxic compared to Florida Gulf coast puffer fish. Therefore, we confirm puffer fish to be a hazardous reservoir of STXs in Florida’s marine waters and implicate the dinoflagellate P. bahamense as the putative toxin source.ConclusionsAssociated with fatal paralytic shellfish poisoning (PSP) in the Pacific but not known to be toxic in the western Atlantic, P. bahamense is an emerging public health threat. We propose characterizing this food poisoning syndrome as saxitoxin puffer fish poisoning (SPFP) to distinguish it from PFP, which is traditionally associated with tetrodotoxin, and from PSP caused by STXs in shellfish.

Phytoplankton of the northern coastal and shelf waters of the Yucatan Peninsula, southeastern Gulf of Mexico, Mexico

“…bahamense, considered potentially toxic only due to a single report on the toxicity of var. bahamense in the coastal waters of East Florida (Landsberg et al 2006), reached the population density of 1.8x10 5 cells l -1 ). In total, 18 potentially toxic species (16 dinoflagellates and two cyanobacteria) were found.…”

Clinical and epidemiological study of 27 poisonings caused by ingesting puffer fish (Tetrodontidae) in the states of Santa Catarina and Bahia, Brazil

“…In Florida's marine waters (USA), puffer fish have been confirmed to be a hazardous reservoir of STX 17 and this toxin was responsible for 28 poisoning cases between 2002 and 2004 8 . A study in Brazil identified saxitoxin and gonyautoxin as the components responsible for toxicity in Colomesus asellus, a freshwater puffer fish 23 .…”

“…STX is produced by microalgae 8 . STX accumulates by feeding on bivalves that have ingested toxic dinoflagellate such as Alexandrium tamarense 19 and Pyrodinium bahamense 17 .…”

“…Although not usually targeted, STXs have been incidentally found in numerous species of fish such as Colomesus asellus and some species of Sphoeroides. Like TTX, STX is found in the skin, muscle, gut contents, gonads and liver 1,8,17,19 .…”

Developmental Biology of Neoplastic Growth

“…The main symptoms of human intoxications associated with PFP and PSP include neurological, cardiac and gastrological complications. Numbness of the mouth, face and fingertips, nausea and vomiting, paralysis of the arms and legs, difficulty in breathing and eventually -for extreme cases -death associated with respiratory paralysis have been described (Landsberg et al 2006;Schantz and Johnson 1992). For more information see Chap.…”