Journal Article

Public Health Response to Puffer Fish (Tetrodotoxin) Poisoning from Mislabeled Product

Cohen, Nicole J, Huh, In, Gerber, Susan I, Pham, Tu D, Deeds, Jonathan R, Guichard, Frances M, Thompson, Trevonne M, Wahl, Michael, Austin, Connie, Hanner, Robert H, Wong, Eugene S, Yancy, Haile F, Dizikes, George, White, Kevin D

2009

Overview

Tetrodotoxin is a neurotoxin that occurs in select species of the family Tetraodontidae (puffer fish). It causes paralysis and potentially death if ingested in sufficient quantities. In 2007, two individuals developed symptoms consistent with tetrodotoxin poisoning after ingesting home-cooked puffer fish purchased in Chicago. Both the Chicago retailer and the California supplier denied having sold or imported puffer fish but claimed the product was monkfish. However, genetic analysis and visual inspection determined that the ingested fish and others from the implicated lot retrieved from the supplier belonged to the family Tetraodontidae. Tetrodotoxin was detected at high levels in both remnants of the ingested meal and fish retrieved from the implicated lot. The investigation led to a voluntary recall of monkfish distributed by the supplier in three states and placement of the supplier on the U.S. Food and Drug Administration's Import Alert for species misbranding. This case of tetrodotoxin poisoning highlights the need for continued stringent regulation of puffer fish importation by the U.S. Food and Drug Administration, education of the public regarding the dangers of puffer fish consumption, and raising awareness among medical providers of the diagnosis and management of foodborne toxin ingestions and the need for reporting to public health agencies.

• Publisher: International Association for Food Protection,Elsevier Limited
• Subject: Animals / Biological and medical sciences / Case reports / Cellulose acetate / Child / Chromatography / consumer education / consumer information / consumer protection / Descriptive labeling / Female / Fish / Fishes, Poisonous / Food and Drug Administration / Food Contamination / Food contamination & poisoning / Food industries / food intoxication / Food Labeling / Food microbiology / food recalls / Food safety / food safety education / Foodborne Diseases / Fundamental and applied biological sciences. Psychology / genetics / health care workers / health education / Humans / imports / Laboratories / Male / Mass spectrometry / Middle Aged / misinformation / mislabeling / Neurotoxins / Phylogeny / Poisoning / Poisons / Public health / Public Health Administration / Retail stores / Scientific imaging / signs and symptoms (animals and humans) / Skin / Tetraodontidae / Tetraodontiformes / Tetraodontiformes - genetics / tetrodotoxin / Tetrodotoxin - poisoning / Toxins / US imports