Paralytic Shellfish Poisoning
PSP is a marine toxin disease with both gastrointestinal and neurologic symptoms reported worldwide. It is caused predominantly by the consumption of
contaminated shellfish.
Gonyaulacoid dinoflagellates are the source of PSP marine toxins.These unicellular dinoflagellates develop algal blooms.....
Five to 30 minutes from consumption, there is slight perioral tingling progressing to numbness which spreads to face and neck to moderate cases. In
severe cases, these symptoms spread to the extremities with incoordination and respiratory difficulty. There are medullary disturbances in severe
cases evidenced by difficulty swallowing, sense of throat constriction, speech incoherence or complete loss of speech, as well as brain stem
dysfunction. Within 2-12 hours, in very severe cases, there is complete paralysis and death from respiratory failure in absence of ventilatory
support. After 12 hours, regardless of severity, victims start to recover gradually and are without any residual symptoms within a few days (Bower et
al, 1981, ILO 1984, Halstead 1988).
Other symptoms include headache, dizziness, nausea, vomiting, rapid pain, and anuria. There is no loss of consciousness and the reflexes are unaltered
except maybe pupillary size and sight may be temporarily lost.
The overall mortality (case fatality rate) was about 8.5% -9.5% in two large series (Meyer 1953, Ayres and Cullum 1978). However, the Guatemalan 1987
outbreak on Pacific coast had a case fatality rate of 14% |
