[Paddlewise] Part 1: Ciguatera, Pufferfish and other lovely toxins

Part 1:

The subject is quite large, but I will mention two areas, if somewhat oversimplified, to clear up questions mentioned recently.
 First Pufferfish...some of which are prepared as the Japanese delicacy fugu by specially trained and liscensed chefs. Pufferfish (blowfish, balloonfish, toadfish, swellfish, toado) are in the order Tetraodontiforms, and have tetrodotoxin, one of the most potent nonprotein poisons in nature. This order includes ocean sunfishes, pufferfish, and porcupine fishes; these are among the most poisonous of marine life. 
  The fish are found in shallow waters of temperate and tropical zones. Tetrodotoxin, a powerful neurotoxin, is contained in the liver (highly toxic), gonads, intestines and skin of these fish, and approximately 60% of those who ingest it will die. The toxin is believed identical to tarichatoxin isolated from other species, such as certain newts, salamanders, shellfish, and a few others.
  Tetrodotoxin is heat-stable, so cooking will not destroy it, and acts by blocking sodium conductance within the depolarized regions of the cell membrane, thus blocking neuromuscular transmission, causing depression of the medullary respiratory mechanism, myocardial and skeletal musle contractility, and intracardiac condution.
  Symptoms begin about 10-45 minutes after ingestion, but may begin as late as 4 hours, with tingling of the tongue and inner surface of the mouth. Other symptoms rapidly develop, including nausea and vomiting (intense), hypersalivation, sweats, abdominal pain, weakness, incoordination, ataxia, tremor, dizziness, lightheadedness, low blood pressure, difficulty speaking or swallowing, wheezing, respiratory failure, coma (hypoxic), heart block, and paralysis. Death can occur in 6-24 hours. 
  If hospitalized and intubated, a person can be completely paralyzed yet fully aware, so long as no brain damage from lack of oxygen has occurred. Bleeding problems can occur from a disseminated intravascular coagulation-like picture. Of the 60% who die, most do so in the first 6 hours. Surviving past 24 hours is a good sign.
  Treatment requires hospitalization, with gastric lavage, administration of Sodium bicarb and activated charcoal.  In serious cases, possible intubation, possible temporary pacemaker insertion and other supportive care may be needed, whereas a mild case might only require initial treatment plus an 8 hour observation for more serious symptoms. There is no antidote, though work is in progress.
  Prevention is really don't eat it; tetrodotoxin, while water-soluble, is extremely difficult to remove from the fish. Even in Japan, where regulations for preparation are strict, there are about 50 deaths a year; their death rate is about 51%, so over 100 people per year are poisoned.
  
Part 2 will discuss Ciguatera.

Regards,
Leander
leander_at_worldnet.att.net

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