Primary prevention

Paralytic shellfish poisoning (saxitoxin)

  • Prevention is by avoiding potentially contaminated bivalve molluscs (e.g., mussels, clams, scallops, oysters, cockles). This is particularly important in areas during or shortly after algal blooms, which may be locally referred to as 'red tides' or 'brown tides'. It is important for individuals to note that, despite the name, any colour water could harbour high levels of harmful algal blooms.[2]​ 

  • Public health agencies commonly monitor toxin levels in susceptible shellfish and post information about beach closures on websites and on signs. Individuals wishing to gather shellfish should investigate the appropriate sources to ensure that toxin levels have been measured and shown to be safe.

  • Travellers to developing countries should avoid eating all shellfish, because they carry a high risk of viral and bacterial infections. Marine shellfish toxins cannot be destroyed by cooking or freezing.[2]​​[13] 

Tetrodotoxin exposure

  • Prevention is by avoiding the consumption of suspect fish. Unless meticulously prepared by a certified chef, globe fish or puffer fish should not be consumed.

  • Tetrodotoxin injection by blue-ringed octopus can be prevented by avoiding handling of this species, as it may bite when threatened. This species can be difficult to identify, so care should be taken when handling any octopus species in the ocean waters of Australia and Asia.[16]

Conotoxin exposure

  • Prevention is by avoiding the injection of conotoxin by the cone snail Conus geographus.

  • Divers and shell collectors should be taught to identify and avoid handling this species. Night divers should be particularly careful, as cone snails are nocturnal feeders and risk of envenomation may be higher at this time.[25]

Secondary prevention

This requires identification of a marine toxin syndrome through suspicious history and physical examination findings, reporting the suspicious event to the proper authorities, and initiation of actions to prevent the exposure of additional people. In most cases, this is required long before confirmation of the specific toxin exposure.

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