Marine toxins (saxitoxin, tetrodotoxin, conotoxin)

Toxin identification

The public health impact of marine toxin exposure requires investigation to identify the specific toxin involved and the source of the toxin, and for elimination of risk of further exposure to additional people. Specific identification is commonly by mass spectroscopy.

Paralytic shellfish poisoning[32]Washington State Department of Health. Shellfish poisoning: paralytic, domoic acid, or diarrhetic. Mar 2018 [internet publication]. https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/NotifiableConditions/ShellfishPoisoning  

A. Clinical criteria for diagnosis: Onset of neurological symptoms (e.g., paraesthesias, ataxia, cranial nerve abnormalities, paralysis) with or without gastrointestinal symptoms within minutes to hours of shellfish ingestion.

B. Laboratory criteria for diagnosis: Identification of saxitoxin in epidemiologically implicated food.

C. Case definition probable: A clinically compatible case that is not laboratory confirmed and not epidemiologically linked to a confirmed case. Confirmed: A case that is laboratory confirmed OR a case that meets the clinical case definition, is not laboratory confirmed, and is epidemiologically linked to a laboratory-confirmed case.