Bacterial Pathogens, Mycotoxins, Viruses, Parasites, and Fish Toxins ◾ 401
and generally subside in a few hours. The incidence is very low in the United States because of
effective monitoring systems. Sometimes a satellite is used to monitor ocean color, including red
tide. Karenia brevis bloom is a recurring problem in Gulf of Mexico.
Diarrhetic Shellfish Poisoning (DSP)
DSP is associated with two types of toxins, okadaic acid and dinophysistoxins produced by the
dinoflagellate species of Dinophysis and Prorocentrum. Gastrointestinal disorders from the consumption of scallops, mussels, and clams that feed on the toxic algae Dinophysis fortii or other
species were reported in Japan and the Netherlands. The gastrointestinal disorders include diarrhea, nausea, vomiting, and abdominal pain. The duration of the symptoms is short. The toxin is
heat stable, and thus cooking does not eliminate it. The incidence of the disease can be reduced
by removing the digestive organs of the shellfish because they tend to accumulate the majority of
the toxins.
Azaspiracid Shellfish Poisoning (AZP)
AZP is associated with the consumption of mussels, which accumulate Azaspiracid toxin. This
toxin is produced by a dinoflagellate Azadinium spinosum. The symptoms are similar to diarrhetic
shellfish poisoning (DSP) and are manifested as diarrhea, nausea, vomiting, and abdominal pain.
Amnesic Shellfish Poisoning (ASP)
Amnesic shellfish poisoning (ASP) results from consumption of mussels, clams, crabs, and anchovies. The neurotoxin is domoic acid, which is produced by algae, Pseudonitzschia pungens. The
neurological and gastrointestinal symptoms include vomiting, diarrhea, headache, disorientation, seizures, coma, and hemiparesis (lack of voluntary movement of limbs and fingers similar
to patients suffering from stroke). In addition, there is a short-term memory loss and confusion
associated with ASP toxicity.
Puffer Fish Poisoning (PFP)
PFP is associated with consumption of puffer fish (also known as fugu), ocean sunfishes, and
porcupine fishes. The toxin involved is tetrodotoxin, a neurotoxin that blocks the sodium channel
in neurons and symptoms include tingling, burning, numbness, headache, vomiting, diaphoresis, respiratory paralysis, circulatory collapse, and death. Symptoms appear with 10–45 minutes.
Puffer fish poisoning is most prevalent in Asian countries with an estimated 50 deaths annually in
Japan. Repeated cases have also been reported from Singapore and Bangladesh.
Parasites 22–24
Included in this group are several intestinal and tissue helminths (roundworms, flatworms, and
tapeworms) and protozoa that are known to cause human illness and where a food association has
either been confirmed or suspected. They can stay in the gastrointestinal (GI) tract and produce
gastrointestinal symptoms. Some invade body tissues and produce specific problems. Several of
these organisms and the diseases they produce are briefly described here.
and generally subside in a few hours. The incidence is very low in the United States because of
effective monitoring systems. Sometimes a satellite is used to monitor ocean color, including red
tide. Karenia brevis bloom is a recurring problem in Gulf of Mexico.
Diarrhetic Shellfish Poisoning (DSP)
DSP is associated with two types of toxins, okadaic acid and dinophysistoxins produced by the
dinoflagellate species of Dinophysis and Prorocentrum. Gastrointestinal disorders from the consumption of scallops, mussels, and clams that feed on the toxic algae Dinophysis fortii or other
species were reported in Japan and the Netherlands. The gastrointestinal disorders include diarrhea, nausea, vomiting, and abdominal pain. The duration of the symptoms is short. The toxin is
heat stable, and thus cooking does not eliminate it. The incidence of the disease can be reduced
by removing the digestive organs of the shellfish because they tend to accumulate the majority of
the toxins.
Azaspiracid Shellfish Poisoning (AZP)
AZP is associated with the consumption of mussels, which accumulate Azaspiracid toxin. This
toxin is produced by a dinoflagellate Azadinium spinosum. The symptoms are similar to diarrhetic
shellfish poisoning (DSP) and are manifested as diarrhea, nausea, vomiting, and abdominal pain.
Amnesic Shellfish Poisoning (ASP)
Amnesic shellfish poisoning (ASP) results from consumption of mussels, clams, crabs, and anchovies. The neurotoxin is domoic acid, which is produced by algae, Pseudonitzschia pungens. The
neurological and gastrointestinal symptoms include vomiting, diarrhea, headache, disorientation, seizures, coma, and hemiparesis (lack of voluntary movement of limbs and fingers similar
to patients suffering from stroke). In addition, there is a short-term memory loss and confusion
associated with ASP toxicity.
Puffer Fish Poisoning (PFP)
PFP is associated with consumption of puffer fish (also known as fugu), ocean sunfishes, and
porcupine fishes. The toxin involved is tetrodotoxin, a neurotoxin that blocks the sodium channel
in neurons and symptoms include tingling, burning, numbness, headache, vomiting, diaphoresis, respiratory paralysis, circulatory collapse, and death. Symptoms appear with 10–45 minutes.
Puffer fish poisoning is most prevalent in Asian countries with an estimated 50 deaths annually in
Japan. Repeated cases have also been reported from Singapore and Bangladesh.
Parasites 22–24
Included in this group are several intestinal and tissue helminths (roundworms, flatworms, and
tapeworms) and protozoa that are known to cause human illness and where a food association has
either been confirmed or suspected. They can stay in the gastrointestinal (GI) tract and produce
gastrointestinal symptoms. Some invade body tissues and produce specific problems. Several of
these organisms and the diseases they produce are briefly described here.