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Neurotoxic Shellfish Poisoning
Aquatic Toxins Program, Division of Environmental Health, Florida Department of Health, Tallahassee, FL 32399-1712, USA
NSF NIEHS Oceans and Human Health Center, Rosenstiel School of Marine and Atmospheric Sciences, University of Miami, FL 33136, USA
Food and Waterborne Disease Program, Division of Environmental Health, Florida Department of Health, Tallahassee, FL 32399-1712, USA
* Author to whom correspondence should be addressed.
Received: 26 February 2008; in revised form: 17 June 2008 / Accepted: 24 June 2008 / Published: 12 July 2008
Abstract: Neurotoxic shellfish poisoning (NSP) is caused by consumption of molluscan shellfish contaminated with brevetoxins primarily produced by the dinoflagellate, Karenia brevis. Blooms of K. brevis, called Florida red tide, occur frequently along the Gulf of Mexico. Many shellfish beds in the US (and other nations) are routinely monitored for presence of K. brevis and other brevetoxin-producing organisms. As a result, few NSP cases are reported annually from the US. However, infrequent larger outbreaks do occur. Cases are usually associated with recreationally-harvested shellfish collected during or post red tide blooms. Brevetoxins are neurotoxins which activate voltage-sensitive sodium channels causing sodium influx and nerve membrane depolarization. No fatalities have been reported, but hospitalizations occur. NSP involves a cluster of gastrointestinal and neurological symptoms: nausea and vomiting, paresthesias of the mouth, lips and tongue as well as distal paresthesias, ataxia, slurred speech and dizziness. Neurological symptoms can progress to partial paralysis; respiratory distress has been recorded. Recent research has implicated new species of harmful algal bloom organisms which produce brevetoxins, identified additional marine species which accumulate brevetoxins, and has provided additional information on the toxicity and analysis of brevetoxins. A review of the known epidemiology and recommendations for improved NSP prevention are presented.
Keywords: Neurotoxic Shellfish Poisoning; NSP; brevetoxins; harmful algal blooms (HABs); Karenia brevis; epidemiology; human health; red tide
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MDPI and ACS Style
Watkins, S.M.; Reich, A.; Fleming, L.E.; Hammond, R. Neurotoxic Shellfish Poisoning. Mar. Drugs 2008, 6, 431-455.
Watkins SM, Reich A, Fleming LE, Hammond R. Neurotoxic Shellfish Poisoning. Marine Drugs. 2008; 6(3):431-455.
Watkins, Sharon M.; Reich, Andrew; Fleming, Lora E.; Hammond, Roberta. 2008. "Neurotoxic Shellfish Poisoning." Mar. Drugs 6, no. 3: 431-455.