Shellfish Toxicity Workup

  • Author: Thomas C Arnold, MD, FAAEM, FACMT; Chief Editor: Asim Tarabar, MD   more...
 
Updated: May 6, 2011
 

Laboratory Studies

  • Direct human serum assays for shellfish toxins are not yet available to clinicians. Research in this area is ongoing, and a reliable assay for several of these specific toxins should be available soon.
  • Saxitoxin can be assayed by using a mouse bioassay, ELISA, and high-performance liquid chromatography (HPLC). Brevetoxin can be assayed by using a mouse bioassay, ELISA, and antibody radioimmunoassay (RIA). Liquid chromatography, mass spectrometry, and ELISA techniques have been developed for domoic acid.
  • A new assay was used to quantify saxitoxin and neosaxitoxin in human urine samples, with results suggesting that few false-positive outcomes would occur when attempting to identify people exposed to these toxins.[5]
 
 
Contributor Information and Disclosures
Author

Thomas C Arnold, MD, FAAEM, FACMT  Professor and Chairman, Department of Emergency Medicine, Section of Clinical Toxicology, Louisiana State University School of Medicine in Shreveport; Medical Director, Louisiana Poison Control Center

Thomas C Arnold, MD, FAAEM, FACMT is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Medical Toxicology, Louisiana State Medical Society, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert L Norris, MD  Professor, Department of Surgery; Chief, Division of Emergency Medicine, Stanford University Medical Center

Robert L Norris, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, California Medical Association, International Society of Toxinology, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Michael J Burns, MD  Instructor, Department of Emergency Medicine, Harvard University Medical School, Beth Israel Deaconess Medical Center

Michael J Burns, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

References
  1. Burgess V, Shaw G. Pectenotoxins--an issue for public health: a review of their comparative toxicology and metabolism. Environ Int. Oct 2001;27(4):275-83. [Medline].

  2. Lefebvre KA, Robertson A. Domoic acid and human exposure risks: A review. Toxicon. Jun 6 2009;[Medline].

  3. Centers for Disease Control and Prevention. Update: Neurologic illness associated with eating Florida pufferfish, 2002. MMWR Morb Mortal Wkly Rep. May 17 2002;51(19):414-6. [Medline].

  4. Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL. 2009 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 27th Annual Report. Clin Toxicol (Phila). Dec 2010;48(10):979-1178. [Medline]. [Full Text].

  5. Johnson RC, Zhou Y, Statler K, Thomas J, Cox F, Hall S, et al. Quantification of saxitoxin and neosaxitoxin in human urine utilizing isotope dilution tandem mass spectrometry. J Anal Toxicol. Jan-Feb 2009;33(1):8-14. [Medline].

  6. Nicholson BC, Shaw GR, Morrall J, Senogles PJ, Woods TA, Papageorgiou J, et al. Chlorination for degrading saxitoxins (paralytic shellfish poisons) in water. Environ Technol. Nov 2003;24(11):1341-8. [Medline].

  7. Ahmed FE. Seafood safety. Committee on Evaluation of the Safety of Fishery Products. Food & Nutrition Board, Institute of Medicine. National Academy Press; 1991.

  8. Chandrasekaran A, Ponnambalam G, Kaur C. Domoic acid-induced neurotoxicity in the hippocampus of adult rats. Neurotox Res. 2004;6(2):105-17. [Medline].

  9. Economou V, Papadopoulou C, Brett M, Kansouzidou A, Charalabopoulos K, Filioussis G, et al. Diarrheic shellfish poisoning due to toxic mussel consumption: the first recorded outbreak in Greece. Food Addit Contam. Mar 2007;24(3):297-305. [Medline].

  10. Gessner BD, Middaugh JP, Doucette GJ. Paralytic shellfish poisoning in Kodiak, Alaska. West J Med. Nov 1997;167(5):351-3. [Medline].

  11. Jeffery B, Barlow T, Moizer K, Paul S, Boyle C. Amnesic shellfish poison. Food Chem Toxicol. Apr 2004;42(4):545-57. [Medline].

  12. Kawatsu K, Hamano Y, Noguchi T. Production and characterization of a monoclonal antibody against domoic acid and its application to enzyme immunoassay. Toxicon. Nov 1999;37(11):1579-89. [Medline].

  13. Poli MA, Musser SM, Dickey RW, Eilers PP, Hall S. Neurotoxic shellfish poisoning and brevetoxin metabolites: a case study from Florida. Toxicon. Jul 2000;38(7):981-93. [Medline].

  14. Stommel EW, Watters MR. Marine Neurotoxins: Ingestible Toxins. Curr Treat Options Neurol. Mar 2004;6(2):105-114. [Medline].

  15. Usleber E, Dietrich R, Burk C, Schneider E, Martlbauer E. Immunoassay methods for paralytic shellfish poisoning toxins. J AOAC Int. Sep-Oct 2001;84(5):1649-56. [Medline].

  16. Vale P, Sampayo MA. Comparison between HPLC and a commercial immunoassay kit for detection of okadaic acid and esters in Portuguese bivalves. Toxicon. Nov 1999;37(11):1565-77. [Medline].

  17. Van Dolah FM. Marine algal toxins: origins, health effects, and their increased occurrence. Environ Health Perspect. Mar 2000;108 Suppl 1:133-41. [Medline].

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