AI Article Synopsis
- - In June 2019, a case of paralytic shellfish poisoning (PSP) was discovered in France, highlighting potential undetected instances of shellfish-related neurotoxic poisoning, even when toxin levels were below regulatory limits.
- - A retrospective study of shellfish poisoning cases from 2012 to 2019 revealed that 22% of 619 cases had neurological symptoms, with 14 suspected to be linked to PSP and one to amnesic shellfish poisoning; blood and urine tests for toxins were not conducted.
- - The findings prompted French health agencies to create a specific questionnaire and recommend protocols for documenting neurological symptoms after shellfish consumption, including enhanced monitoring of poisoning cases.
Article Abstract
Context: In June 2019, a paralytic shellfish poisoning (PSP) case related to the consumption of mussels contaminated by saxitoxins at a concentration below the regulatory threshold came to the attention of the French Agency for Food, Environmental and Occupational Health and Safety (ANSES). This pointed to probable undetected human cases of poisoning by neurotoxic phycotoxins.
Methods: We conducted a retrospective study of poisoning cases by bivalve shellfish (oysters, mussels and scallops) recorded by the French Poison Control Centres (PCC) from 2012 to 2019. All medical records were reviewed by a toxicologist.Cases that could be related to neurotoxic phycotoxins were selected and described. Diagnosis was based on symptoms compatible with ingestion of contaminated shellfish and on contamination data for the shellfish production area (analysed by the French Research Institute for Exploitation of the Sea, Ifremer), or notifications to the European Rapid Alert System for Food and Feed when the origin of the shellfish was known.
Results: Among the 619 shellfish poisoning cases recorded by the PCCs from 2012 to 2019, 22% ( = 134) had reported at least one neurological symptom (headache, dizziness or paraesthesia). Review of medical records for the 134 patients led to suspicion of 14 cases of PSP and one case of amnesic shellfish poisoning. Five patients experienced persistent neurological symptoms. Marine toxins were not tested for in the blood or urine of these patients.
Conclusion: This retrospective identification of cases strongly suspected of being related to neurotoxic phycotoxins led ANSES, PCCs and Ifremer to develop a specific questionnaire and to recommend actions to take when neurological symptoms related to shellfish consumption are reported to a PCC. Daily monitoring of shellfish poisoning cases registered in the national PCCs database was also implemented in order to rapidly detect any suspicious cases, alert the competent authorities, and warn the general population.
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| http://dx.doi.org/10.1080/15563650.2022.2034840 | DOI Listing |
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