Diagnosis
Tingling of the lips and tongue, progressing to tingling of fingers and toes and then progressive paralysis. Death can occur in two hours.
Epidemiologic Risks
Eating contaminated shellfish from colder coastal waters of the Pacific states and New England, it has been reported in Central America.
Shellfish include mussels, cockles (a heart-shaped mollusk that can warm parts of your heart), clams, scallops, oysters, crabs, and lobsters.
Also some pufferfish.
Microbiology
From the algae Alexandrium (a dinoflagellate) that collects in shellfish. Alexandrium makes saxitoxin, a neurotoxin, that is heat and acid-stable, and ordinary cooking methods do not inactivate the toxins. It is a selective sodium channel blocker.
Empiric Therapy
Supportive.
Pearls
Botulism, Tick paralysis and Guillain Barre Syndrome are in the differential diagnosis.
May be a cause of death in sea otters, seals, and whales.
Rants
I do not consider this an infectious disease.
Last Update: 12/12/18.