Diseases

Fish poisoning - causes, signs and therapy

Fish poisoning - causes, signs and therapy


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Poisoning from eating fish

Fish poisoning is a special form of food poisoning that can occur after eating mussels, fish, crabs and other marine life. Fish poisoning poses a serious health risk that, in the worst case, can lead to the death of those affected. If you suspect fish poisoning, a doctor should be consulted immediately.

Definition

In the narrower sense, fish poisoning means intoxications that are triggered by poisons in marine dishes. These are also known as toxidrome or fish poisoning toxidrome. Colloquially, the term "fish poisoning" is also used for gastrointestinal infections caused by bacteria in fish, mussels and crabs, although this is not actually poisoning. Fish poisoning is sometimes further subdivided into fish poisoning in the true sense and shell poisoning.

Causes and symptoms of fish poisoning

Fish poisoning usually manifests itself very quickly after the toxin intake through massive gastrointestinal complaints, such as abdominal pain, diarrhea, nausea and vomiting. Here the symptoms of fish poisoning largely agree with those caused by an infection with pathological microorganisms.

However, the various toxins contained in marine food (over 50 toxic substances are known here) can cause numerous other complaints. For example, saxitoxins, which are found in mussels or oysters, among other things, are often associated with gastrointestinal complaints with visual disturbances and, at worst, with fatal paralysis of the respiratory or cardiac muscles.

The actual source of the poison are certain algae (or unicellular organisms that live on them; so-called dinoflagellates), which are absorbed by the mussels, as a result of which the toxins accumulate in the mussels. Saxitoxins can be fatal to humans from a dose of 0.2 milligrams.

Poisoning from ciguatoxins in edible fish

The so-called ciguatoxins are also formed by special genera of dinoflagellates and subsequently accumulate in the marine food chain. Higher doses of ciguatoxins can therefore be found primarily in predatory fish that are at the end of the food chain.

In humans, the ciguatoxins trigger a so-called ciguatera, which can be accompanied by significant gastrointestinal complaints, skin rash, numbness or tingling in the limbs, abnormal sensations of the lips and oral mucosa, paralysis and a disturbed feeling of temperature.

The ciguatera is sometimes fatal. It is not uncommon for those affected to suffer from the symptoms for weeks - sometimes even for several months - in particular from hypersensitivity to the cold.

Fish poisoning from tetrodotoxin

Tetrodotoxin poisoning is a special form. Tetrodotoxin is also known as pufferfish poison and has a fatal effect on nerve and muscle function after consumption. Already in the first hour after consumption, those affected show considerable symptoms of deficiency, such as muscle paralysis, coordination and consciousness disorders.

The paralysis may also affect the respiratory muscles, which leads to the death of the patient if medical care is neglected. From a dose of 0.5 milligram to one milligram, tetrodotoxin is fatal.

In addition to the toxins mentioned here, numerous other poisons, such as okadaic acid or azaspiracid, can be responsible for fish poisoning. In individual cases, a differentiated view must therefore be made to ensure appropriate treatment of the patient.

Bacterial infections

Infections with pathological microorganisms when eating fish are often due to inadequate compliance with hygiene regulations and / or interruptions in the cold chain. The germs can multiply excessively and lead to massive gastrointestinal complaints after consumption. However, they are significantly less threatening than the intoxication shown above, since in addition to stomach pain, diarrhea, nausea and vomiting, there are generally no further health problems.

In the worst case, the massive loss of fluids can lead to dehydration of those affected, which is a risk that should not be underestimated, especially for patients who are already weakened.

Diagnosis

Since the first symptoms usually appear relatively shortly after consumption, the connection is often easy to recognize even for laypeople. However, the question remains unanswered whether pathological microorganisms or bacteria or toxins are the cause of the complaints. Potentially ingested germs can be detected with a stool sample, the toxins can be determined with the help of a blood test.

Treatment for fish poisoning

Treatment generally aims to compensate for fluid loss. Intoxication may also require artificial respiration. Here, an attempt is subsequently made to alleviate the effect of the poison, although often no concrete antidote is available. With ciguatera, for example, only therapeutic relief of symptoms can be achieved because no antidote is known.

In order to get rid of the toxins from the organism as quickly as possible, activated carbon is also used in emergency medicine, which in the form of high-dose tablets should help to eliminate the toxins in the digestive tract. If patient care is initiated in good time, fish poisoning can usually be managed and rarely leads to the death of those affected. However, this presupposes that immediate action is taken when there is evidence of fish poisoning. (fp)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch

Swell:

  • Schaper, Andreas / Ebbecke, Martin / Rosenbusch, Joachim / u.a .: Fischvergiftung, Dtsch Arztebl, 2002, aerzteblatt.de
  • Merck & Co. Inc .: Fish Poisoning and Seafood Poisoning (Retrieved: August 5, 2019), msdmanuals.com
  • Federal Ministry for Risk Assessment (BfR): Brochure How fresh is the fish? Characteristics of fresh fish, as of January 2014, bfr.bund.de
  • Hamdorf, Johann / Keweloh, Heribert / Revermann, Maria: Microorganisms in Food: Theory and Practice of Food Hygiene, Pfanneberg, 6th Edition, 2016
  • DIN e.V .: The new European Food Information Regulation (LMIV): Implement safely. Mark correctly, Beuth, 2014
  • Bavarian State Office for Health and Food Safety: Fish, fish cuts (accessed: August 5, 2019), lgl.bayern.de
  • Johns Hopkins Medicine: Fish Poisoning (accessed: August 5, 2019), hopkinsmedicine.org
  • Centers for Disease Control and Prevention (CDC): Food Poisoning from Marine Toxins (accessed: August 5, 2019), cdc.gov
  • Public Health Portal of Austria: Food Infections: Causes & Prevention (accessed: 05.08.2019), gesundheit.gv.at

ICD codes for this disease: T61ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


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