Paralytic shellfish poisoning
- Associated with red tides, but can occur independently
- Caused by ingestion of contaminated shellfish which harbor toxin (heat stabile) producing algae
- Shellfish typically from colder waters (New England, Pacific NW, Alaska)
- Symptoms develop within minutes to hours of ingestion
- Typically neurologic symptoms only: Paresthesias, dizziness, ataxia. May progress to dysphagia and/or respiratory failure. 
- Report any suspect cases to local department of health
- Venomous fish (catfish, zebrafish, scorpion fish, stonefish)
- Sea urchins
- Cone shells
- Based on symptoms plus history of shellfish ingestion
- Mortality up to 12% if untreated 
- Symptoms usually self resolved within hours to days
- Centers for Disease Control and Prevention (CDC). Paralytic shellfish poisoning --- southeast Alaska, May-June 2011. MMWR Morb Mortal Wkly Rep 2011; 60:1554.
- Etheridge SM. Paralytic shellfish poisoning: seafood safety and human health perspectives. Toxicon 2010;56:108
- Mines D et al. Poisonings: food, fish, shellfish. Emerg Med Clin North Am 1997;15:157.