Paralytic shellfish poisoning

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  • 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)[1]

Clinical Features

  • Symptoms develop within minutes to hours of ingestion
  • Typically neurologic symptoms only: Paresthesias, dizziness, ataxia. May progress to dysphagia and/or respiratory failure. [2]
  • Report any suspect cases to local department of health

Differential Diagnosis

Marine toxins and envenomations


  • Based on symptoms plus history of shellfish ingestion



  • Mortality up to 12% if untreated [3]
  • Symptoms usually self resolved within hours to days

See Also


  1. Centers for Disease Control and Prevention (CDC). Paralytic shellfish poisoning --- southeast Alaska, May-June 2011. MMWR Morb Mortal Wkly Rep 2011; 60:1554.
  2. Etheridge SM. Paralytic shellfish poisoning: seafood safety and human health perspectives. Toxicon 2010;56:108
  3. Mines D et al. Poisonings: food, fish, shellfish. Emerg Med Clin North Am 1997;15:157.