Case Definition: Saxitoxin
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Clinical description
Exposure to saxitoxin might cause numbness of the oral mucosa within 30 minutes after ingestion. In severe poisoning, signs and symptoms typically progress rapidly, including parasthesias, a floating sensation, muscle weakness, vertigo, and cranial nerve dysfunction. Respiratory failure and death might occur from paralysis (1-5).
Laboratory criteria for diagnosis
- Biologic: A case in which saxitoxin in urine is detected, as determined by a commercial laboratory.
- OR-
- Environmental: Detection of saxitoxin in ingested compounds or seafood, as determined by a commercial laboratory or FDA.
Case classification
- Suspected: A case in which a potentially exposed person is being evaluated by health-care workers or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists.
- Probable: A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for saxitoxin exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.
- Confirmed: A clinically compatible case in which laboratory tests have confirmed exposure.
The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical was present or a 100% certainty of the etiology of the agent is known.
Additional resources
- Gessner BD, Middaugh JP, Doucette GJ. Paralytic shellfish poisoning in Kodiak, Alaska. West J Med 1997:67:351-3.
- Janiszewski L. The action of toxins on the voltage-gated sodium channel. Pol J Pharmacol Pharm 1990;42:581-8.
- Rodrigue DC, Etzel RA, Hall S, et al. Lethal paralytic shellfish poisoning in Guatemala. Am J Trop Med Hyg 1990;42:267-71.
- Shoff WH, Shepherd SM. Scombroid, ciguatera, and other seafood intoxications. In: Ford MD, Delaney KA, Ling LJ, Erickson T, eds. Clinical toxicology. Philadelphia, PA: W.B. Saunders; 2001:959-69.
- Tunik MG, Goldfrank LR. Food poisoning. In: Goldfrank LR, Flomenbaum NE, Lewin NA, Howland MA, Hoffman RS, Nelson LS, eds. Goldfrank's toxicologic emergencies. 7th ed. New York, NY: McGraw-Hill; 2002:1085-99.
Page last reviewed February 22, 2006
Page last modified March 11, 2005