Seafood toxicity arises contaminated by consuming seafood harvested from the sea.

Diagnosis with seafood-related illnesses is difficult due to vary symptoms, severity, and unclear exposure.

Seafood-related illnesses are common due to more travelling and expanding seafood trade.

Toxins, pollutants, and pathogens in seafood can cause seafood poisoning in humans. Seafood importance as protein source threatened due to environmental and human pollution and activities.

Types of seafood toxicity are:

Biological toxins

Chemical contamination

Microbial contamination

Marine organisms may produce toxins from phytoplankton, which remain heat-stable even after cooking.

Ciguatera poisoning is prevalent in warm waters as per global data. It is reported as nonbacterial fish-borne illness in the United States.

Ciguatera poisoning is linked to reef fish may be underreported due to symptom recognition issues.

Annual incidence ranges from 10000 to 50000 worldwide with unreported cases.

Scombroid poisoning occurs when fish are consumed without proper refrigeration. Sporadic outbreaks follow harmful algal blooms with fatal consequences if untreated.

Ciguatoxins activate VGSCs causes constant sodium entry and membrane depolarization in nerve and muscle cells.

This leads to hyperexcitability and symptoms like muscle weakness and reversed temperature sensation.

Saxitoxins inhibit sodium channels in nerves and muscles to cause paralysis and fatal respiratory failure in severe cases.

Domoic acid activates glutamate receptors in the brain to cause excitotoxicity and neuronal death in hippocampus.

The causes of seafood toxicity are:

Harmful Algal Blooms

Biomagnification

Bioaccumulation

Improper Storage

Pollution

Most individuals recover within weeks to months, but some develop chronic symptoms that last for years.

Mild cases recover without complications, but severe causes respiratory failure and death. Reversible symptoms from aerosol exposure resolve in days or weeks.

The outcome ranges from full recovery in mild cases to permanent neurological damage in severe cases.

Outcomes from full recovery to permanent neurological damage severity.

Collect details including food, medical, and family history to understand clinical history of patient.

Neurological Examination

Cardiovascular Examination

Gastrointestinal Examination

Respiratory Examination

Acute symptoms are:

Nausea, vomiting, diarrhea, tingling, numbness, flushing, headache, gastroenteritis, and wound infections

Use oral or intravenous rehydration to treat gastrointestinal symptoms.

Use anti-emetics and analgesics agent for symptom relief.

Monitor respiratory function cases closely for signs of respiratory muscle paralysis.

In some cases, intubation and mechanical ventilation if respiratory failure occurs.

Mannitol infusion effective within 24 to 48 hours onset. Use gastric lavage or activated charcoal within 1 hour.

Use antiemetics and analgesics agent for gastrointestinal and neurological symptoms.

Avoid shellfish from areas affected with red tides or harmful algal blooms.

Emergency Medicine

Proper storage and refrigeration should be done of fishes to prevent histamine formation.

Arrange shellfish monitoring programs to prevent outbreaks.

Patients with prompt respiratory support are recover within a few days.

Raw seafood and seawater should be avoided in individuals with chronic liver disease.

Avoid fish with high in mercury during pregnancy or in young children.

Proper awareness about seafood toxicity should be provided and its related causes with management strategies.

Appointments with a physician and preventing recurrence of disorder is an ongoing life-long effort.

Emergency Medicine

Mannitol:

It reduces symptoms to promote the excretion of ciguatoxin.

Emergency Medicine

Loratadine:

It blocks histamine receptors to reduce allergic-type reactions.

Emergency Medicine

Albuterol:

It is used to relax bronchial smooth muscles.

Emergency Medicine

Intervention therapies include endoscopy, intubation, or surgical debridement improves outcomes to prevent long-term complications.

Emergency Medicine

In the initial treatment phase, evaluation of patient history, physical examination and laboratory testing to confirm diagnosis.

Pharmacologic therapy is effective in the treatment phase as it includes use of diuretics, antihistamine, and bronchodilators.

In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.

The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.