Resources for Healthcare Professionals

Marine and Freshwater Toxins are natural toxins created by small micro-organisms (such as phytoplankton and blue-green algae). Humans can be exposed to these toxins through eating contaminated seafood, skin contact, breathing an aerosol, and even drinking water. These toxins are exceedingly potent: even picogram doses can cause both acute and chronic diseases in humans. Some of the human diseases reported after exposure to these toxins include:

Diseases Associated with Shellfish Ingestion

Diseases Associated with Fish Ingestion

Diseases Associated with Aerosol or Water Spray

Although many of the Marine and Freshwater toxin diseases are reportable disease, these illnesses are highly under-reported in the United States and elsewhere. For example, the US Centers for Disease Control and Prevention (CDC) estimated that Ciguatera Fish Poisoning is only reported 2-10% of the time. Part of this under-reporting is due to under-diagnosis by patients, physicians and other healthcare workers, even in endemic areas. Under-diagnosis is an important problem not only because it contributes significantly to subsequent under-reporting, but also because persons with undiagnosed marine and freshwater toxin diseases will receive inadequate acute treatment. For example, if Ciguatera is not correctly diagnosed within the first days from exposure, then the appropriate acute therapy, intravenous mannitol, will not be given during its most efficacious period. Persons who do not receive intravenous mannitol within the first 2-3 days from exposure are much more likely to experience subsequent chronic Ciguatera, a debilitating neurologic disease, for which there is no definitive treatment.

An easy way to receive rapid diagnostic and treatment information, and report these diseases is to contact the Marine & Fresh Water Toxin Disease Reporting Hotline (888-232-8635) of the South Florida Poison Information Center. This Hotline is a toll-free 24 hour 365 day a year multi-lingual (English, Spanish and Haitian Creole with availability of 125 other translated languages) hotline. It provides diagnostic, treatment and educational information, and will officially report cases of reportable diseases (such as Ciguatera, PSP, Scombroid, tetrodotoxin poisoning, and NSP) to the Florida Dept of Health. Additional informational follow-up is performed by referral to NIEHS Center personnel. In addition, this Hotline is known as the Marine and Fresh Water Toxin Disease Resource for the national and international Poison Control Network. This Hotline serves not only as an informational resource, but also to begin the process of case surveillance for the highly under-reported Marine and Fresh Water Toxin Diseases.