Toxin Table

Toxin Number	Saxitoxin (18+)	Brevetoxin (10+)	Okadaic Acid (4)	Domoic Acid (3)	Ciguatoxin (10+) Maitotoxin Scaritoxin	Brevetoxin (10+)	Anatoxins (3+) Saxitoxins (2+) Microcystins Nodularins Cylindrospermopsins
Disease	Paralytic Shellfish Poisoning	Neurotoxic Shellfish Poisoning	Diarrheic Shellfish Poisoning	Amnesic Shellfish Poisoning	Ciguatera Fish Poisoning	Aerosolized Brevetoxin	Blue-Green Algal/Cyanobacterial
Causative Organism	Red Tide Dinoflagellate	Red Tide Dinoflagellate	Red Tide Dinoflagellate	Red Tide Diatom	Epibenthic Dinoflagellate	Red Tide Dinoflagellate	Blue-Green Algae Cyanobacteria
Route of Exposure	Ingestion	Ingestion	Ingestion	Ingestion	Ingestion	Ingestion Skin	Ingestion Skin Inhalation
Major Transvector	Shellfish	Shellfish	Shellfish	Shellfish Fish	Fish	Water	Water
Moleculary Mechanism	Na+ Channel Blocker	Na+ Channel Activator	Phosphorylase Phosphatase Inhibitor	Glutamate Receptor Agonist	Na+, Ca++ Channel Activators	Na+ Channel Activator	Acetylcholinesterase Inhibitor Na+ Channel Blocker Phosphorylase Phosphatase Inhibitor Protein Synthesis Inhibitor
Incubation Time	5-30 minutes	30 minutes to 24 hours	less than 24 hours	less than 24 hours	less than 24 hours	minutes	hours to days
Duration	days	days	days	years	months	unknown	days to unknown
Acute Symptoms	Gastrointestinal Neurologic Respiratory	Gastrointestinal Neurologic Respiratory	Gastrointestinal Neurologic	Gastrointestinal Neurologic	Gastrointestinal Neurologic Respiratory	Respiratory	Gastrointestinal Neurologic Respiratory Dermatologic
Chronic Symptoms	unknown	unknown	unknown (carcinogen)	amnesia	paraeshesias	unknown	unknown (carcinogen)
Fatality Rate	1-14%	0%	0%	3%	0.1-12%	unknown	0-50%
Diagnosis	clinical mouse bioassay HPLC ELISA???	clinical mouse bioassay HPLC ELISA???	clinical mouse bioassay HPLC	clinical mouse bioassay HPLC	clinical mouse bioassay HPLC ELISA???	clinical mouse bioassay HPLC ELISA???	clinical mouse bioassay HPLC ELISA???
Therapy	supportive antibody???	supportive	supportive	supportive	IV Mannitol supportive Tricyclic Antidepressants chronic	anti-asthma medications???	supportive
Prevention	Red Tide Monitor & Seafood/Case Surveillance	Red Tide Monitor & Seafood/Case Surveillance	Red Tide Monitor & Seafood/Case Surveillance	Red Tide Monitor & Seafood/Case Surveillance	Fish???/Case Surveillance	Red Tide Monitor & Seafood/Case Surveillance	Bloom & Water Monitor & Case Surveillance
Human Intoxication Syndromes Caused by Marine & Freshwater Toxins (adapted from Fleming 2001, Baden et al 1995) Tetrodotoxin (Fugu or Pufferfish) poisoning presents clinically similar to paralytic shellfish poisoning (PSP) except for history of pufferfish ingestion. Pfiesteria/Estuarine associated syndrome, azaspiracidosis, shark toxins, and others have not been included due to insufficient knowledge to characterize.