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Case Definition: Saxitoxin

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

  1. Gessner BD, Middaugh JP, Doucette GJ. Paralytic shellfish poisoning in Kodiak, Alaska. West J Med 1997:67:351-3.
  2. Janiszewski L. The action of toxins on the voltage-gated sodium channel. Pol J Pharmacol Pharm 1990;42:581-8.
  3. Rodrigue DC, Etzel RA, Hall S, et al. Lethal paralytic shellfish poisoning in Guatemala. Am J Trop Med Hyg 1990;42:267-71.
  4. 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.
  5. 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 updated March 11, 2005
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