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Poisoning - fish and shellfish - Treatment

Alternative Names

Fish poisoning; Dinoflagellate poisoning; Seafood contamination; Paralytic shellfish poisoning; Ciguatera poisoning

Home Treatment:

Shellfish poisoning may be a medical emergency. With sudden or significant symptoms, the person should be taken immediately to an emergency medical center. You may need to call the local emergency number (such as 911) or poison control for appropriate treatment information

Before Calling Emergency:

Determine the following information:

  • Patient's age, weight, and condition
  • Type of fish eaten
  • Time it was eaten
  • Amount swallowed

Poison Control, or a local emergency number:

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to expect at the emergency room:

If you have Ciguatera poisoning, you may receive:

  • Medicines to stop vomiting
  • Fluids by IV (to replace fluids lost from vomiting and diarrhea)
  • A medication called Mannitol to help reduce neurological symptoms

If you have Scombroid poisoning, you may receive:

  • An antihistamine medication, such as diphenhydramine (Benadryl)
  • Fluids by IV (to replace fluids lost from vomiting and diarrhea)
  • Medicines to stop vomiting
  • Medicines to treat severe allergic reactions (if needed)
  • Breathing tube (in rare cases)

If you have shellfish poisoning, you may receive:

  • Medicines to stop vomiting
  • Fluids by IV (to replace fluids lost from vomiting and diarrhea)

If shellfish poisoning causes paralysis, you may have to remain in the hospital until your symptoms improve.

Expectations (prognosis):

Fish and shellfish poisonings occur on occasion in the United States. You can protect yourself by avoiding fish and seafood caught in and around the areas of a known red tide, and by avoiding clams, mussels, and oysters during the summer months. If you are poisoned, your long-term outcome is usually quite good.

Scombroid poisoning symptoms usually only last for a few hours after medical treatment has begun. Ciguatera poisoning and the various shellfish poisoning symptoms may last from days to weeks depending on the severity of the poisoning. Only very rarely have serious outcomes or death occurred.

Since these poisons are heat stable, there is no way for the person who prepares the food to know that their food is contaminated. Therefore, it is very important that your doctor tell the restaurant that their food is contaminated so that they may throw it away before other people become sick. Your doctor should also contact the Department of Health to make sure that the suppliers providing the contaminated fish are identified, and all possibly contaminated fish from the same lot are destroyed.

  • Reviewed last on: 2/2/2011
  • Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Goldfrank LR, ed. Goldfrank’s Toxicologic Emergencies. 8th ed. New York, NY: McGraw-Hill; 2006.

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