Human poisonings by neurotoxic phycotoxins related to the consumption of shellfish: study of cases registered by the French Poison Control Centres from 2012 to 2019

Type Article
Date 2022-06
Language English
Author(s) Sinno-Tellier Sandra1, Abadie EricORCID2, de Haro LucORCID3, Paret Nathalie4, Langrand JérômeORCID5, Le Roux Gaël6, Labadie MagaliORCID7, Boels DavidORCID8, Bloch Juliette1, Delcourt NicolasORCID9
Affiliation(s) 1 : French Agency for Food, Environmental and Occupational Health and Safety, Maisons-Alfort, France
2 : French Research Institute for Exploitation of the Sea, Sète, France
3 : Poison Control Centre, Marseille University Hospital, Marseille, France
4 : Poison Control Centre, Lyon University Hospital, Lyon, France
5 : Poison Control Centre, Paris University Hospital, Paris, France
6 : Poison Control Centre, Angers University Hospital, Angers, France
7 : Poison Control Centre, Bordeaux University Hospital, Bordeaux, France
8 : Pharmacology and Toxicology Department, Nantes University Hospital, Nantes, France
9 : Poison Control Centre, Toulouse University Hospital, Toulouse, France
Source Clinical Toxicology (1556-3650) (Informa UK Limited), 2022-06 , Vol. 60 , N. 6 , P. 759-767
DOI 10.1080/15563650.2022.2034840
WOS© Times Cited 4
Keyword(s) Phycotoxins, poison control centre, shellfish, saxitoxin, epidemiology
Abstract

Context

In June 2019, a paralytic shellfish poisoning (PSP) case related to the consumption of mussels contaminated by saxitoxins at a concentration below the regulatory threshold came to the attention of the French Agency for Food, Environmental and Occupational Health and Safety (ANSES). This pointed to probable undetected human cases of poisoning by neurotoxic phycotoxins.

Methods

We conducted a retrospective study of poisoning cases by bivalve shellfish (oysters, mussels and scallops) recorded by the French Poison Control Centres (PCC) from 2012 to 2019. All medical records were reviewed by a toxicologist.

Cases that could be related to neurotoxic phycotoxins were selected and described. Diagnosis was based on symptoms compatible with ingestion of contaminated shellfish and on contamination data for the shellfish production area (analysed by the French Research Institute for Exploitation of the Sea, Ifremer), or notifications to the European Rapid Alert System for Food and Feed when the origin of the shellfish was known.

Results

Among the 619 shellfish poisoning cases recorded by the PCCs from 2012 to 2019, 22% (n = 134) had reported at least one neurological symptom (headache, dizziness or paraesthesia). Review of medical records for the 134 patients led to suspicion of 14 cases of PSP and one case of amnesic shellfish poisoning. Five patients experienced persistent neurological symptoms. Marine toxins were not tested for in the blood or urine of these patients.

Conclusion

This retrospective identification of cases strongly suspected of being related to neurotoxic phycotoxins led ANSES, PCCs and Ifremer to develop a specific questionnaire and to recommend actions to take when neurological symptoms related to shellfish consumption are reported to a PCC. Daily monitoring of shellfish poisoning cases registered in the national PCCs database was also implemented in order to rapidly detect any suspicious cases, alert the competent authorities, and warn the general population.

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Sinno-Tellier Sandra, Abadie Eric, de Haro Luc, Paret Nathalie, Langrand Jérôme, Le Roux Gaël, Labadie Magali, Boels David, Bloch Juliette, Delcourt Nicolas (2022). Human poisonings by neurotoxic phycotoxins related to the consumption of shellfish: study of cases registered by the French Poison Control Centres from 2012 to 2019. Clinical Toxicology, 60(6), 759-767. Publisher's official version : https://doi.org/10.1080/15563650.2022.2034840 , Open Access version : https://archimer.ifremer.fr/doc/00750/86204/