Tetrodotoxin Poisoning in Mainland France and French Overseas Territories: A Review of Published and Unpublished Cases

Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collecti...

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Published in:	Toxins Vol. 14; no. 5; p. 351
Main Authors:	Gouel, Pierrick, Gatti, Clémence Mahana Iti, de Haro, Luc, Liautaud, Alice, Langrand, Jérôme, Boucaud-Maitre, Denis
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 17-05-2022 MDPI
Subjects:	Animals Ciguatera Poisoning Fish France Humans Intoxication Life Sciences marine toxicology Mortality Neurotoxicity Syndromes Neurotoxins Patients Poisoning review Surveillance Tetraodontiformes Tetrodotoxin Tetrodotoxin - toxicity Toxicology Toxins France French Polynesia tetrodotoxin France review marine toxicology
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Abstract	Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number ( ) = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found ( = 17). All cases happened in overseas territories: French Guyana ( = 7), New Caledonia ( = 11), Reunion ( = 35) and French Polynesia ( = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential.
AbstractList	Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number (n) = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found (n = 17). All cases happened in overseas territories: French Guyana (n = 7), New Caledonia (n = 11), Reunion (n = 35) and French Polynesia (n = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential. Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number ( n ) = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found ( n = 17). All cases happened in overseas territories: French Guyana ( n = 7), New Caledonia ( n = 11), Reunion ( n = 35) and French Polynesia ( n = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential. Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number ( ) = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found ( = 17). All cases happened in overseas territories: French Guyana ( = 7), New Caledonia ( = 11), Reunion ( = 35) and French Polynesia ( = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential.
Author	Liautaud, Alice Gouel, Pierrick de Haro, Luc Gatti, Clémence Mahana Iti Langrand, Jérôme Boucaud-Maitre, Denis
AuthorAffiliation	2 Laboratoire des Biotoxines Marines, Institut Louis Malardé, UMR 241 EIO (Ifremer, ILM, IRD, UPF), 98713 Papeete, French Polynesia; cgatti@ilm.pf 5 Department of Research an Biostatistics, University Hospital of Guadeloupe, LAMIA (EA4540) French West Indies University, 97159 Pointe-à-Pitre, France 1 Service des Urgences, Centre Hospitalier de Mayotte, 97600 Mamoudzou, France; pierrick.gouel@gmail.com 4 Centre Antipoison de Paris, Hôpital Fernand Widal, 75010 Paris, France; alice.liautaud@aphp.fr (A.L.); jerome.langrand@aphp.fr (J.L.) 3 Clinical Pharmacology, Poison Control Center, St Marguerite Hospital, 13009 Marseille, France; luc.deharo@ap-hm.fr
AuthorAffiliation_xml	– name: 1 Service des Urgences, Centre Hospitalier de Mayotte, 97600 Mamoudzou, France; pierrick.gouel@gmail.com – name: 2 Laboratoire des Biotoxines Marines, Institut Louis Malardé, UMR 241 EIO (Ifremer, ILM, IRD, UPF), 98713 Papeete, French Polynesia; cgatti@ilm.pf – name: 3 Clinical Pharmacology, Poison Control Center, St Marguerite Hospital, 13009 Marseille, France; luc.deharo@ap-hm.fr – name: 4 Centre Antipoison de Paris, Hôpital Fernand Widal, 75010 Paris, France; alice.liautaud@aphp.fr (A.L.); jerome.langrand@aphp.fr (J.L.) – name: 5 Department of Research an Biostatistics, University Hospital of Guadeloupe, LAMIA (EA4540) French West Indies University, 97159 Pointe-à-Pitre, France
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Cites_doi	10.1016/j.jemermed.2008.09.024 10.1007/s13149-014-0340-2 10.1016/j.toxicon.2007.11.025 10.1016/S0750-7658(00)00195-7 10.1002/jgf2.384 10.1016/j.fct.2017.12.039 10.1136/bmj.n71 10.1016/S0196-0644(86)80135-4 10.1016/j.neurol.2009.06.004 10.1016/j.toxicon.2009.08.001 10.3390/md20080011 10.3109/15563659809028940 10.1016/S1043-4526(06)52004-2 10.1016/0041-0101(93)90286-R
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SubjectTerms	Animals Ciguatera Poisoning Fish France Humans Intoxication Life Sciences marine toxicology Mortality Neurotoxicity Syndromes Neurotoxins Patients Poisoning review Surveillance Tetraodontiformes Tetrodotoxin Tetrodotoxin - toxicity Toxicology Toxins
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Title	Tetrodotoxin Poisoning in Mainland France and French Overseas Territories: A Review of Published and Unpublished Cases
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