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Lethal paralytic shellfish poisoning in Guatemala.

D C Rodrigue1, R A Etzel, S Hall

  • 1Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia.

The American Journal of Tropical Medicine and Hygiene
|March 1, 1990
PubMed
Summary
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A 1987 paralytic shellfish poisoning outbreak in Guatemala, caused by saxitoxin-contaminated clams, led to 26 deaths. Young children showed higher fatality rates, suggesting increased sensitivity to the neurotoxins.

Area of Science:

  • Environmental Health
  • Neuroscience
  • Toxicology

Background:

  • Paralytic Shellfish Poisoning (PSP) is a serious public health concern.
  • Saxitoxins are potent neurotoxins that can accumulate in shellfish.
  • Outbreaks of PSP have significant morbidity and mortality.

Purpose of the Study:

  • To investigate a large outbreak of paralytic shellfish poisoning in Guatemala.
  • To identify the source and causative agent of the poisoning.
  • To assess the clinical characteristics and risk factors associated with the outbreak.

Main Methods:

  • Case study of affected individuals in Champerico, Guatemala.
  • Identification of implicated shellfish species (Amphichaena kindermani).
  • Neurologic symptom assessment and mortality data collection.

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Main Results:

  • 187 individuals were affected with neurologic symptoms; 26 died.
  • Clams (Amphichaena kindermani) harvested from local beaches were identified as the source.
  • Children under 6 years old had a 50% fatality rate, compared to 7% in adults over 18.
  • Estimated minimum lethal dose in children was 140 mouse units/kg.

Conclusions:

  • This was the first recognized large-scale PSP outbreak in Guatemala.
  • Children may be more susceptible to saxitoxin toxicity.
  • Public health interventions are crucial to prevent future PSP outbreaks.