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Differences in Marine Toxin Poisonings Reported to US Poison Centers After Pandemic Restrictions
Baylin J Bennett1, Cailee Hill2,3, Hugh B Roland4
1Department of Medicine, Division of Occupational, Environmental and Climate Medicine, University of California, 490 Illinois Street, San Francisco, CA 94158, USA.
Toxins
|September 26, 2025
Summary
Marine toxin poisonings saw shifts during the COVID-19 pandemic. While some decreased, palytoxin and tetrodotoxin poisonings significantly increased, with tetrodotoxin linked to pandemic restrictions and outdoor activities.
Area of Science:
- Environmental toxicology
- Public health surveillance
- Epidemiology
Background:
- Marine toxin poisonings pose significant public health risks.
- Understanding temporal trends in these poisonings is crucial for prevention.
- The COVID-19 pandemic may have influenced human behaviors leading to toxin exposures.
Purpose of the Study:
- To investigate changes in marine toxin poisoning incidence reported to U.S. Poison Centers during the COVID-19 pandemic.
- To analyze trends for specific marine toxins including ciguatera, clupeotoxic fish, diarrhetic shellfish, paralytic shellfish, scombroid fish, palytoxin, and tetrodotoxin.
- To determine associations between pandemic restrictions and observed changes in poisoning call volumes.
Main Methods:
- Utilized the National Poison Data System to query single-substance human exposure calls for ichthyosarcotoxins from 2000 to 2022.
- Employed mixed-effects negative binomial regression to calculate incidence rate ratios for exposure calls.
- Aggregated call counts by year and regressed them against a binary indicator for the pandemic period (April 2020-December 2021).
Main Results:
- Exposure calls decreased significantly for ciguatera, clupeotoxic fish, diarrhetic shellfish, paralytic shellfish, and scombroid fish poisoning during the pandemic peak.
- Palytoxin poisoning and tetrodotoxin poisoning exposure calls significantly increased during the same period.
- Sensitivity analyses indicated palytoxin increases predated restrictions, while tetrodotoxin increases were associated with restrictions, potentially linked to increased outdoor activities.
Conclusions:
- The COVID-19 pandemic altered the landscape of marine toxin poisonings in the U.S.
- Specific toxins like palytoxin and tetrodotoxin showed concerning increases, necessitating further investigation and targeted public health interventions.
- Tetrodotoxin exposure trends suggest a link to increased engagement in outdoor activities during the pandemic.
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