Beware of poisonous sea fish

Treatment for patients with eel poisoning at the Poison Control Center (Bach Mai Hospital). *Photo: Xuan Loc*

Fish that are potentially toxic

Lying in the Poison Control Center (Bach Mai Hospital), Ms. HTM (Phuc Tho District, Hanoi ) could not hide her fatigue, her face was gloomy, her head was still pounding. Ms. M recounted: “A friend from far away came to visit, so we invited each other to go to a restaurant to eat. All the dishes that day were made from eel, such as grilled eel, braised eel... I had never eaten this dish before. A few hours after eating, I started to feel uncomfortable, nauseous, my body ached, and I had diarrhea continuously. After that, I started to have a fever and then a fever mixed with malaria; my hands and feet felt numb, my jaw was stiff and difficult to move.”

After receiving emergency care at a lower level, Ms. M was transferred to Bach Mai Hospital with a diagnosis of eel poisoning. Near Ms. M's hospital bed was Ms. PTB, who was also one of the people present at the eel party that day. After the meal, Ms. B vomited a lot and also experienced symptoms of muscle pain, weak limbs, stiff jaw, numb tongue, etc.

“When I saw the unusual symptoms, I called the people who had eaten with me and found that they all had similar symptoms. Currently, out of the 9 people who attended the meal that day, 8 had to be hospitalized. The remaining person had milder symptoms so they are being monitored at home,” said Ms. B.

Currently, the Poison Control Center (Bach Mai Hospital) is treating 3 patients with eel poisoning out of the 9 people mentioned above. Dr. Nguyen Trung Nguyen, Director of the Poison Control Center, said that eel poisoning is the most common type of seafood poisoning. Studies have shown that eels often contain ciguatera toxin. This toxin is not naturally present in fish but is produced by seaweed, mainly Gambierdicus toxicus. These algae are food for many species of herbivorous fish (small fish). Small fish are food for larger fish such as eels. Ciguatera toxin enters the food chain and accumulates in the meat of large fish. This toxin is odorless, tasteless, not destroyed by cooking and is stable in an acidic environment.

Fish species containing ciguatera toxins are widely distributed throughout the seas, from 35 degrees North to 34 degrees South, most concentrated in the Caribbean Sea and the Indian Ocean and the Pacific Ocean . Currently, with the increasing trend of importing fish species for food, ciguatera poisoning is also increasing. In addition to eels, marine fish containing ciguatera toxins are commonly found in coral reef fish such as: barracuda, snapper, sturgeon, anchovy, amberjack, grouper, parrotfish, sea bass, shark (fish liver), blue-striped cleaner fish, etc.

In recent years, the number of patients detected at the Poison Control Center has increased significantly, most commonly in cases of food poisoning due to toxins from the sea. Poisoning can be individual but often occurs in groups after traveling together and eating seafood, eating seafood at restaurants or buying imported fish to eat.

Signs of marine fish poisoning

According to Dr. Nguyen Trung Nguyen, Director of the Poison Control Center (Bach Mai Hospital), eel is a fairly common food and not many people pay attention to the risk of poisoning. However, in reality, this type of seafood causes the most poisoning, even more than puffer fish. Patients with acute eel poisoning often have symptoms of diarrhea, nausea, vomiting, and abdominal pain, most of which appear within the first 2-6 hours after eating.

In addition, patients may have cardiovascular signs, arrhythmia. After showing signs of gastrointestinal poisoning, patients often have neurological symptoms, including: Numbness, tingling in the hands, feet, mouth area, muscle pain, fatigue. Some people have a disorder in the perception of hot and cold temperature changes. For example, when the outside temperature is cold, the patient feels hot and vice versa...

According to doctors, there are also other neurological symptoms that can be encountered such as anxiety, depression, and even memory loss. Some cases may have changes in mental status such as hallucinations, playfulness, coma, etc. Symptoms of poisoning at different levels depend on the toxin in different geographical areas. Death is rare but can occur due to respiratory failure due to paralysis of respiratory muscles, convulsions, or cardiac arrhythmia.

Therefore, experts recommend that people should not eat many fish containing ciguatera toxin. When there are signs of poisoning, the patient should be given activated charcoal at a dose of 1g/kg of body weight, mixed and drunk at once. Then, quickly take the patient to a medical facility for emergency treatment.

To limit food poisoning from eating sea fish, according to Associate Professor, Dr. Nguyen Duy Thinh, former lecturer at the Institute of Biotechnology and Food (Hanoi University of Science and Technology), people need to choose fresh, safe sea fish based on observed characteristics. For example, fresh fish eyes are slightly convex, the cornea is transparent, the pupil is black and bright. Spoiled fish eyes are flat or concave, the cornea is cloudy, the pupil is opaque...

In addition, fresh fish gills are dark red or bright red, the mucus is clear, odorless, and the gill covers are tightly closed. Spoiled fish gills are dark reddish brown to pale brown, the mucus is opaque or light gray, and there is dirt on the gills. Use your hand to gently press on the fish meat, especially near the belly of the fish. If it feels firm, has good elasticity, and does not leave finger marks, then the fish is fresh...

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