title: Saxitoxin puffer fish poisoning in the United States, with the first report of Pyrodinium bahamense as the putative toxin source.
abstract: BACKGROUND
  From January 2002 to May 2004, 28 puffer fish poisoning (PFP) cases in Florida, New Jersey, Virginia, and New York were linked to the Indian River Lagoon (IRL) in Florida. Saxitoxins (STXs) of unknown source were first identified in fillet remnants from a New Jersey PFP case in 2002.
  
  
  METHODS
  We used the standard mouse bioassay (MBA), receptor binding assay (RBA), mouse neuroblastoma cytotoxicity assay (MNCA), Ridascreen ELISA, MIST Alert assay, HPLC, and liquid chromatography-mass spectrometry (LC-MS) to determine the presence of STX, decarbamoyl STX (dc-STX), and N-sulfocarbamoyl (B1) toxin in puffer fish tissues, clonal cultures, and natural bloom samples of Pyrodinium bahamense from the IRL.
  
  
  RESULTS
  We found STXs in 516 IRL southern (Sphoeroides nephelus), checkered (Sphoeroides testudineus), and bandtail (Sphoeroides spengleri) puffer fish. During 36 months of monitoring, we detected STXs in skin, muscle, and viscera, with concentrations up to 22,104 microg STX equivalents (eq)/100 g tissue (action level, 80 microg STX eq/100 g tissue) in ovaries. Puffer fish tissues, clonal cultures, and natural bloom samples of P. bahamense from the IRL tested toxic in the MBA, RBA, MNCA, Ridascreen ELISA, and MIST Alert assay and positive for STX, dc-STX, and B1 toxin by HPLC and LC-MS. Skin mucus of IRL southern puffer fish captive for 1-year was highly toxic compared to Florida Gulf coast puffer fish. Therefore, we confirm puffer fish to be a hazardous reservoir of STXs in Florida's marine waters and implicate the dinoflagellate P. bahamense as the putative toxin source.
  
  
  CONCLUSIONS
  Associated with fatal paralytic shellfish poisoning (PSP) in the Pacific but not known to be toxic in the western Atlantic, P. bahamense is an emerging public health threat. We propose characterizing this food poisoning syndrome as saxitoxin puffer fish poisoning (SPFP) to distinguish it from PFP, which is traditionally associated with tetrodotoxin, and from PSP caused by STXs in shellfish.
authors.affiliation: Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, St. Petersburg, Florida 33701, USA. jan.landsberg@myfwc.com
authors.forename: Jan H
authors.initials: JH
authors.lastname: Landsberg
authors.forename: Sherwood
authors.initials: S
authors.lastname: Hall
authors.forename: Jan N
authors.initials: JN
authors.lastname: Johannessen
authors.forename: Kevin D
authors.initials: KD
authors.lastname: White
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Conrad
authors.forename: Jay P
authors.initials: JP
authors.lastname: Abbott
authors.forename: Leanne J
authors.initials: LJ
authors.lastname: Flewelling
authors.forename: R William
authors.initials: RW
authors.lastname: Richardson
authors.forename: Robert W
authors.initials: RW
authors.lastname: Dickey
authors.forename: Edward L E
authors.initials: EL
authors.lastname: Jester
authors.forename: Stacey M
authors.initials: SM
authors.lastname: Etheridge
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Deeds
authors.forename: Frances M
authors.initials: FM
authors.lastname: Van Dolah
authors.forename: Tod A
authors.initials: TA
authors.lastname: Leighfield
authors.forename: Yinglin
authors.initials: Y
authors.lastname: Zou
authors.forename: Clarke G
authors.initials: CG
authors.lastname: Beaudry
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Benner
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Rogers
authors.forename: Paula S
authors.initials: PS
authors.lastname: Scott
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawabata
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Wolny
authors.forename: Karen A
authors.initials: KA
authors.lastname: Steidinger
mesh_terms: D000818:Animals; D002851:Chromatography, High Pressure Liquid; D004141:Dinoflagellida / Q000737:chemistry*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008387:Marine Toxins / Q000506:poisoning; D013058:Mass Spectrometry; D008855:Microscopy, Electron, Scanning; D011041:Poisoning / Q000453:epidemiology*; D012530:Saxitoxin / Q000506:poisoning*; D023741:Takifugu; D014481:United States / Q000453:epidemiology
chemical_list: D008387:Marine Toxins; D012530:Saxitoxin