Puffer poisoning: Epidemiology and treatment

Tetrodotoxin (TTX) intoxication resulting from the ingestion of toxic puffer is relatively common in a number of Asian countries. In Japan, 100 annual human fatality due to ingestion of toxic puffer have been reported until 1960. Poisoning incidents, however, decreased in the recent years by imposing quarantine rule and creating public awareness after extensive study of the toxicity and toxin properties of puffer. Generally, the oral paresthesia is the initial symptom of puffer poisoning. The onset of symptoms is rapid. In spite of long history of TTX intoxication, no antidotes or antitoxins to TTX is invented so far. Treatment is supportive.