Puffer Fish Poisoning: Symptoms, Causes, Treatments

Puffer fish poisoning is considered to be dangerous and sometimes even fatal, since there is no antidote so far. Know the symptoms of puffer fish poisoning along with its causes and treatment options for the same.

Puffer Fish Poisoning

Puffer Fish Poisoning

Found in the waters of South Pacific Ocean and coastal areas of the Indian Ocean, the puffer fish is considered to be a food delicacy in several Asian countries especially Japan. It gets its name from its inflatable nature wherein it swallows a lot of water when facing any kind of danger thereby replicating a huge ball which is far bigger than the fish’s original size. Other names given to the puffer fish include globefish, sugar toads, sea squab and balloon fish.

However, eating this sea fish can prove to be quite dangerous because of the presence of the potent venom known as TTX or tetrodotoxin which has adverse effects on the human nervous system. Hence, puffer fish poisoning is a cause of concern. Till date, no antidote has been found for this toxin. Consuming a puffer fish which has not been cut and cooked properly can cause the person to fall sick or even collapse right after eating it. This is a common concern regarding puffer fish poisoning.

Studies reveal that the tetrodotoxin venom found in puffer fish is even more powerful than cyanide. Hence, a patient of puffer fish poisoning should be given immediate medical attention or the chances of survival reduce considerably. The prognosis of a person with puffer fish poisoning depends on the amount of toxin entered into the body and the rate at which emergency treatment is received.

It is important to know the symptoms of puffer fish poisoning along with its major causes and treatment options.

Symptoms of Puffer Fish Poisoning

A person will start developing the signs and symptoms of puffer fish poisoning within 30 minutes to 5 hours after consuming the fish. The amount of tetrodotoxin present in the fish consumed determines how rapidly the symptoms occur and how severe it is.

Some of the common symptoms of puffer fish poisoning include:

  • Initial symptoms of puffer fish poisoning include a tingling sensation in the lips and tongue region followed by numbness. Soon after the entire face, even in the extremities start feeling numb.
  • Person with puffer fish poisoning will start having symptoms of feeling intoxicated and dizzy.
  • Abdominal pain, nausea, vomiting, diarrhea and other symptoms related to the gastrointestinal tract start to occur rapidly.
  • Limbs start feeling weak and the person finds it difficult to breathe
  • Speech becomes slurred or difficult in person suffering from Puffer fish poisoning
  • Hypotension
  • Limbs start getting paralyzed
  • Heart rate and respiratory rate become abnormal
  • Severe toxicity can lead to seizures and the person might become unconsciousness or even go into coma.

The deadly toxin present in puffer fish prevents and blocks adequate supply of sodium to the skeletal muscles and the heart. At the same time sodium infiltration to the nervous system gets prevented giving rise to a severe imbalance in the electrolytes. Respiratory distress too starts to occur as the toxin acts on the medulla oblongata.

If the patient is able to survive after experiencing acute symptoms of puffer fish poisoning for 24 hours, then recovery is possible without any deficits or disability. However, if the respiratory muscles get paralyzed during the poisoning it can lead to death in many cases.

Causes of Puffer Fish Poisoning

The main cause of puffer fish poisoning is the exposure to fish bite and the entry of toxin into the body. The risk of suffering from puffer fish poisoning runs for all those individuals who eat this fish at any point of time. The highly potent and dangerous neurotoxin not only gives rise to an array of severe symptoms but can prove fatal in many cases.

The deadly toxin can be found in the puffer fish’s intestine, skin, liver and the ovaries thus the chances of consuming the toxin increases ten-fold. However, the toxin is not found in the body’s musculature.

One of the major causes of puffer fish poisoning is its excessive consumption as a food delicacy. Countries like Japan see hundreds of people consuming this fish on a regular basis. When the fish is not cut properly or cooked adequately, such a poisoning takes place right after its consumption. Also, the puffer fish is most toxic during its reproductive stages and consuming such a fish increases the chances of puffer fish poisoning to a large extent.

Treatment Options for Puffer Fish Poisoning

Till date no antidotes have been found for tetrodotoxin and it remains a potent poison, probably one of the most dangerous poisons found in fishes. This is the reason why treatment for puffer fish poisoning is completely symptomatic and supportive in nature. Also, the sooner the patients are given treatment, higher are the chances of their survival following Puffer Fish Poisoning.

Here are some of the best treatment options for puffer fish poisoning:

  • Induce vomiting within 2 to 3 hours of consuming the puffer fish and developing the symptoms of puffer fish poisoning. This will help to flush out all the contents from the stomach and prevent any absorption of any toxin which gets left behind. Turn the patient on to one side as soon as the vomiting occurs.
  • Activated charcoal along with gastric lavage is given to the patient as this mixture binds with the toxin which remains inside unabsorbed.

These treatment options for puffer fish poisoning are usually applied, in addition to other symptomatic treatment. The doctors monitor the pulse and respiratory rate along with the patient’s blood pressure constantly, thereby treating the patient accordingly. In some cases, the patient might become paralyzed. When patients are being rushed to a hospital, they might need artificial respiration to stay alive.

The first 24 hours after the occurrence of the poisoning are extremely crucial. If patients are able to survive these crucial hours there are chances that they may survive without any complications and residual deficits in the future.


The main cause of puffer fish poisoning is consuming inadequately chopped and cooked puffer fish. It is imperative that you eat it only when it’s prepared at a renowned place by an experienced chef who knows how to eliminate the toxins and provide you only with the flesh.

Puffer fish poisoning has already taken several lives and is fatal for humans. Prevention is always better than cure, especially in this case where the treatment options for puffer fish poisoning are limited and there is no antidote.

Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 12, 2017

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