The FDA and state and local officials investigated a case of tetrodotoxin poisoning in Fairfax County, Virginia which is believed to be linked to the consumption of imported puffer fish that was not processed and prepared by specially trained and certified fish cutters as part of an agreement between the U.S. and Japan. The liver, gonads (ovaries and testes), intestines, and skin of some puffer fish contain the toxins tetrodotoxin and/or saxitoxin.
According to Fairfax County Health Department authorities, the individual who developed tetrodotoxin poisoning received the puffer fish in a package from relatives in South Korea, rather than purchasing it from a restaurant or other retail outlet in the United States.
Consumers should only eat puffer fish (also known as fugu, bok, blowfish, globefish, swellfish, balloonfish, or sea squab) from two known safe sources.
The safe sources are:
- Imported puffer fish that have been processed and prepared by specially trained and certified fish cutters in the city of Shimonoseki, Japan, and
- Puffer fish caught in the mid-Atlantic coastal waters of the United States, typically between Virginia and New York. Puffer fish from all other sources potentially contain deadly toxins and therefore are not considered safe.
Symptoms resulting from ingesting tetrodotoxin and/or saxitoxin include tingling of the lips and mouth, followed by dizziness, tingling in the extremities, problems with speaking, balance, muscle weakness and paralysis, vomiting, and diarrhea. These symptoms can begin anywhere from 20 minutes to 2 hours after eating the toxic fish. In extreme cases death can result from respiratory paralysis.