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Review
. 2022 May 17;14(5):351.
doi: 10.3390/toxins14050351.

Tetrodotoxin Poisoning in Mainland France and French Overseas Territories: A Review of Published and Unpublished Cases

Pierrick Gouel  1 , Clémence Mahana Iti Gatti  2 , Luc de Haro  3 , Alice Liautaud  4 , Jérôme Langrand  4 , Denis Boucaud-Maitre  5
Affiliations
Review

Tetrodotoxin Poisoning in Mainland France and French Overseas Territories: A Review of Published and Unpublished Cases

Pierrick Gouel et al. Toxins (Basel). .

Abstract

Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number (n) = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found (n = 17). All cases happened in overseas territories: French Guyana (n = 7), New Caledonia (n = 11), Reunion (n = 35) and French Polynesia (n = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential.

Keywords: France; marine toxicology; review; tetrodotoxin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow-chart of TTX poisonings in Mainland France and French Overseas Territories (CAP = Centre Antipoison or Poisoning Center).
Figure 2
Figure 2
Geographic distribution of the cases.
Figure 3
Figure 3
TTX poisonings reported in France by decades.
Figure 4
Figure 4
Incriminated fish families in tetrodotoxin poisoning in France.
See this image and copyright information in PMC

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