Crook in the hook
The death of Dorin raises many questions about fish poisoning
By Apsara Kapukotuwa
The death of a poor mother due to complications arising from the consumption of a rarely eaten type of fish, has given rise to many questions. One of them is, 'what makes fish lethal'?

In the case of 54-year-old Dorin Fernando, coming from a family barely able to make ends meet what was to be a sampling of what they were told was "Jetta" (surgeon fish) , a fish that they have never tasted before, turned fatal to her and resulted in her husband, son and daughter falling sick and the death of their household cat.

The family from Mattakkuliya says Dorin ate more of the fish's roe than any other member. Her husband had bought it from a fish seller who is known in the area, for allegedly picking up fish thrown away by fishermen and selling them to the poor folk of St. Andrew’s Mawatha and its vicinity, to support his drug habits. Residents speculate the fish seller would have probably sold "bada theppaya/pettaya (puffer fish)" instead of "Jetta" (surgeon fish).

Dorin's death is still under investigation but her symptoms according to her sister-in-law Shriyani Malkanthi, has also included difficulty in breathing and signs of a heart problem.

If her neighbours suspicions are true and what she consumed was indeed a puffer that was de-skinned and made to look like a "jetta" or any other fish for that matter, then her death could have been due to tetrodoxin poisoning. Puffer fish poisoning is known to be common in the Indo-Pacific especially South East Asia and fatality rate at about 60 percent and if death occurs it usually takes place within the first 24 hours.

Dr. Amila Gunesekera, a Senior House Officer- at the National Hospital, believes he has identified the kind of fish poisoning that may have killed Dorin through research based on the symptoms shown by Dorin's son.

The son, who was admitted to the Casualty Ward last Sunday has shown symptoms of numbness of the lips, tongue and limbs. Dr .Gunasekera says these symptoms could be a result of "Ciguatera poisoning". He also believes that this is the first instance of a ciguatera poisoning being reported from Sri Lanka.

Ciguatera poisoning has a fatality rate of about 12 percent and complete recovery may require many months and even years in some cases. Dr. Amila says he hopes to continue to monitor the condition of Dorin's family members and make known his findings in the interest of the public.

Bruce W. Halstead in his much-referred-to-book "Dangerous Marine Animals" states that "one cannot detect a poisonous fish by its appearance...The viscera -liver and intestines-of tropical marine fishes should never be eaten. Also, the roe of most marine fishes is potentially dangerous, and in some cases may produce rapid death".

The treatment of Ciguatera, according to is possible through mannitol -however, according to various authorities, this is effective only if used within the first 48-72 hours of illness. What sort of measures can be taken to prevent such occurrences remain the question.

"Go along with types of fish that are known. If fish eat toxic algae, the fish would be able to pass on that toxin to any person consuming it. This could prove fatal. Another danger with fish is that if it is not well preserved, it can develop certain allergies which in turn can turn into food poisoning which can cause shock and that is sometimes enough to kill a person."- says Arjan Rajasuriya, Research officer, Coral Reef Research programme of the National Aquatic Resources and Development Agency (NARA).

Mr.Rajasuriya also said that toxic algae has yet not been found in Sri Lankan waters-as such the discovery of a fish that has turned toxic due to feeding on toxic algae could pave the way for more research into that area.

A. Goonetilleke and J. B. Harris( of the Department of Neurology, Newcastle General Hospital and The Medical School, University of Newcastle, UK) in their editorial "Envenomation and consumption of poisonous seafood" ( points out that "it can be difficult to predict cases of seafood poisoning. The toxic animals exhibit no obvious signs of being poisonous, and two animals caught in the same area at the same time only one might be poisonous".

Stating general measures to prevent seafood poisoning, the editorial goes on to state that "the broth in which the sea food has been cooked should be discarded, and the viscera of any fish should not be consumed. No seafood should ever be eaten uncooked and only freshly caught fish should be purchased".

Mr. Goonetilleke and Mr. Harris also state that "it is becoming increasingly clear that in the tropics animals that either graze on coral reefs or feed in the benthos may accumulate a range of potential toxins, all of which enter the food chain. The hapless victim may therefore in turn have accumulated a cocktail of toxins".

They also state that true incidence of cases of neurotoxic poisonings is impossible to ascertain because of underreporting.

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