Shellfish poisoning can occur after eating clams, mussels, oysters, scallops, cockles, starfish, and crustaceans that consume dinoflagellates during a red tide. During a red tide, sea waters turn a reddish color because large numbers of red organisms (dinoflagellates) are present. Dinoflagellates kill fish and other organisms by releasing toxins (poisonous substances). Consequently, shellfish take in the concentrated saxitoxin, a poison that causes paralysis.
Red tides are most common in the cold waters of North America, Europe, Africa, Asia, and Japan. A red tide rarely occurs in warmer climates. People are poisoned when they unknowingly eat shellfish contaminated during a red tide with saxitoxins.
Shellfish that is contaminated during a red tide does not have an abnormal taste, smell, or color, and the toxin is not destroyed by heating or cooking. Paralysis due to shellfish poisoning follows a similar progression to that of pufferfish poisoning.
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Infectious agents cause most shellfish-associated illness.
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