Clupeotoxin Poisoning

  • Medical Author: Scott H Plantz, MD, FAAEM
  • Medical Editor: N Stuart Harris, MD, MFA
  • Medical Editor: Francisco Talavera, PharmD, PhD
  • Medical Editor: James Kimo Takayesu, MD
Reviewed on 10/12/2021

Facts on Clupeotoxin Poisoning

Sea foods include fish and others
Clupeotoxin poisoning is a potentially fatal poisoning that occurs after eating fish contaminated with the toxin.
  • Clupeotoxin poisoning occurs in humans who eat fish contaminated with the toxin.
  • This toxin (poison) occurs in plankton-eating fish, such as
    • herring,
    • anchovies,
    • bonefish,
    • slickheads,
    • tarpons, and
    • sardines.
  • These fish are found in African, Caribbean, and Indo-Pacific coastal waters.
  • Clupeotoxin is more commonly found in fish caught in the summer.
  • The toxin is concentrated in fish organs and is tasteless and odorless.
  • The identity of the toxin is unknown.
  • Toxicity does not depend on fish freshness or size.
  • The poison does not break down when the fish is cooked.

Clupeotoxin Poisoning Symptoms

Symptoms of clupeotoxin include:

  • Symptoms of clupeotoxin poisoning begin 30-60 minutes after eating contaminated fish.
  • The poisoned person may experience
  • The lips, fingers, nose, and toes may become blue-tinged.
  • The poisoned person may become very lightheaded, and the person’s blood pressure may drop.
  • Death occurs in about 50% of people poisoned by clupeotoxin.

Clupeotoxin Poisoning Treatment

  • Vomiting should be induced if the poisoned person is awake and alert and has eaten the fish within the last 3 hours.
  • Maintain hydration. Intravenous fluids may be necessary for uncontrollable nausea and vomiting.
  • No specific antidote is available.

When to Seek Medical Care for Clupeotoxin

Seek medical treatment as soon as possible.

Reviewed on 10/12/2021
Medically reviewed by Joseph Palermo, DO; American Osteopathic Board Certified Internal Medicine


"Ichthyosarcotoxism: poisoning by edible fish"
JAccid Emerg Med 1997;14:246-251
Iain C Grant