Palytoxin Poisoning

[FraggledRock]

I just grabbed a pair of these!

http://www.homedepot.com/p/Trimaco-B...1905/203680369

[Typography]

Thats some scary stuff, thanks for the heads up

[jasjenne]

Great info. I now use rubber gloves and eye protection. Palytoxins can be very dangerous.

[ryeguyy84]

Originally Posted by jasjenne

Great info. I now use rubber gloves and eye protection. Palytoxins can be very dangerous.

I'd add some mouth protection as well, if it can get in your eyes it can get in your mouth. Equally bad.

I cut some zoas last night and accidentally crazy glued my tweezers to my glove. when I pulled it off there was a hole in my glove. I scrubbed my hands like a surgeon before I replaced the gloves and moved on.

Maybe i'm a bit paranoid but i'm still alive :-)

[rgulrich]

Suspected Palytoxin Inhalation Exposures Associated with Zoanthid Corals in Aquarium Shops and Homes — Alaska, 2012–2014

http://www.cdc.gov/mmwr/preview/mmwr...cid=mm6431a4_e


My brother runs a lab for NIH and sent me a little "light reading" that is critical to our hobby if anyone works with palyothoa/zoanthids. I know this has been discussed before, but here's a little more info that may come in mighty handy.

Please make this a "sticky", pass it to your friends in the hobby, and make sure your local pet shops get a copy as well. It might be a good idea to see if we could get copies to the local emergency rooms as well. :dry:

Mods: I'd like to post this in the zoanthid section as well, but I'll let you decide where it can get the widest dissemination.

Ray

[birdfish]

Someone just sent me this story today....... referencing the Alaska and CDC story....

http://m.livescience.com/51853-coral...aquariums.html

But I wonder if they meant this to be for live zoas - or ones you wanted to
stay that way: "The toxin from zoanthids can be neutralized by soaking the coral for 30 minutes in household bleach and water. " I bet that neutralizes more than the toxin?

Folks, always use protection. That said I have handled thousands of zoa rocks,
bare-handed and never had any issue whatsoever. Though never played with
Hawai'i Palys.

Better safe than sorry, ounce of prevention .....

birdfish

[zoomonster]

http://www.ijreview.com/2015/08/3992...ing-newsletter

Good god when will the stupidity end... Family poisoned and off to ER after boiled paly's in home. Paly's and Zoa's seem to be on CDC radar and probably that of other government orgs. I would not be surprised if they are not banned from possession or sale at least starting in some liberal nanny state like CA, NY, NJ.

[jbsp]

I was having light tank problems with a 3 month old biotope 21 gallon tank everything broke, the fans, the light, the pump, so I decided in a last ditch effort to save my coral to move them into a new tank.around 4 pm I finshed I washed my hands afterwards, my husband works nights and he left for work, I put my kids to bed, at around pm I start feeling like I have the flu, freezing cold and burning hot at the same time, slightly nauseous, I try to lay down mu back start hurting. By 11pm I'm so uncomfortable I cant lay down, everytime I lay down I feel worse. Now my skin on my chest , sides, and back feels like it was on fire, as time progresses it gets so bad I get into the shower by the time I got out of the shower I'm so weak I could even walk to my closet to dressed. I tryed to lay down thats when the pain in my skin started moving deeper like into my muscles then what felt like my heart and or lungs. So I had to force myself to sit up or I felt like I would die. I thought I was having a heart attack. I was 33 in good health. So I thought I was nuts. I could even move to he to my phone I was literally frozen cuz if I tried to move the heart pain was worse. Then I started vomiting on myself. My husband came home at 6:30 am to find me sitting on the bed naked in vomit with tears running down my face. I wouldn't move or talk to tell him what was wrong. Cuz it hurt to bad. I didn't even know what palytoxin poisoning was. He was like I'm going to call 911 I said no. I was thinking it was like in my head. Like a panic attack from hell or something. By 9am I was 70% better, but I still couldn't lay down. When my back started hurting I took my 8yr old daughters prescription cough syrup because it had codine in it. So I also thought maybe I was allergic to that. I only took 2 table spoons. Was honestly the worse thing I've ever lived through worse than when I gave birth and my epidural didn't work. I went to the Dr that day. He confired it wasn't the codine cuz he perscribe it to me before I had forgotten and had no reaction. He couldn't figure out what happened to me a week later my husband told one of his reefer friends about what happened to me. And that guys says paly toxin posioning we google it, exactly my symptoms. Scary as hell

[peter fumo]

i rubbed my eye once after handling green Palythoa and woke up the next day looking like i aged 20 years it went away after a week,i guess i was lucky it wasnt worse

[NYCSTORMTROOPER]

Great information...Thanks for posting...My tank is not running yet but its almost there and it's going to be a zoa garden ..I'm glad I found this post!!!

[al404]

since i'm starting a new tank and i knew about palytoxin i decide not have any paly or zoa

the tank is 15G and I'm adding live rocks, one or two play could be on the rock and it would be very difficult to see them, i may sit the rock on paly and i guess is going to die

would the water be poisoned and harmful?
would the toxin evaporate from water?

[Louis Z]

Cured me of ever wanting zoas in my tank. I have kids that work in the tanks with me. Not worth it although there might be other things like vibrio and mycobacterium that are just as dangerous. Policy of washing hands and no hands in the tank with open cuts. Trained my kids early on, we have reptiles, so we have those polices already in place to prevent E. coli and salmonella infections.

[Rural]

Originally Posted by acerhigh

The doctors at U of M say, there was still an unusual inflammation of the cornea, but that they still didn't feel there is any permanent damage to the eye or eyesight. I had to trust them at this point and hope they were right.

06/04/2010 - It's been 3 weeks now since the incident. my cornea is still slightly inflamed. Dan

thanks for posting, got me reading some stuff. being a non-allergic type person, i wanted to see if this was immune mediated hypersensitivity or by what mechanism this happed (i wanted a reason to not need gloves). i'll post the highlights from some peer reviewed journals below. most notably: anything in the tank can have PTX in/on it. Even Dino's. There is even a syndrome for death from eating seafood with PTX and other suspected toxins (Haff disease).

[This persone needed an amniotic tissue transplant to save the cornea, you sir, were lucky...]Dangerous reef aquaristics: Palytoxin of a brown encrusting anemone causes toxic corneal reactions.
Ruiz Y, et al. Toxicon. 2015.
Abstract
Although frequently observed in domestic saltwater aquariums, literature on exposure to palytoxin (PTX) of encrusting anemones (Zoanthidea) kept in aquariums is rare. Handling these animals for propagation purposes or during cleaning work can lead to dermal, ocular or respiratory contact with the PTX generated by some Zoanthids. The present study describes a case of ocular exposure to liquid from a Zoanthid, which led to corneal ulcers. The patient also suffered from systemic symptoms of dyspnea and shivering and a suspected rhabdomyolysis, which required monitoring in the Intensive Care Unit. After symptomatic treatment provided insufficient results, the corneal ulcers improved with an amniotic membrane transplantation. A review of the literature regarding ocular exposures to this diverse order of Hexacorallia reveals that severe and systemic symptoms can develop with minimal contact.


Human risk associated with palytoxin exposure.Review article.
Deeds JR, et al. Toxicon. 2010.
Abstract
Palytoxin (PTX) was first isolated from the zoanthid Palythoa toxica. Evaluation of PTX toxicity using various animal models determined that PTX was extremely potent through intravenous, intraperitoneal, and intratracheal exposure. PTX was less potent by direct intragastric exposure. PTX also caused significant, non-lethal effects through dermal and ocular exposure. PTX and PTX-like compounds have now been found in additional zoanthid species, red alga, a sea anemone, and several dinoflagellates. PTXs are found throughout certain reef associated food webs, including in fish and crabs responsible for human illness and death. Many of the organisms found to contain PTXs in the environment are also sold in the home aquarium trade, and recent evidence suggests poisonings have occurred through exposure to these organisms. Due to co-occurrence with other seafood toxins, such as ciguatoxins, saxitoxins, and tetrodotoxin, it has been difficult to assess the true risk of PTX poisoning through seafood consumption in humans, but limited cases have been well documented, some involving human fatalities. Recent evidence also suggests that humans are negatively impacted through PTX exposure by inhalation and dermal routes. Continued research into the distribution and occurrence of PTX and PTX-like compounds both in seafood and marine organisms sold in the aquarium trade appears warranted.


[More evidence, No antidote]Case series: inhaled coral vapor--toxicity in a tank.
Sud P, et al. J Med Toxicol. 2013.
Abstract
INTRODUCTION: Palytoxin (PTX) is considered a severe marine toxin. Although rare, reports of human exposure from consumption of PTX have described significant morbidity and mortality. PTX is the suspected agent in Haff disease, in which rhabdomyolysis occurs within 24 h of eating contaminated fish such as buffalo fish. PTX is primarily present in soft corals or in dinoflagellates, and it can contaminate crustaceans and other fish as it bioaccumulates up the food chain. Only 23 cases have been reported in the USA, including two recent cases in New York City. Reports of inhalational exposure to PTX are uncommon.

CASE REPORTS: We describe a case series of six patients, including four adults and two children, with inhalational exposure to PTX aerosolized from Palythoa corals. Their symptoms included some degree of respiratory involvement, myalgias, paresthesias, low-grade fevers, and gastrointestinal symptoms. Fortunately, there were no serious outcomes and all patients survived without sequelae.

DISCUSSION: Although rare, exposure to palytoxin is not restricted to people visiting marine environments because of Palythoa coral in some home aquariums. Routes of exposure go beyond consumption of fish that feed on the coral and include dermal as well as inhalational exposure. Palytoxin exposure should be considered in the differential diagnosis of patients who own or work with fish tanks and present with symptoms that include respiratory complaints, myalgias, neuromuscular dysfunction, hemolysis, and cardiac toxicity. There is no known antidotal therapy and treatment should focus on meticulous supportive care.


[this article is an animal mode of "HOW?", interestingly irreverible cardiac damage also occurs]Toxicity of palytoxin after repeated oral exposure in mice and in vitro effects on cardiomyocytes.
Del Favero G, et al. Toxicon. 2013.
Abstract
Palytoxin (PLTX) is a highly toxic hydrophilic polyether detected in several edible marine organisms from intra-tropical areas, where seafood poisoning were reported. Symptoms usually start with gastro-intestinal malaise, often accompanied by myalgia, muscular cramps, dyspnea and, sometimes, arrhythmias. Monitoring programs in the Mediterranean Sea have detected PLTX-like molecules in edible mollusks and echinoderms. Despite the potential exposure of the human population and its high toxic potential, the toxicological profile of the molecule is still an issue. Thus, the effects of repeated oral administration of PLTX in mice were investigated. Seven days of PLTX administration caused lethality and toxic effects at doses ≥ 30 μg/kg/day. A NOAEL was estimated equal to 3 μg/kg/day, indicating a quite steep dose-response curve. This value, due to the limited number of animal tested, is provisional, although represents a sound basis for further testing. Macroscopic alterations at gastrointestinal level (gastric ulcers and intestinal fluid accumulation) were observed in mice dead during the treatment period. Histological analysis highlighted severe inflammation, locally associated with necrosis, at pulmonary level, as well as hyper-eosinophilia and fiber separation in myocardium. A cardiac damage was supported by the in vitro effect of the toxin on cardiomyocytes, indicating a severe and irreversible impairment of their electrical properties: electrophysiological recordings detected a progressive cell depolarization, arrest of action potentials and beating.

I will be wearing barriers and eye protection now...
thanks.

[FireEater]

Originally Posted by 650-IS350

Common sense should tell you to read more about these animals and their capabilities. People get lax when working on tanks and dealing with all these saltwater animals. Do you know you can easily get tetanus from the water in our tanks if you had deep cuts? if your not using PPE when dealing with Z's and P's and fragging, you should start. EVERYONE SHOULD.

You're absolutely right and after 15 years with saltwater tanks, getting lax has cost me.

Yesterday, I spent about 6 hours weeding out my 29g zoa tank of the ugly brown Palys that were taking over.

This is before
ImageUploadedByTapatalk1450154681.157101.jpg

This is after
ImageUploadedByTapatalk1450154718.742296.jpg

I usually just get dizzy when I mess with them, nothing more. A few times I was not bothered by them. But this time, I got hit pretty bad.

After I was done at about 1800, I ate and started to watch Sunday Night Football. About the third quarter I started feeling flu like symptoms coming on.

Then once the game was over, the flu like symptoms had hit me full force. I had the chills real bad, my skin was hurting, body got real achy, I couldn't breath deeply without coughing as my lungs ached. I was running a low grade fever of 99.7.

I took a long hot shower, but as soon as I got out, the chills were relentless. Got dressed and under the covers to warm up. Tossed and turned with the chills, sweats, and labored breathing all night.

Woke up this morning at 0630 worn out. Stayed in bed until sometime around 1100, which is very rare for me. The labored breathing had stopped sometime around 0400 I think. The chills stopped around the same time.

I got up several times during the night to pee as I drank so much water before bed. At about 0330 I got up because my eyes were dried shut. I put contact solution in them and tried to remove my contacts.

I was so out of it still and had trouble removing them. This morning they were both red with my right one really sore. Actually, the eyeball itself is really sore. Both are still red as of now, 12 hours later. The right eye still hurts pretty good.

Both have yellowish puss in them. So even after that long hot shower, I must still have had the toxin on my fingers.
ImageUploadedByTapatalk1450155755.462381.jpg

Both thumbs are sore and swollen, including my left finger. I was using a stainless wire brush to get a bunch of Palys off a few rocks I wanted to reuse.

As you can see from the pics, the wires acting like little hypodermic needles, injecting the toxins under my skin. They have swelled up some since this morning.

This morning
ImageUploadedByTapatalk1450156090.945857.jpg

About 30 minutes ago
ImageUploadedByTapatalk1450156123.481314.jpg

ImageUploadedByTapatalk1450156139.335660.jpg

I can only blame myself for being so lax when it came to doing this. I have spotted a few of the Palys left that opened up today. I will dig definitely wear gloves when I remove them.

I seem to be over the major part of it. But if the swelling in my fingers do not go down tomorrow and my eyes still hurt, I'll leave work and go to the Urgent Care.

I'm at the FD tomorrow for my 24 hour shift. I'm driving the ambulance, so I don't want to feel like crap, then get beat down all shift with sick calls making it worse.

[FireEater]

Went to the Urgent Care today. When she asked why I was there, I said Palytoxin. I said that the Doctor most likely doesn't know what it is, but he's about to learn. She laughed.

The Doctor that came in is one of the ones I know from Mainland ER when I transport patients there from my FD job. He said he had no clue what Palytoxin was, and to please explain it all to him. Once I explain it all and what happened, we agreed that the only thing to do now was treat the symptoms I had from the toxin.

Both of my eyes are pretty messed up, with my right eye starting to get blurry. Not much, but enough to make me go to the urgent care. He did examine them for any type of abrasions just to rule that out.

He prescribed three meds, Mupirocin Ointment 2% for my fingers, Vigamox .5% for my eyes and Doxycycline Hyclate 100mg caps.

If it wasn't for getting the toxin in my eyes, I would have put this behind, lesson learned, don't get complacent in this hobby.

Both eyes hurt pretty good, and I mean the actual eyeballs which is weird. Right eye is still a little blurry, but it hasn't progressed.

[Clown99]

I was just talking to my son about this last night. Glad you kept your eye sight.

[reef thief]

I cut myself on some rock I removed from a harbor that was covered with green palys and mucus I felt a burn when it started to seep into my and before I knew it my whole hand was reacting with pain. I could feel it creeping up my arm down to the bone. Within an hour I was sweating lightly and driving back up the mountain when I noticed that I had to remind myself to keep breathing. I got home and Dr. Google explained everything to me. I let the poison take its course while enjoying several margaritas. My suggestion is to just relax and let mother nature have her way with you.

[aqua tech]

Lesson learned always use ppe.

[coryclay]

I just want to add this to warn you of what can happen. I never got anything in my eyes that I know of. I washed my hands many times with dish soap. My cornea melted in about 5 days. The picture is what my eye looked like at the Miami eye hospital emergency room. This is after handling zoos.

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[CLR]

Should a skimmed be oversized if you plan to keep a lot of zoos ? Are palys more the danger or zoos just as bad ? Had a palytoxin exposure with the grandis and landed in the ER for about 7 hours . Worst night ever !

[A. Grandis]

Important update! This confirms what happened to one of my kids on the beach. By touching the rocks we could get the toxin through the skin!!



Aloha,
Grandis.

[A. Grandis]

Originally Posted by CLR

Should a skimmed be oversized if you plan to keep a lot of zoos ?

No need worry about that. Best skimmer you can get for any reef system is the rule.

Originally Posted by CLR

Are palys more the danger or zoos just as bad ?

Yes, Palythoa spp. most of the time have higher concentrations of palytoxin then Zoanthus spp.
Now, you've got a home work! You'll need to understand what are REAL Palythoa spp. and what are REAL Zoanthus spp.
The market calls many types of polyps "Palys", but most of them are Zoanthus spp.!!!
So bad that cartoon name thing...

Originally Posted by CLR

Had a palytoxin exposure with the grandis and landed in the ER for about 7 hours . Worst night ever !

Sorry to hear that!!
Be careful!

Aloha,
Grandis.

[A. Grandis]

Originally Posted by coryclay

I just want to add this to warn you of what can happen. I never got anything in my eyes that I know of. I washed my hands many times with dish soap. My cornea melted in about 5 days. The picture is what my eye looked like at the Miami eye hospital emergency room. This is after handling zoos.

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Sorry to hear that!! Please elaborate and tell us your story...
Would be great to have a picture of the zoanthids you've handled so we could take a look.
Aloha,
Grandis.

[A. Grandis]

Originally Posted by FraggledRock

I just grabbed a pair of these!

http://www.homedepot.com/p/Trimaco-B...1905/203680369

Make sure the gloves are non-toxic.
Other wise you could kill fish or inverts in the tank.
Grandis.

[Zatoichi]

That is devastating sorry to hear about it

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