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Infections and Toxic Syndromes From Fish and Shellfish Consumption

Arch Intern Med. 1990;150(11):2425. doi:10.1001/archinte.1990.00390220149048.
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To the Editor.—A recent review appearing in the August 1989 issue of the Archives1 provided an excellent overview of syndromes induced by consumption of a variety of shellfish. However, we would like to point out that a serious outbreak of an unusual and hitherto unknown shellfish toxininduced syndrome that occurred in eastern Canada in 1987 was omitted from that review. We believe that it deserves mention here. Several hundred persons in the Montreal (Quebec, Canada) area became ill after eating cultured blue mussels from Prince Edward Island (Canada). This syndrome was characterized by severe nausea, gastrointestinal bleeding, and a severe and protracted central nervous system upset that included confusion, dizziness, seizures, coma, persistent memory loss, and, in several cases, death.2 We have named this phenomenon "neurovisceral toxic syndrome,"3 in view of its prominent gastrointestinal and central nervous system features. The offending agent was identified as the


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